A High-Tech Future for Health Care? Yes, But It Won't Be Easy

Ann All

I and IT Business Edge colleagues Lora Bentley and Loraine Lawson have all written about health care IT this week, specifically the push to get doctors, hospitals and other organizations to adopt electronic health records. Organizations that meet "meaningful use" requirements can qualify to receive federal incentives for medical records systems under the HITECH Act.


But as Lora wrote, many hospitals and other organizations say "meaningful use" requirements are too stringent. She cited a New York Times article in which several medical professionals called the government's expectations unrealistic and said it would be tough for many organizations to implement electronic health records by the government's deadline of 2015.


The HITECH Act and move toward electronic health records were among the topics I discussed in my recent interview with Joseph De Venuto, VP of Information Services and CIO of Norton Healthcare, a Louisville, Ky.-based health care system with five hospitals, 11 immediate care centers and more than 90 physicians practice locations. He told me:

Sharing data is a clear winner for patients in the long run. The mechanism to do it right now just seems a little draconian.

While the banking and automobile industries were given more latitude as to how they spent stimulus funds, health care providers face very specific requirements. Not only that, he told me, but "meaningful use" dollars won't cover the expense of introducing new technology for many organizations. For organizations with little of the required technology already in place, "meaningful use" money might cover 25 percent of the total cost to introduce electronic health records, estimated De Venuto. Norton is farther down the road than many hospitals because of CareLINK, a common clinical system used by all of its hospitals and freestanding image centers. Explained De Venuto:

It's fairly integrated, so the nurse and the lab and the pharmacy and the radiology department are all looking at the same system. If you've been to any of our hospitals, the doctors at the next hospital you go to in our system can see what happened at the last hospital. Implementing that system was a major undertaking in and of itself, but along the way we also implemented an enterprise-wide PAC (picture archiving and communicant) system so digital images are now also incorporated in the medical records.

The common platform positions Norton to add more advanced clinical features and puts Norton "in sync" with the "meaningful use" requirements, said De Venuto:

We'll accelerate our timeline on a few things if we want to qualify for "meaningful use" dollars, but what it comes down to is, all those things are the right things to do to improve patient care.

Norton's physician practices will present a greater challenge because their processes generally aren't as well documented or as automated as those in the hospitals, De Venuto said.


Loraine wrote a post in which she predicts a coming land run on health care IT, in which technology vendors are eager to help companies spend some of those government dollars. She also links to her two-part interview with Dr. Doug Fridsma, acting director of the Office of Interoperability and Standards in the Office of the National Coordinator for Health Information Technology. The interview is a sobering read, with Fridsma laying out some of the integration and interoperability challenges of moving to electronic health care records.


De Venuto shared a sobering thought with me as well. Though electronic health records should improve the quality of health care, it's not yet clear whether they wil help reduce costs. He said:

There's still a big debate as to whether there's a financial ROI from implementing clinical systems. Intuitively, there's clearly a quality ROI. I tend to use more of a value on investment rather than a return on investment. If I'm looking at bedside barcode reading, I could say you don't give the wrong meds, so you're at a lesser risk for litigation, so my malpractice insurance costs should go down. But that's hard to back into what your true savings will be.

A few months back, Loraine wrote about a Harvard Medical School study of 4,000 U.S. hospitals that found implementing new technology didn't reduce medical costs. The big lesson here: Simply throwing technology at tough problems won't fix them. De Venuto confirmed that as well. He told me:

People are used to saying, "If I buy that technology, it'll fix that problem." Instead of saying "If I buy something, it'll fix it," we need to start looking at it as a tool in the tool belt. It's not the solution in and of itself. People will say, "We implemented it and it didn't work. It was a bad technology." Not necessarily. It may have been a bad implementation.

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Add Comment      Leave a comment on this blog post
Jun 10, 2010 8:03 AM Glenn Whitfield Glenn Whitfield  says:

The challenge healthcare organizations will face is simply laying technology on broken processes will only create more frustration and added costs in the long run.  Organizations should look at and fix their processes first, then apply appropriate technology.  If they don't, no one should be surprised with the the results.

I touch on this here: http://piadvice.wordpress.com/2010/05/05/electronic-medical-records-and-higher-costs/


Jun 10, 2010 9:38 AM Jeremy Engdahl-Johnson Jeremy Engdahl-Johnson  says:

Federal funding may be encouraging a move toward EHR, but there's more to it than just installing systems. How can healthcare data pooling lead to a better system? More at http://www.healthcaretownhall.com/?p=2193

Jun 10, 2010 7:02 PM Wellescent Health Blog Wellescent Health Blog  says:

The last paragraph hits the real problems associated with new technology introduction. It is easy to blame the technology itself as if it is some independent entity capable of solving problems on its own. How a technology is set up to be used and  how people are trained to use it are more important than the given technology itself in terms of achieving a successful solution.

Jun 11, 2010 2:17 PM Rebecca Morehead Rebecca Morehead  says:

Have to agree with Glenn that implementing a new system into a broken system already will only enhance the problems within a practice.  Whether it is a good implementation or not is highly dependent upon the buy in that the providers and staff have for the system.  Unfortunately, it is very difficult when some providers are not on board with the process or there is resistance with staff to change.

I like posts like this one that get you thinking....



Jun 14, 2010 1:17 PM Lumeris Lumeris  says:

Good article.  It would be great if you published a follow up piece about how health care payers (e.g., insurance companies) are sitting on but not effectively using a gold mine of data that could be used to improve outcomes and contain costs ... basically, a powerful tool that can help move health care from a volume-based system to a value-based system.

Lumeris, a provider performance management technology company, is doing some very neat things in this area, as are other technology organizations.  (Learn more about Lumeris at http://www.lumeris.com)

Surprisingly little attention has paid to this topic.  I guess many people assume health care payers are already maximizing the information at their disposal.  But in most cases, data is trapped in silos that make it difficult or impossible to perform meaningful analysis. By collecting disparate data from across the continuum of care and consolidating it into one common view, users can confidently find those areas best positioned for improvement.

Sep 21, 2010 7:35 PM DrFirst DrFirst  says: in response to Lumeris

EHR's are the way of future, we just need to make sure that doctors follow the meaningful use guidelines.

Aug 25, 2011 10:05 AM dedicated servers dedicated servers  says:

This is information that has been floating around the medical industry for years now but still without gaining an audience. Technology, while attractive and impressive does very little to reduce overall medical costs. The benefits of better treatment through computerized analysis are there of course but the salesmen keep banging the 'cost-savings' drum and it's starting to sound tinny.

Oct 10, 2011 11:30 AM Junebug Junebug  says:

"Meaningful use" is such a broad term that it gives me a headache. Who would have the heart to say something like that to a patient for that matter? Here, in the real world, we don't have enough money to go to a local rehab clinic so we have to go to Alcohol Treatment Seattle and that means moving there, yes. Some of us were left behind during the Health care reform and nobody noticed.     

Dec 8, 2016 6:44 AM detox centers detox centers  says:
Good to read this blog. Reply

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