Innovation and emerging opportunities in times of crisis


Guest editor letter highlights contributions of health information technology to improving patient-centered healthcare delivery through innovation in data analytics, provider connection and the implementation of telehealth.

Am J Manag Care. 2021; 27 (1): 7-8.


The 10th annual Health Information Technology (HIT) issue of The American Journal of Managed Care® comes at a time of innovation and opportunity for HIT. The Interoperability Promotion Incentive Program has advanced interoperability and more directly links the use of electronic health records (EHRs) to quality improvement and value-based payment programs. Additionally, the final rule of the 21st Century Cures Act, released earlier in 2020, aims to promote patient access to their electronic information. Given this political backdrop, researchers have increasingly focused on understanding how to capitalize on these advances to make healthcare more patient-centered. This trend is highlighted in the 10 articles included in this special issue, which pay special attention to 3 areas of innovation: DSE data analysis methods, the use of HIT to connect suppliers and best practices. in the implementation of telehealth. As a body of work, these papers highlight the success of technology in improving patient-centered health care delivery and also reveal future opportunities to refine the use of ITH to further support improvements in care delivery.

Develop data analysis methods

As the healthcare system accumulates electronic data, researchers are developing innovative approaches to extract information that can benefit patient care. In an excellent example of the application of machine learning to advance the selection of patients who might benefit from palliative care, Guo et al compare 4 approaches to construct predictive models of all-cause mortality. In a second exemplary study that demonstrates a novel approach to using unstructured textual data stored in the EHR, Bako et al present the results of using natural language processing to extract data from social worker encounter notes. , which could then be categorized into intervention types using a machine learning approach. Using these emerging methods can help create value for patients from the breadth of data stored in the EHR.

Supplier connection

The growth of HIT has improved the ability of providers to connect with each other through electronic consultations, or e-consultations, which can make the care experience less expensive and more convenient for patients. The use of electronic consultations allows providers, typically primary care providers (PCPs), to receive patient-specific advice from a specialist without requiring the patient to visit the specialist. Saxon et al assess the growth and variation of e-consultations within the Veterans Health Administration (VHA) from 2012 to 2018. Also focusing on VHA, Whittington and colleagues study the implications of e-consultations for cost savings . Outside of the VHA, Mizes et al report the patient benefits associated with using storage-and-forward image sharing for electronic outpatient primary care consultations with a dermatologist. From a broader perspective of online consultations, an article by Mechanic et al focuses on the use of TeleConnect (digital connections between specialists and PCPs) to create opportunities to build relationships and support referral networks. . These articles, taken together, present a comprehensive picture of the potential of electronic consultations to deliver a more seamless patient experience.

Implementation of telehealth

The disruption caused by the 2019 coronavirus disease (COVID-19) pandemic this year has taken a huge social and economic toll. Importantly, in addition to caring for people with COVID-19, the healthcare system has faced the heavy responsibility of maintaining the continuity of high-quality clinical care and services despite the risks to the health of patients and providers. during traditional health in person. care visits. Telehealth was quickly adopted as a means of achieving the goal of providing continuing care while maintaining social distancing and preserving personal protective equipment. While this technology can offer many benefits to both providers and patients, questions remain about telehealth and the unintended consequences of its dramatic expansion: who may not have access to telehealth and how it might. exacerbate existing disparities? How can the characteristics of providers and clinics affect the delivery of telehealth? What are the concerns of patients and how can they be addressed? How can politics support telehealth? The articles in this special issue by Trivedi et al, Rodriguez et al, Raj et al and Bowman et al highlight these issues and highlight both successes and future opportunities to improve telehealth and ensure that its growth incorporates patient-centered considerations and health equity.


The 3 areas of innovation captured in the articles in this special issue clearly show that researchers are expanding the body of knowledge on the use of TIH to improve patient-centered healthcare. These contributions come at a critical time given the challenges imposed by the COVID-19 pandemic. The science presented in this issue demonstrates the various ways in which TIH can be adapted and modified to support targeted patient care, link providers, and support patient use of telehealth.

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