The meaningful use era is nearing an end. And the buying wish lists of the people who build and run healthcare providers' IT systems are increasingly being populated by technologies that have few or only tangential ties to the now six-year-old federal incentive program for EHRs.
That trend is one of the key findings from TechTarget's survey of health IT purchasing plans, done in partnership with the College of Healthcare Information Management Executives.
Examining the poll's results unearths illuminating insights about EHRs, which remain important even though most survey respondents reported security, analytics, compliance and mobile ahead of EHRs in their purchasing plans.
IT changes driven by HIPAA worries
Meaningful use's requirements play into some of the technologies that are driving IT spending changes, such as the following:
- Easily topping the list was HIPAA privacy and security upgrades, with standalone hospitals as opposed to healthcare systems and ambulatory clinics most concerned with HIPAA.
- Next was patient access to electronic records, a component of both HIPAA and meaningful use.
- Third was patient care quality, followed in equal measure by EHR issues (likely attestation and audit prep), ICD-10 conversion, and HIE participation.
- Accountable care organizations issues are fueling changes, too, perhaps reflecting the ongoing adoption of their shared risk model by many other provider organizations, including hospital systems
Smaller EHR role
Way down the list for buying decisions were EHRs, the principal beneficiary of meaningful use for the thousands of healthcare systems, hospitals and physician practices that have installed them since 2009's HITECH Act provided $30 billion in incentives for doing so.
That lessened role for EHR buying held true in the survey for big systems, at which EHRs were sixth on the buying chart, and ambulatory practices, at which they ranked seventh in interest. Standalone smaller hospitals, however, are still looking at investing in new EHRs; EHRs ranked third on their list, according to the survey.
Tellingly, the survey showed that 56% of healthcare systems, 50% of hospitals and 35% of ambulatory clinics planned no investment at all in EHR software this year.
Wellness and EHRs fuel mobile wish lists
Mobile applications have garnered buying attention, too: Mobile placed third in the results for large healthcare systems and fourth in the ambulatory class.
Shruthi Parakkal, a health IT analyst for consulting firm Frost & Sullivan, said this finding probably reflects the growing prominence of personal wellness apps and providers' desire to integrate individual health and wellness data into either their EHRs or patients' health summaries.
Mobile also figures prominently in patient access to electronic health portals and in physicians increasingly tapping into EHRs and other data sources on the go.
Data centers move into health IT purchasing plans
While technologies like EHRs, mobile health and cloud services figured prominently in the survey, so did a few new areas, such as data centers.
For example, employees of more than half of the hospital systems in the survey said they are investing in data center technology, while 43% of standalone hospitals said they were going to data centers.
That move toward data centers is another sign of the growing prominence of analytics and big data, Parakkal said. Instead of the data remaining housed in individual silos around a big data network, it is more and more being clustered together in servers that function as private cloud systems.
Hybrid clouds gain a following
In terms of the trend toward cloud services and applications, while nearly all big hospitals and healthcare systems still are exclusively on enterprise platforms, providers overall appear to be stepping closer to the cloud, the purchasing plans survey showed.
Hybrid cloud services showed strong interest, with 64% of hospitals and 36% of big healthcare systems planning to invest in systems that combine on-site enterprise storage and retrieval of images and data.
Disaster recovery, data center, EHRs, compliance and mobile were the top areas in which providers expect to use cloud services.
Among both healthcare systems and standalone hospitals, 75% of those surveyed said they are increasing cloud investments, and half of those at ambulatory settings said they were investing more in cloud.
While the survey clearly showed that there is plenty of technology that IT executives and managers want, their capacity to acquire it is still somewhat circumscribed.
Provider IT dollars, though growing slightly, are still tight. Parakkal said they average about 1% of an organization's overall budget -- a notably smaller proportion than in other major industries.
Nearly three out of 10 survey respondents indicated their annual IT budget was less than $1 million.
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