From The Editor | April 1, 2011

IT: The Only Certainty In Healthcare's Future


By Ken Congdon, editor in chief, Health IT Outcomes

Two things were made abundantly clear in a recent survey of 150 hospital executives and 309 hospital patients conducted by Dell:

  1. The future of healthcare delivery in the United States is clouded with uncertainty, and;
  2. Information technology will play a key role in shaping this future.

Dell's survey indicates that much of the uncertainty in the industry is thanks to healthcare reform. For example, virtually all hospital executives surveyed are worried about how states will cope with an expanded role in healthcare financing through Medicaid and other programs required under reform. As a result of this and other concerns, only 37% of hospital executives have a favorable opinion of the legislation.

Patients, on the other hand, seem too uninformed to have an educated opinion on reform. 68% of patients surveyed classify themselves as not knowledgeable about reform. However, only one-third of respondents expect healthcare reform to improve coordination and quality of care, or reduce overall spending. The uncertainty around healthcare reform points to the need for patient education on how reform will change healthcare financing and delivery.

Accountable Care Organizations: The Next Big Thing
Accountable Care Organizations (ACOs), a key provision in reform, are intended to align providers into a continuum of care responsible for the ongoing treatment of a patient over his or her lifetime. The potential impact ACOs will have on how healthcare providers are paid for service has made the concept the next big thing in healthcare. Providers throughout the country have placed increased emphasis on establishing ACOs in their regions. For example, 23% of hospital executives that responded to the Dell survey indicated that their hospital is already investing in establishing an ACO, while 56% said they are planning to.

While this data points to a clear push to form ACOs, a great deal of uncertainty surrounds healthcare delivery under the ACO model. For example, respondents were split about who should spearhead the coordination of care in an ACO. 77% say the role of physicians and specialists should decrease and 69% say the role of hospitals should decrease. Patients were equally as split. 41% of patients surveyed said they would want their hospital to coordinate their care, while 36% would prefer their insurance company to fill this role.

Technology Will Help Shape Healthcare
While uncertainty abounds regarding healthcare reform, respondents to the Dell survey were nearly unanimous in their belief that information technology will be a crucial to shaping the future of healthcare delivery. Of course, we should look at this with some skepticism since a technology company conducted the survey. In any case, more than half of the hospital executives surveyed believe EHR adoption will have a positive affect on the healthcare industry as a whole. Likewise, 87% believe technologies that measure and share the quality of care in their organizations will be helpful. Finally, 84% think IT can help their physicians increase patient contact and involvement.

Of course, adopting these technologies will not come without its challenges. For example, 85% of the executives surveyed worried if they would be able to afford the initial investment and ongoing cost of EHRs, particularly in today's troubled economy. Furthermore, nearly 80% are apprehensive about the prospect of training clinicians and hospital staff on how to use the technology. While these issues will create a significant obstacle for some hospitals, the adoption of EHRs and other technologies has become one of the few things healthcare facilities can be confident is in their future.

Ken Congdon is Editor In Chief of Health IT Outcomes. He can be reached at