If reforming the health care system is like making buttered toast, then health IT is like plugging in the toaster—it is necessary, but not an end in and of itself, according to CBO director Peter Orszag, and echoed by fellow panelists Sara Rosenbaum and Janet Wright at Friday’s Alliance for Health Reform event, “Health Information Technology and Its Future: More Than the Money.” The event examined where health IT is today, and what the future has in store.

Orszag spoke about the potential of health IT, but cautioned the audience (continuing the hot breakfast metaphor) not to put all their eggs in the health IT basket. Orszag said that while policy makers have good reasons to be excited about health IT, the oft-cited RAND study—predicting $80 billion in annual savings from the adoption of health IT—focuses on potential benefits instead of the likely benefits. "They studied a much different question than the one relevant to policy makers," said Orszag. "The question relevant to policy makers is what is the likely effect of a broader set of HIT systems, not what is the maximum potential impact if you're doing everything else right." (See the full CBO report here.)

Sara Rosenbaum identified some benefits of and barriers to health IT, citing a recent study published in the New England Journal of Medicine. The study found that 83% of physicians have no functioning electronic health record system, but of those who do, most reported a positive impact on their practice and high satisfaction rates. So why is health IT not more widespread? Because adoption is not pain free: doctors face economic and practical barriers to using electronic health records and many express concern over the legal ramifications of electronic information.

Janet Wright presented the IC3 Program to advance ambulatory registries in cardiology as an example of a private health IT initiative. She emphasized health IT's potential in improving care, rather than IT as a method to reduce costs. The major barrier is a lack of IT infrastructure in the medical field—physicians are nervous about trying new things, especially as national policymakers have not yet worked out the technical standards that will guarantee that various electronic health systems will be able to communicate with one another. (The "interoperability" problem.)

The event was an excellent reminder of the potential and the limitations of health IT at a time when everyone seems to be talking about it—just today a House health subcommittee marked up the "PRO(TECT)T Act" and sent it to the full Energy & Commerce Committee, and on Friday Sen. Mike Enzi urged Congress to move on the “Wired for Health Care Quality Act.” As both proposals move through the House and the Senate, the Alliance event provides three great take away points:

1. Health IT is a necessary but not sufficient part of decreasing medical spending and increasing the quality of care. More comprehensive health reform is needed to capture the full benefits of electronic systems.
2. Health care providers are unlikely to adopt health IT systems without financial incentives.
3. Standards are necessary to ensure that all health IT systems can communicate with each other.