Summary

GAO reviewed computerized hospital medical information systems (HMIS), which are expected to proliferate in the nation's hospitals within the next 5 to 10 years. The review was made to determine what the National Center for Health Services Research (NCHSR) has done to answer questions on the social and economic impact of HMIS. NCHSR is responsible, among other things, for supporting research, demonstration, and evaluations of the systems.

NCHSR has made only limited studies to evaluate the social and economic impact of HMIS in a hospital setting. The evaluations indicated that the systems improved health care delivery. However, the question of whether the systems are cost saving or cost raising was not completely resolved. In 1978, NCHSR specified that it was committed to evaluating HMIS. However, it did not have sufficient fiscal year (FY) 1980 funds to meet all of its priorities and to adequately evaluate the systems. It has no approved plan for spending FY 1981 funds for evaluating the systems. Further, NCHSR has not updated its plan since the early 1970's, nor has it selected a strategy for further HMIS evaluations. NCHSR has spent a minimum amount of funds for evaluating the systems in hospital settings. During the last 9 years about $29.5 million was provided for HMIS-related projects, but only 2.5 percent of the money was spent for evaluating the systems in hospital settings. The remaining funds were spent on various HMIS-related projects, such as a computer-aided medical audit and drug interaction warning applications. For example, the Bureau of Health Planning (BHP) and NCHSR are developing a workbook with added guidance to help health systems agencies evaluate hospital requests to acquire HMIS.