What is on the Health IT Horizon?

Trends and Glimmers in Health IT

John Tempesco

During the ACHE conference this year in Chicago, John Danielsand John Hoyt of HIMSS analytics gave a presentation about the “Trends and Glimmers” on the horizon in Health Information Technology. They began their presentation by referencing the landmark IOM article, “To Err is Human: Building a Safer Health System” (1999), which was the first study to point out just how many patients die every year because of medical errors (98,000 at that time). The reason for so many deaths centered on the lack of relevant information available to the clinicians caring for those unfortunate former patients. Referring to the follow-up IOM study in 2001, “Crossing the Quality Chasm: A New Health System for the 21st Century”, the pair said that information technology assisted in the “STEEEP” climb necessary to transform healthcare. That is: Safe, Timely, Effective, Efficient, Equitable and Patient centered care. HIMSS Analytics defines trends as “supported by data that shows market movement toward or away from a certain technology or application”, and glimmers as “supported by anecdotal data, market noise and industry hype”.

Market Trends

Over the past six years, total IT operating expenses as a percentage of total operating expenses for hospital organizations remained at about 2.5 percent (actually in 2011 was exactly 2.5%), and ranged from a low of 2.35 percent in 2008 to a high of 2.9 percent in 2006. This year’s survey results showed 43 percent of hospitals spent more than last year, 34 percent were even with the prior year and 23 percent of respondents predicted a decline in their spending. Integrated Delivery Systems saw spending the same as last year (45%) with about 33 percent increasing budgets and 22 percent spending less.

And what are they spending money on? HIMSS Analytics predicts that the Radiology PACS market is about at its saturation point, showing that just shy of 89 percent of all hospitals reported at least one modality installed on PACS, with CT, CR, ultrasound and MRI leading the way. Only angiography and digital remained at a penetration rate of less than 75 percent. They warned PACS sales personnel that they had better move into cardiology PACS if they wanted to keep their income where it had been over the past decade. The adoption level within cardiology PACS remained at less than 40 percent last year with CT, intravascular ultrasound and nuclear cardiology well behind on the adoption curve.

With all the talk about meaningful use and stage 7 adoption in the news, a surprising statistic is that 35 percent of all hospitals surveyed do not include in their plans to implement or even contract for computerized physician order entry (CPOE). Thirty two percent have CPOE installed (up from 27% in 2010); 18 percent have contracted with a vendor and 11 percent are in some stage of implementation. CPOE adoption varies drastically by hospital type as well. Almost 70 percent of academic institutions have CPOE compared to almost 55 percent of general medical and almost 48 percent of critical access hospitals.

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