Health Information Technology Needs to Support Patient-Centered Health Care

The March/April 2009 issue of Health Affairs included an article entitled, “From Tasks to Processes: The Case for Changing Health Information Technology to Improve Health Care,” by James Walker and Pascale Carayon.

The authors discuss the need to shift health information technology design from task-focused care that is provider and facility-centered to process-focused care that is patient-centered.  Moreover, they also state:

• “To deliver better health care at a lower cost, health information technology (IT) should be redesigned to support improved, patient-centered care and not the isolated tasks of physicians and clinicians.” (p. 467)
• “Task-focused care is centered on the provider or facility rather than on the patient. The focus on tasks (and payment for isolated tasks) is a fundamental cause of the fragmentation, low quality, and high cost of U.S. health care. On the other hand, process-focused care is centered on the patient. It coordinates the work of many care team members (including patients, physicians, nurses, midlevel providers, lay caregivers, clinical educators, pharmacists, case managers, and call-center personnel) to provide each patient with high-quality, efficient care across time and across all venues of care.” (p. 468)
• “The current task focus of health IT is also apparent in the development of personal health records (PHRs) without supporting analysis and design of such processes as patient-physician communication, shared care planning, patient education, and remote monitoring of outcomes.” (p. 469)
• “Processes that are computerized without careful analysis and redesign can lead to inefficiencies and workarounds, with potential loss of patient safety.” (p. 470)

The authors also highlight the importance of human factors and ergonomics, including:

• “Human-factors engineering (HFE, the application of knowledge regarding human characteristics to the design of work systems) can provide theoretical and pragmatic guidance to process design.” (p. 471)
• “An important way for information system developers and managers to support both the quality and efficiency aspects of value-added processes is to fundamentally improve the usability of health IT.” (p. 474)
• “Clinically astute health care system analysts, human-factors engineers, software developers, and process managers will be needed in large numbers to design and refine hundreds of care processes and the health IT and process management services to support them.” (p. 475)

This is an article that both senior health care executives (e.g., CEOs, CIOs, CTOs, CMOs, etc.) and human factors and ergonomics professionals should take the opportunity to review.

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