The dam has broken.
The federal government is poised to pour, by Congressional Budget Office estimates, as much as $38.3 billion into healthcare information technology support through 2015 under the American Recovery and Reinvestment Act of 2009. The following trends, based on data from the 19th annual
Modern Healthcare/Modern Physician Survey of Executive Opinions on Key Information Technology Issues, reflect the impact the legislation might have on the industry.
Former President George W. Bush raised the profile of health IT to a national priority in 2004 when he created the federal Office of the National Coordinator and tasked the office and the healthcare industry with providing an electronic health record to most Americans by 2014. Bush, however, staked out the ideological position that the nation’s IT goals should be achieved largely through free-market activity and specifically ordered the ONC to “not assume or rely upon additional federal resources or spending” to accomplish adoption of interoperable health information technology.
According to our survey results, an overwhelming majority of respondents aligned more with recent congressional intent and favored the government changing the game plan by providing direct financial support for a federal IT development program.
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Asked if they thought the government should subsidize the cost of providing electronic health record systems to physicians, 80.6% of respondents said yes. Asked if the government should subsidize IT systems for hospitals and other healthcare organizations in rural and medically underserved areas, 89.7% of respondents said yes. And even when it came to subsidizing IT programs at community hospitals and other healthcare organizations, 74.2% said yes.
The survey period began on Jan. 5 and closed Feb. 27, spanning the time frame of final debate on the economic stimulus bill, which passed its last vote in Congress on Feb. 13 and was signed by President Barack Obama on Feb. 17. We received 156 completed responses during the survey period, up from 145 respondents last year.
In addition, our survey shows that healthcare leaders may be just a bit more bullish on healthcare IT budgeting than in the 2008 survey. Meanwhile, clinical systems are a priority for most respondents, even in these tough economic times.
Better than half of our survey respondents, or 51.9%, were chief information officers, vice presidents or directors of information services. Another 16% were either CEOs or chief administrators while 7.1% were chief medical information officers, medical directors of information systems, chief medical officers or vice presidents or directors of medical affairs. The remaining 25% of respondents carried other titles.
A plurality of respondents, or 37.2%, work in multihospital systems or integrated delivery networks; 33.3% come from general, acute-care hospitals; 10.3% were from academic medical centers; and another 5.8% were from specialty, children’s or behavioral health hospitals. Only 7.7% of respondents were from medical groups or clinics.
The multihospital systems in the survey ranged in size from two to 77 hospitals and averaged 1,744 beds. The average size of the acute-care hospitals in the survey was 193 beds, with facilities ranging in size from 25 to 900 beds. The average size of the academic medical centers in the survey was 706 beds and ranged from 350 to 1,100 beds.
Competition was a common denominator for most respondents with 42.9% indicating they were from a “highly competitive market” and another 46.8% were from a “competitive” market. Only 6.4% are in a geographically isolated location and 3.8% are from a noncompetitive market.
