The Affordable Care Act and electronic health care records: can technology help reduce the cost of health care?

In the previous issue, we reviewed the ways in which the Affordable Care Act (ACA) promotes the continued development of electronic health records (EHRs) to improve the quality of health care. In this companion article, we’ll focus on the cost-saving arguments behind the development of a digital health care system by contrasting the utopian vision of the mid1990s with its real-world implementation. The entire concept of health care reform embodied in the ACA is dependent upon the generation, collection and sharing of information made possible by the advancement of health care information technology (HIT). Widespread adoption of digital information throughout the system is pivotal for the success of many of the ACA’s goals, including: comparative effectiveness research to yield cost-efficient, effective treatment protocols; reducing waste in the system; curbing hospital readmissions; and encouraging the development of Accountable Care Organizations (ACOs).1 Many directives contained in the ACA implement HIT to promote cost savings, as first envisioned when the possibilities of computerized records and transactions were identified in the early 1990s. However, as HIT has been implemented over the past two decades expectations have often been thwarted by other forces, suggesting that any future results in the reduction in health care costs will not be automatic or easy.