Agency to assess value of electronic health networks

A research group within the Health and Human Services Department plans to determine the value doctors derive from electronic records by distributing questionnaires and conducting focus groups in Colorado.

The two-year project is expected to cost nearly $34,000 if approved by the Office of Management and Budget, and is designed to gather clinicians' feedback on a soon-to-be-launched online portal that will allow Colorado health care providers to find and organize patients' medical histories from multiple sources. Colorado is one of six states under contract with the HHS Healthcare Research Quality Agency to build such portals.

"While many have hailed the development of [health information exchanges], only a handful have been developed, few have survived, and even fewer have clearly proved beneficial to their stakeholders, making each case study worthy of investigation," the agency stated in a November 2008 document making the case for the evaluation.

According to a notice posted in the Federal Register on Monday, the questionnaires and focus groups will explore whether the portal, developed by the nonprofit Colorado Regional Health Information Organization and scheduled to be completed in December, is user-friendly. The survey also will help determine "the value of the exchanged clinical information to inform decision-making, patient disposition and potentially redundant test ordering," the notice stated. And it will inform the future design and phased implementations of the portal, known as the point-of-care clinical exchange system.

"The approach [of] surveys and focus groups seems right to me, [but] the big question is, will doctors use the service and do they find it valuable?" said John Glaser, vice president and chief information officer of Partners Healthcare in Boston. "If they don't use it for whatever reasons the more concrete value assessments become meaningless."

HHS will survey clinicians at three emergency departments in the Colorado Regional Health Information Organization on a quarterly basis through the start of 2010. The focus groups will be conducted with select frequent and infrequent users of the portal from each of the three emergency departments and one call center. They'll be conducted four and eight months after the system is launched.

"I think it is really hard to get great data that would 'prove' that these kinds of exchanges can reduce costs, decrease errors, etc.," said Glaser, who integrated the health information systems of three organizations that plan to run a cancer center for clinical research and treatment as part of his work at Partners. "There are so many intervening and confounding variables that it is hard to provide the value of an exchange."

Written comments on HHS' research proposal can be e-mailed to Doris Lefkowitz, doris.lefkowitz@ahrq.hhs.gov, and must be submitted by Jan. 30, 2009.