Healthcare information pros are taking stock of the computer systems they've installed during a hectic past few years and asking, How do we make the most of what we've got?
With millions of dollars sunk into Y2K-related projects and millions of dollars lost to the infamous Balanced Budget Act of 1997, computer staffs are getting the message that they'd better start contributing to the push for better financial performance, says Roger Allison, a consultant with Chicago-based Sheldon I. Dorenfest Associates.
That could be good news for vendors of information services that aim to maximize the return on existing systems and selectively add Internet-oriented enhancements.
But it could cause concern for vendors of complex clinical and analytical software, according to Allison's take on the results of a survey conducted at the annual Windows on Healthcare conference for information professionals.
Many vendors are waiting for the Y2K veil to lift and release pent-up demand assumed for their products, says Allison, the lead analyst for the survey of 186 respondents at the September conference, sponsored by Microsoft Healthcare Users Group.
However, the survey reveals that healthcare organizations are interested mainly in developing Internet strategies and combining them with a greater return on existing computer applications (See chart).
The purchase of new applications ranks far down on a list of project priorities, and continued replacement of older computer systems seems to be fading as a priority now that the rush to buy Y2K-ready systems is winding down, Allison says.
"We had to slam-dunk these (replacement systems) in just because they were compliant (with Y2K-computation requirements)," he says. "We didn't have a chance to get the most out of them."
Those interpretations are validated, says Allison, by answers to a survey question about what initiatives would be undertaken if the budget for information technology in the coming year were 25% bigger.
The top unfulfilled initiative on the wish list related to maximizing existing computer applications.
And although respondents identified Internet-oriented projects as a significant priority, they would do more if they had more to spend. Second on the wish list was greater attention to e-commerce, the types of advancements made possible by investment in Internet and intranet capabilities.
The next wave in information systems development is likely to center on supply-chain management, electronic data interchange and other initiatives that permanently reduce the costs of doing business and take some of the heat off financially strapped institutions, Allison says.
Those priorities will be driven to the front by internal cost pressures and imminent federal regulations to simplify and standardize electronic transactions under the Health Insurance Portability and Accountability Act of 1996, he says.
The emergence of Internet-delivered healthcare applications could help healthcare organizations develop efficient business processes by filling in the software gaps immediately with targeted task automation. Internet-delivered applications, offered for a monthly subscription fee, would require little upfront implementation time and expense, Allison says.
Ultimately, healthcare organizations require decision-support systems and data-repository capacity to perform the analyses necessary to control costs systematically, he says. But respondents said that they need to nail down the basic return on investment in their financial and administrative systems before moving on to the next frontier of clinical management.
"These (clinical and analytical applications) are wonderful systems . . . but if we can't get the basics to pay for themselves, how can we get these to pay for themselves?"