Health care providers facing technology quandary

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As hospitals struggle to meet new budget demands, they are faced with delaying or scaling back information technology projects — despite the fact that technology offers the promise of more efficient, less expensive care.

Moving from a paper-based system to an electronic system, prescribing medicine using hand-held devices, checking drug interactions via computers — all can restrain rampant, out-of-control health care spending, said the American Hospital Association.

The problem is with the initial cost of the projects — which can be prohibitive during a recession. Even the top “wired” hospitals are torn between building networks and meeting other demands of health care — particularly as rising unemployment leads to more uncompensated care.

“Most hospitals are doing their best to stay the course,” said Alden Solovy, executive editor of Hospitals and Health Networks, the magazine that annually surveys hospitals to discover how they are dealing with new technology needs.

To complicate matters this year, the great “unknown” of health care reform looms over any technology decision because regulatory changes are inevitable, said Rich Umbdenstock, president and CEO of the hospital association.

“As the health care reform debate continues, it’s clear that IT will play an even more important role in the health system of tomorrow,” he said. “Most wired hospitals help illustrate IT in action — improving efficiency, quality and safety of care while helping to control costs.”

Although total spending is down, IT spending as a percentage of operating budgets is increasing, he said. Hospitals continue to invest in technology that supports quality and safety — electronic medication management is considered one of the basic ways to use technology to improve care.

The survey shows that 6.8 percent of hospitals have implemented technology to avoid prescription medication errors — both when the doctor prescribes it and when the nurse administers it at the patient’s bedside. At a typical hospital, 26 percent of medications are entered electronically by physicians, compared with 19 percent during 2008.

Hospitals should increase their technology spending despite the gloomy economy, according to studies by United Healthcare. The company believes that implementing new technology can save providers, insurance companies and the government more than $330 billion during the next decade. Of those savings, the majority would go to hospitals, the report said.

Despite dealing with budget issues, Memorial Health System is not backing down from implementing health care information technology. But it’s difficult to determine the amount of savings, said Dr. Jonathan Velez, chief medical information officer for Memorial.

“You can’t put a dollar figure on the fact that new technology makes catching drug interactions easier,” he said. “Or that eliminating redundancies in the emergency rooms gets people the care they need faster.”

Memorial is testing computer tablets as a means to prescribe medicine and check patients into the hospital through emergency rooms. It already uses mobile computers to do that job; all are linked to a wireless network.

The hospital ranks in the top 6 percent of hospitals nationwide for its IT use, Velez said.

“Our system uses electronic health records,” he said. “And we aren’t scaling back. This month, we’re testing new tablet computers to see which are best used at the bedside.”

While Memorial isn’t holding off on implementing technology, Velez said he understands why some hospitals might — the initial costs can be staggering, and the return on investment isn’t always clear.

“If you just look at the cost of implementing these systems and expect a significant return on investment in terms of dollars, you’d be disappointed,” he said. “But they do save time, eliminate redundancies and they save lives through eliminating errors in prescribing medicine.”

Health care reform legislation will almost certainly carry a technology component, he said, and hospitals that wait could face even higher costs.

“And if they implemented a pay-for-performance system, technology is necessary to reduce medical errors,” Velez said. “And that’s really what we’re about — improving the quality and efficiency of the services we provide to patients. It’s hard to put a dollar figure on — but if we can reduce medication interaction errors by 50 percent, then we’ve made the system more efficient, provided higher quality care and saved money.”

But even as hospitals move toward udated IT, the United Healthcare studies show that its full potential isn’t being realized because providers, hospitals and insurance companies aren’t working together.

“For example, United HealthGroup now has 30 million magnetic swipe cards in circulation that would eliminate much red tape for patients, but full adoption will require greater uptake of matching technology by doctor’s office ands hospitals across the nation,” the report said. “We believe that shared and consistent action is needed across all payers … to unleash savings.”

Amy Gillentine covers health care for the Colorado Springs Business Journal.