The economic benefits of health information exchange interoperability for Australia

Abstract

Objective: To estimate costs and benefits for Australia of implementing health information exchange interoperability among health care providers and other health care stakeholders. Design:A cost-benefit model considering four levels of interoperability (Level 1, paper based; Level 2, machine transportable; Level 3, machine readable; and Level 4, machine interpretable) was developed for Government-funded health services, then validated by expert review.Results: Roll-out costs for Level 3 and Level 4 interoperability were projected to be $21.5 billion and $14.2 billion, respectively, and steady-state costs, $1470 million and $933 million per annum, respectively. Level 3 interoperability would achieve steadystate savings of $1820 million, and Level 4 interoperability, $2990 million, comprising transactions of: laboratory $1180 million (39%); other providers, $893 million (30%); imaging centre, $680 million (23%); pharmacy, $213 million (7%) and public health, $27 million (1%). Net steady-state Level 4 benefits are projected to be $2050 million: $1710 million more than Level 3 benefits of $348 million, reflecting reduced interface costs for Level 4 interoperability due to standardisation of the semantic content of Level 4 messages. Conclusions:Benefits to both providers and society will accrue from the implementation of interoperability. Standards are needed for the semantic content of clinical messages, in addition to message exchange standards, for the full benefits of interoperability to be realised. An Australian Government policy position What are the implications for practitioners?The authors suggest that the greatest risk to achieving value from interoperability is not the cost of implementation, but whether or not rigorous standards for Level 4 interoperability are developed and implemented across Australia.

Physicians' Perceptions and Use of a Health Information Exchange: A Pilot Program in South Korea

“…This finding stands in refutation of the frequently quoted benefits of the technology in literature. 2,3,8,9,25 Physicians also indicated they were least worried about the compromise in their revenue as the result of the technology. Although this finding needs further study with empirical data, it suggests that the muchdiscussed physicians' concern about the reduction in revenues may not be the biggest hurdle in introducing an HIE in South Korea, where medical services are paid by a fee-for-service method.…”

“…H ealth information exchange (HIE), defined as the electronic transmission of healthcare information among organizations, 1 is expected to improve quality of care, reduce medical error, and lower healthcare costs, [2][3][4][5][6][7][8][9] and HIE systems have become more prevalent worldwide as many countries have recognized the potential of the technology. 3,6,10,11 The need for efficient and effective ways to exchange clinical information among providers is particularly great in South Korea, where physician care at clinics is discontinued when a patient moves to a hospital or other clinic for further management.…”

Interoperability—Making Information Systems Work Together

“…Internationally, interoperability is a significant HIT priority and is a cornerstone of the many governmental initiatives, including those in Australia, Great Britain, Canada, and the U.S. (Cox, 2008;Sprivulis et al, 2007). The Office of the National Coordinator for Health Information Technology (ONC) has been charged with establishing a National Health Information Network (NHIN), a public-private partnership, that aims to improve data-sharing across four levels of data.…”

Rights and responsibilities of users of electronic health records

“…16 Thus, clinicians may perceive that the costs of electronic health records (e.g., in time or money, or from required changes in workflow) outweigh direct benefits to themselves, whereas patients and payers appear to benefit more readily. 17 Clinicians require assurances that electronic health records will deliver the features and functions they need and that the regulatory environment will support them.…”