title: Leveraging Health Information Technology to Improve Quality in Federal Healthcare.
abstract: OBJECTIVE
  Healthcare delivery in America is extremely complex because it is comprised of a fragmented and nonsystematic mix of stakeholders, components, and processes. Within the US healthcare structure, the federal healthcare system is poised to lead American medicine in leveraging health information technology to improve the quality of healthcare. We posit that through developing, adopting, and refining health information technology, the federal healthcare system has the potential to transform federal healthcare quality by managing the complexities associated with healthcare delivery. Although federal mandates have spurred the widespread use of electronic health records, other beneficial technologies have yet to be adopted in federal healthcare settings. The use of health information technology is fundamental in providing the highest quality, safest healthcare possible. In addition, health information technology is valuable in achieving the Agency for Healthcare Research and Quality's implementation goals.
  
  
  METHODS
  We conducted a comprehensive literature search using the Google Scholar, PubMed, and Cochrane databases to identify an initial list of articles. Through a thorough review of the titles and abstracts, we identified 42 articles as having relevance to health information technology and quality. Through our exclusion criteria of currency of the article, citation frequency, applicability to the federal health system, and quality of research supporting conclusions, we refined the list to 11 references from which we performed our analysis.
  
  
  RESULTS
  The literature shows that the use of computerized physician order entry has significantly increased accurate medication dosage and decreased medication errors. The use of clinical decision support systems have significantly increased physician adherence to guidelines, although there is little evidence that indicates any significant correlation to patient outcomes. Research shows that interoperability and usability are continuing challenges for implementation.
  
  
  CONCLUSIONS
  The Veterans Administration is the only entity within the federal health system that has published research on the use of health information technology to improve quality. The federal healthcare system has existing systems in place with computerized physician order entry systems and clinical decision support systems, but these should be advanced.
  
  
  CONCLUSIONS
  Particular focus and attention should be placed on data mining capabilities, integrating the electronic health record across all aspects of care, using the electronic health record to improve quality at the point of care, and developing interoperable and usable health information technology.
authors.affiliation: US Army-Baylor University Graduate Program in Health and Business Administration, Fort Sam Houston, Texas.
authors.forename: Fred K
authors.initials: FK
authors.lastname: Weigel
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Switaj
authors.forename: Jessica
authors.initials: J
authors.lastname: Hamilton
mesh_terms: D020000:Decision Support Systems, Clinical; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D035082:Federal Government; D008490:Medical Informatics / Q000458:organization & administration*; D008887:Military Medicine / Q000458:organization & administration*; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D014481:United States