efficiency. The use of health information technology can improve thecontinuity and integration of care the committee espouses, by facilitating exchanges of information when a patient is referred from one physician to another, goes to a different hospital, fills prescriptions at different pharmacies, seeks care while traveling, or obtains health-supporting services from social workers, mental health specialists, or other health care professionals.

Such technology would make health care more accessible for patients if more physician offices allowed patients to schedule appointments and obtain test results online, send their physician e-mail queries, receive electronic reminders, and provide helpful clinical information. Early efforts to facilitate the exchange of health information, so that health professionals and patients can access electronically all necessary information at the point of care, should be strengthened to improve patient safety, improve the quality of care, and reduce the costs of missing information and duplicated services. Yet adoption of electronic records at the physician-office level has been slow—in 2006, only 29 percent of physicians reported using any type of electronic medical record in their office-based practices (Hing et al., 2007)—mostly because of high infrastructure costs, uncertainty about which system to buy, the need for training and integration with other office systems, concerns about patient privacy, and the lack of incentives to do so.

Although only a small proportion of medical records are fully electronic today, many important elements of medical care exist in electronic form—insurance status; claims for services; pharmacy, laboratory, and other reports—that can give insights into the operations of the health care system. In the future, systems that allow selective information exchange, while maintaining patient privacy, will eventually provide the databases for systematic review and synthesis of the clinical effectiveness and cost-effectiveness of various treatments and help establish their relative value. The results can be used to create “rapid learning” for providers and payers, enable large-scale national research projects with robust results in shorter time frames, facilitate technology assessment, and monitor and improve system performance overall (Etheredge, 2007). Electronic distribution of the findings from these analyses, in forms suitable for different audiences—health care professionals, payers, and the public—would fill current information gaps.

HHS has identified many of the previously cited benefits for patients of expanded use of health information technology as well as predicting



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