Editor’s Notebook: Technology is ‘just a tool.’ If only it were that easy.


Susan Carr
Editor, susan.psqh@gmail.com

When technology seems too big for its britches, or we let it run the show, many of us remind ourselves that “it’s just a tool,” hoping that observation will help us put technology in its place and restore the world’s balance. The bandwidth currently consumed by health information technology (IT), especially electronic health records (EHRs), has increased to such a point today that we all might wish that intoning, “It’s just a tool,” were enough to regain control.

Health IT is crucial to current efforts at healthcare improvement, from patient safety to implementation of the Affordable Care Act, population health, participatory medicine, value-based purchasing, and more. It’s a challenge to keep the role of health IT in perspective while facing the heavy demands of these programs, not to mention the pressure of Meaningful Use deadlines, and at the same time, providing patients with high-quality care. Into the foreseeable future, providers and health systems will spend disproportionate energy wrestling with complex technology systems and ambitious regulations while consumers, politicians, and the media add their expectations to the mix.

Health Affairs has just released a list of its most-read articles for 2013, and health IT is number one. In “What It Will Take to Achieve the As-Yet-Unfulfilled Promises of Health Information Technology,” Arthur Kellerman and Spencer Jones, both of the RAND Corporation, evaluate the development of health IT since 2005 when other RAND researchers forecasted great things to come. Kellerman and Jones find the current state of health IT disappointing, and chart a path forward toward the promise that health IT still holds.

We believe that the original promise of health IT can be met if the systems are redesigned to address these flaws by creating more-standardized systems that are easier to use, are truly interoperable, and afford patients more access to and control over their health data. Providers must do their part by reengineering care processes to take full advantage of efficiencies offered by health IT, in the context of redesigned payment models that favor value over volume.1

Their roadmap demonstrates how health IT is more than “just a tool.” Current expectations and demands require us to overhaul how healthcare is defined, delivered, and paid for in this country. While technology is “just a tool” we are using in that effort, whether the tool supports or hinders the work at hand, whether it is costly or cost-effective, whether it promotes or prevents innovation, and how capable we are at using it to advantage will make all the difference. When we say, “It’s just a tool,” we need to make sure that we really mean it and take responsibility for the project’s success by making sure the tools are effective and apropriate and the work is designed to take advantage of what technology has to offer.

1 Kellerman, A. L. & Jones, S. S. (2013, January). What It Will Take to Achieve the As-Yet-Unfulfilled Promises of Health Information Technology. Health Affairs, 23(1), 63–69.