Hospitals and health systems have been making steady progress over the past several years in deploying information technology systems. As executives look out over the horizon of a shifting landscape, they are demanding that systems be more robust and more integrated.
Hospital leaders face some daunting challenges. Regulatory mandates to implement health IT continue to mount. They are bracing for an influx of patients who, starting in January, will be newly eligible for insurance coverage, and, at the same time, they need to adjust to new payment models that place a great emphasis on quality, outcomes and data. As Rod O’Reilly suggests in this issue, executives need to step back and look at the larger picture.
For 15 consecutive years, ®, the flagship magazine of the American Hospital Association (AHA), has surveyed the nation’s hospitals on their use of information technology. The survey results in our annual list of hospitals. Additionally, every hospital taking the survey receives a detailed benchmarking study comparing their institution to the rest of the field. This year, a third of all hospitals responded, giving us in-depth insight into the level of health IT adoption across the country and advancements at Most Wired hospitals. More than 280 hospitals and health systems earned Most Wired designation this year.
The results of the survey show that the field is continuing to make steady progress in establishing the building blocks needed to manage the challenges of healthcare reform.
Not surprisingly, the level of IT adoption is strongest within the four walls of a hospital. The survey showed that 69% of the Most Wired hospitals and 60% of hospitals in general now have medication orders entered electronically by physicians. This is a significant increase from a decade ago, and typical of the increasing use of health IT to manage clinical documentation and monitor quality metrics.
Hospitals also have moved the ball in terms of pushing data and information to physicians at the point of care, through alerts, CPOE, and physician portals.
Though we’re still in the early stages when it comes to enhancing the quality and usefulness of that information through data analytics, important progress has been made. We found that 84% of the Most Wired use business intelligence tools, while 58% use predictive modeling to improve decision making.
This is especially promising when we consider the benefits of bringing actionable intelligence to the point of need through the delivery mechanisms that are now in place.
Gaps to Fill
Of course, there’s plenty of work left to be done and new issues have emerged that need to be addressed.
Despite the active exchange of data within hospitals, even the Most Wired organizations have not made as much progress sharing patient information with affiliated hospitals and providers. And they have even farther to go in sharing data with non-affiliated hospitals and providers. Consider this: just 40% of Most Wired hospitals and 24% of all respondents can share a patient’s medication list and history electronically with nonaffiliated hospitals.
This lack of exchange across providers illustrates how much work remains to be done in coordinating care across the care continuum. It also highlights the persistent challenge of interoperability. In regions around the country, certain health information exchanges have improved data sharing, but the success of HIEs remains inconsistent. There’s also the question of sustainability, which sank pervious iterations of HIE. Remember RHIOS or CHINs?
A fundamental issue that seems to be a stumbling block for greater data exchange is standards. Even the simplest data collection is impeded by subtle differences in standards. Consider how many different ways there are to enter the date or your phone number on a digital form. Now imagine the variation in clinical definitions.
Another “next level” challenge has to do with patient engagement. If the past decade or so has been focused on getting better physician adoption of health IT, the next decade may very well center on patient engagement. CIOs at leading hospitals know that they have to meet the patient on their terms. That means embracing more mobile strategies and adopting tools created to actively engage patients in their care. Most Wired data show that this is certainly a point of interest for hospital leaders.
Bringing the Pieces Together
In conducting the survey, we spoke with many thought leaders grappling with health IT issues. There’s optimism about the progress that’s been made, and acknowledgement of the work to be done. It is clear that executives and trustees understand how critical IT is in propelling their institutions forward. It is no longer just about checking the meaningful use box; it’s about bringing the pieces together to make real healthcare transformation happen.
The best of the Most Wired already recognize this. They don’t see health IT as an end in itself, but as part of an overall strategy to better position their organizations in the next five to ten years.
Are Your Peers on One of H&HN’s “Most Wired” Lists?
The annual survey by Hospitals & Health Networks® (H&HN) evaluates the progress hospitals and health systems are making in the use of information technology to improve operations and patient care. The survey focuses on four key areas:
- Business and administrative management
- Clinical quality and safety
- Clinical integration
For each of these areas, respondents answer a series of questions about their status. Based on the results, H&HN publishes lists of the hospitals and health networks leading the way in automating and integrating clinical, patient safety and administrative functions. While many know the Most Wired list, there are other lists that highlight organizations that are making strides in implementing health IT.
Read H&HN’s cover story for more information on the .