Hospital executives are becoming more tailored and sophisticated in their consideration of the technology issues they face. Finding the money to invest in IT and electronic health record (EHR) systems continues to top their worries, however.
At the Healthcare Information and Management Systems Society's HIMSS 2011 conference in February, a bevy of meaty educational sessions addressed the interests of providers who have moved beyond EHR adoption into the areas of data analytics and enterprise intelligence -- that is, providers looking for ways to get value out of the costly systems they've already spent time and effort implementing.
A Dell Inc. survey of 150 hospital executives indicates that health care providers are looking at IT investments, particularly in areas pertaining to EHR systems. They're interested in more than just purchasing a system, however. Rather, providers have moved into thinking about privacy and security, business intelligence, data storage, and health informatics. They also are taking on or have completed specific initiatives: improving core IT infrastructure for advanced clinical use, selecting and implementing EHR systems that meet meaningful use requirements, aligning strategies with doctors also using EHR systems, and so on.
Dell reports that 83% of the executives it surveyed have selected or implemented an EHR system that meets the requirements of the federal government's EHR Incentive Programs. Most of the executives plan to participate in a health information exchange and provide a physician portal to push electronic communication, but they remain daunted by the initial cost of the technology and the cost of training staff to use the systems.
Meaningful use is not something you can throw on as an extra task in your project plan.
Elizabeth Johnson, vice president of applied clinical informatics, Tenet Healthcare Corp.
At this point, most people in the health care industry understand the task of implementing electronic systems, and know that meeting federal meaningful use standards is only the start of a long journey. Those who aren't aware should learn quickly, said Elizabeth Johnson, vice president of applied clinical informatics at Dallas-based Tenet Healthcare Corp. "It is not something you can throw on as an extra task in your project plan."
Johnson, who serves on the federal Health IT Standards Committee and is helping draft the technology standards used in EHR products, spoke at HIMSS 2011 during a session on enterprise business intelligence. Tenet Healthcare is in the middle of a year-long EHR implementation, rolling out one clinical system for its 49 acute care hospitals, as well as a separate EHR system for their emergency departments. In addition to the EHR launch, there is a separate, concurrent launch for rolling out meaningful use.
It will cost $630 million to complete the launch across all of Tenet Healthcare's sites, the health care services company has estimated. It expects to receive about $320 million in incentive payments for meeting the three stages of meaningful use requirements before the 2015 deadline. If it did not participate in the meaningful use program, it could expect $90 million a year in penalties for not complying, Tenet calculates.
The crucial elements for success in deploying and getting value from EHR systems are to communicate, to ensure physicians and staff are on board, and to understand down to specific data elements what the system is doing, Johnson said. Some 400 people across all of Tenet Healthcare's hospitals are involved in the project to consider how data will be used. "We spent a great deal of time understanding the intent of each [meaningful use] measure."
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