Healthcare organizations nationwide have spent billions of dollars to implement health information technology, most with the expectation that it will improve quality and safety, and lower costs. According to a recent report, however, not all outcomes have been positive, particularly with regard to efficiency.

The January study, conducted by RAND Corporation for the Office of the National Coordinator for Health IT, examined 236 health IT studies from 2010 to 2013. It found that 77 percent of them reported either positive or mixed-positive outcomes -- meaning there existed at least one negative association between health IT and the care metric, but the original authors concluded the benefits outweighed negative or neutral effects.

However, nearly 20 percent of the studies on health IT's efficiency outcomes yielded negative results, and only 45 percent saw overwhelmingly positive outcomes. Researchers described efficiency as including costs, utilization and timelines.

Drilling down further into efficiency, CDS alerts and reminders were proven to be most ineffective, with some 43 percent having reported negative results.

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"Cost effects ranged from a 75 percent decrease to a 69 percent increase in the targeted costs; however, many of the studies clustered in the range of six percent to 12 percent increases in the targeted costs," RAND officials wrote in the report. "These findings suggest that layering technology on the existing payment system may not result in lower costs."

As for patient safety, researchers also found mixed results. For instance, 17 percent of the studies assessing health IT's impact on safety had produced negative outcomes, and 67 percent had reported all positive results.

"While the great majority of studies reported positive outcomes for process quality measures, not all studies did so, and most studies lacked sufficient detail to determine which factors may have led to the lack of benefit found," officials wrote.

The report underscored quality as the metric most improved by implementing health information technology, as the lion's share of studies, 58 percent, saw positive outcomes, and another 24 percent saw mixed-positive results.

When officials drilled down further into the data, they also found clinical decision support, computerized provider order entry and meaningful use all produced the most beneficial outcomes, at 66 percent, 64 percent and 63 percent positive respectively.

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Contrastingly, electronic prescribing was the least able to prove its worth, as more than one-fourth of all studies reported negative outcomes.