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Feb 22 2012   12:17PM GMT

Why CIOs aren’t worried about health IT infrastructure



Posted by: Jenny Laurello
health IT infrastructure, HIMSS survey, HIMSS12, Infrastructure

After attending the 23rd Annual Leadership Survey results brunch yesterday at HIMSS 12, I had a few questions, as did many other members of the press in attendance. The survey, conducted in December of 2011, included just over 300 participating health care provider organizations and shed light on how health IT leaders are prioritizing the many enterprise-level IT issues that continue to come down the pike.

Not surprisingly, achieving meaningful use was the primary business objective, and ICD-10 implementation took the top spot as the primary financial focus for IT over the next two years. I was a bit surprised, however, to see that coming in last under the “business issue with most impact on health care” category were external threats and infrastructure, with health care reform and policy mandates taking the top spots. As a hospital’s IT infrastructure is truly the building block upon which all of its applications run and systems depend, I had a hard time wrapping my head around all 302 respondents listing it as an issue that has 0% impact on health care.

I was lucky enough to have an interview immediately following the brunch with just the guy to help clear the air and frame the results in terms of what he is seeing in his hospital. When I shared the survey data with Rick Haverty, director of IT at the University of Rochester Medical Center, he was not surprised in the least. “The infrastructure is at the bottom of the pyramid, and people expect it to work. Like dial tone in telephony. Or cleaning up the garbage. Someone has to do it, or else it starts to stink. But others don’t think about it, nor should they have to. Again, it is an expectation that it will work and it is our job to make sure it does.”

And in this light, one can see how respondents might not see health IT infrastructure considerations as impacting care as directly as the other areas of IT and informatics. Still, I had a hard time believing that 100% of those surveyed said it had no impact whatsoever.

This was especially true as I considered mobile health integration, mHealth apps and the bring your own device (BYOD) movement.  With mobile device usage by clinicians on the rise — to access protected health information (PHI) and deliver care remotely — there are many issues related to infrastructure that stand to impact care. Timely access to accurate patient data is vital for physicians on the go, and without a solid infrastructure that allows for secure connectivity, a provider’s ability to deliver the highest quality of care could be impaired. The same can be said for telehealth and remote patient monitoring systems. Without a strong foundation on which to build them, care delivery will continue to be restricted to the walls of the provider institution.

However, as Haverty noted, “the whole idea is for your infrastructure to be solid, and the people who manage it know this. No guts [in the technical sense], no glory. No one knows that we’re on conference calls into the wee hours of a Sunday morning making necessary updates at the least impactful time, nor should they. They expect it to work, and if we’re doing our jobs, it should.”

My feeling is this: If you still believe that infrastructure has no impact on health care delivery, you probably have an outstanding infrastructure director and IT staff making sure that’s the case.

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