IT Investment Gives Californian HMO an Edge Over the NHS

A comparison of the NHS and non-profit Californian health maintenance organisation, Kaiser Permanante, has revealed that investment in information technology is one of the explanations for the HMO’s superior performance on several measures.

Writing in the British Medical Journal, the researchers from the University of California and the Healthcare Redesign Group, conclude, “Healthcare costs per capita in Kaiser and the NHS are similar to within 10% and Kaiser’s performance is considerably better in certain respects, particularly access to specialist diagnosis and treatment and hospital waiting times.”

Better use of information technology at Kaiser was one of the explanations found for this difference between the two systems.

”The more advanced parts of the Kaiser system have sophisticated and efficient information technology that reduces administrative time, particularly clinician’s time spent taking medical histories, dictating letters and locating patient records,” the researchers report.

”Kaiser plans to invest a further $2bn over the next five years (2% of total budget) to extend this virtually paperless patient care to 423 outpatient centres and over 11,000 clinicians.”

The researchers contrast this with NHS investment of 0.5% of total budget, but acknowledge that reforms in information technology use are being pursued.

Other factors thought to explain Kaiser’s better performance were: achieving real integration through partnerships between physicians and administration; treating patients at the most cost effective level of care; and the effects of competition and choice.

In an extensive examination of the comparability of the two systems, the research team made adjustments to account for the differences in the populations served by the NHS and Kaiser. They found, after all adjustments that the costs were similar – $1,764 per capita for the NHS and $1,951 for Kaiser.