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IHT2 summit attendees identify 20 health IT challenges

The C-level health care executives at this conference list paper records, infrastructure, poor strategic vision and absent standards among their toughest obstacles to IT success.

The Institute for Health Technology Transformation's iHT2 Health IT Summit takes a collaborative approach to addressing today's health IT challenges, with panel discussions emphasizing audience participation and a half-hour group exercise on the agenda.

Attendees at the March event in San Francisco, the second of nine the organization will hold in 2012, used the group activity to discuss the specific health IT challenges that applied to their roles as C-level executives, administrators, program director and department managers.

A lengthy list followed. Here are the 20 issues that the conference as a whole came up with.

  • The pace and volume of initiatives, ranging from meaningful use of electronic health record (EHR) technology to e-prescribing to quality reporting to, most recently, the accountable care organization (ACO).
  • The general presumption that, as a result of the ACO model and other shared savings initiatives, hospitals expect annual revenue to drop as much as 15%.
  • Poor investment in preventive health and, conversely, too much investment in revenue-generating corrective treatments.
  • Poor participation in patient engagement endeavors, especially since connecting patients to physicians is merely a starting point.
  • The struggle of mobile health technology to cross the digital divide and reach the patients most likely to benefit from it.
  • Mobile health's emphasis on wellness, which, again, largely fails to reach chronic care patients.
  • A fragmented care delivery system. Here, attendees said, the answer need not be nationalized health care but, rather, a national health infrastructure.
  • Inadequate IT infrastructure, plagued by longtime underinvestment. One attendee, charged with implementing information technology in California's prison health care system, noted that that system lacked email as recently as three years ago.
  • Poor Internet connectivity for rural health care facilities, though grant money may help.
  • Inadequate resources, not just for capital but also for talent acquisition, which is critical as IT needs become increasingly complex.
  • Along with the usual health IT challenges of security and privacy, there's the need to align health information exchange (HIE) initiatives with HIPAA requirements as well as state data privacy laws.
  • Inadequate standards for "idiosyncratic" definitions, lab codes and other narrative information, even among individual departments within a hospital.
  • Poor disaster recovery planning.
  • No standard compensation model for physicians who use telemedicine technology, email or other treatment aids not covered by traditional medical billing.
  • Developers' inability to articulate to physicians and end users the strategic vision for IT implementations. This fosters the smartest guy in the room syndrome, which makes collaboration difficult.
  • No vision for the overall goals of a health IT implementation to begin with.
    As a result of the ACO model and other shared savings initiatives, hospitals expect annual revenue to drop as much as 15%.
  • The rapid pace of IT innovation versus the slow pace, and cost, of changing existing workflows.
  • Arguably the biggest workflow and health IT challenges -- getting rid of paper, even with an EHR system in place.
  • The fate of health care reform and what that means for health IT.
  • Low expectations of the benefits of health IT for patients and physicians alike.

Whatever the solutions to these health IT challenges happen to be -- and, not surprisingly, the half-hour group exercise did not produce any -- they won't come quickly. Later in the summit, Hal Wolf, senior vice president and COO of Kaiser Permanente's The Permanente Federation, noted that it took him six weeks to get used to his wife having moved the under-sink trash from the left side of the cabinet to the right.

However, several summit sessions did address many of these health IT challenges. Forthcoming coverage of the iHT2 Health IT Summit will summarize the speakers' thoughts on meaningful use, health care reform and mobile health and telemedicine.

Let us know what you think about the story; email Brian Eastwood, Site Editor or contact @SearchHealthIT on Twitter.

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