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By Matthew Weinstock | Data By Suzanna Hoppszallern for H&HN Magazine
It’s a bumpy road, but the 200-plus hospitals on this year’s Most Wired list are driving toward meaningful use of health care information technology
The road to meaningful use of health information technology is riddled with detours, potholes and yield signs. Yet the 2012 H&HN Most Wired Survey proves that hospitals with well-crafted and well-mapped plans can motor their way toward successful adoption.
A record number of hospitals â€” more than 200 â€” earned Most Wired status in this, the 14th annual survey, which gauges how organizations are planning for, utilizing and securing information technology across the entire enterprise. While there is a certain amount of cachet that comes with being associated with Most Wired, as with many other lists throughout health care, the survey is less about the designation and more about serving as a roadmap for how hospitals are using IT to transform their organizations. Perhaps the most significant development over the past couple of years is the greater strategic role IT and IT departments now play in hospitals and health systems.
Given the dramatic changes taking place in health care, and the ever-increasing importance of data, IT systems must be more than just plug-and-play toys; they need to be high-powered analytical tools that can deliver real-time, actionable data to clinicians and executives alike.
“It’s probably been in the last 24 months that we’ve seen the conversations become more strategic,” says Rose Higgins, vice president of payer and provider solutions at McKesson, an information technology firm and sponsor of the H&HN Most Wired Survey. “Organizations are having conversations around their strategic imperatives for the next three to five years: What kind of organization do they want to be and how can they sustain that in the long run? People are very focused on IT’s laying the groundwork and foundation.”
Driving toward value
So much of the focus on information technology over the past year or two has been on clinical applications â€” computerized provider order entry, clinical decision support, health information exchange and more â€” and the potential to improve patient safety and create greater efficiencies. That’s in large part due to the federal government’s push to digitize health care and to regulations governing meaningful use. But officials at Most Wired hospitals note that their emphasis goes beyond what’s prescribed by those mandates. “It’s not just about meeting the letter of the law. It’s about meeting our definition of meaningful use,” says Timothy Sullivan, M.D., a family practice physician at Thayer County Health Services, a rural health system in Hebron, Neb. Sullivan championed IT adoption at the 19-bed critical access hospital and its clinics.
While that definition varies from organization to organization, it almost always includes a focus on value and data. The dramatic shift to a value-driven delivery system, where reimbursement is much more aligned to quality measures and outcomes, demands that IT systems are used to promote evidence-based care and, at the same time, provide executives with a holistic view the organization’s operations. Health IT is “fundamental” to the success of a value-driven system, says Tara Jones, vice president of acute care services and chief information officer at Vanguard Health Systems, headquartered in Nashville, Tenn.
“Until recently, we’ve been in the era of getting data into our HIT platforms,” says Joe Boyce, M.D., chief medical information officer at Heartland Health, St. Joseph, Mo. “Now, the fun part of getting knowledge and wisdom out â€” evidence-based care, actionable alerts, patient engagement, population health management dashboards and real-time decision support at the point of care â€” is taking center stage. The conversations are changing from ‘Why are you making me do this?’ to ‘Can it do that?'”
Setting the standard
The accompanying charts show areas in which the Most Wired are excelling in their use of IT for operational efficiency, patient safety and patient satisfaction, along with significant advances in security protocols. Although the year-over-year data show gains in areas such as CPOE and medication management, it does not mean that everything is on a glide path. There are still significant hurdles, especially in relation to some core meaningful use criteria. Hospitals continue to struggle to record patient demographics as structured data, the same for problem lists. That is a major reason several organizations failed to achieve Most Wired status this year.
Chantal Worzala, director of policy for the American Hospital Association, says the survey also points to a need for providers, vendors and regulators to come to terms on standards. “Learning to use standards is an underappreciated aspect of getting to meaningful use,” she says.
Standards are instrumental not just to ensure that electronic health records act in a predictable way, but also, ultimately, for the seamless exchange of data between providers. “It is all about the information flow that is going to support more informed, more logical and better care,” Worzala says.
Faces of Most Wired
Overall, Worzala says, the Most Wired data show hospitals and health systems are moving in the right direction. “I look at the Most Wired to see where leading organizations are taking the field,” she adds. In particular, she’s encouraged by the growing use of remote monitoring for disease management and telemedicine. These are examples of the benefits that can be achieved when there is linkage to providers from outside the care setting.
What follows are profiles of three Most Wired organizations that are themselves on the leading edge. Each has a vastly different background and story. One, a critical access hospital in Nebraska, made patient safety the driving force behind its rapid adoption of IT. At a public health system in Atlanta, the IT department is finally viewed as a strategic partner across the organization. And an independent hospital, nestled in the mountains of Southern California with two other competitors, proves that working with physicians can lead to big things.