In this issue of Modern Physician, technology writer Neil Versel analyzes data gleaned from a survey of technology leaders at more than 1,000 medical groups. The survey was conducted by Modern Physician and the Kennedy Group, a Chicago-based provider of strategic services in healthcare information technology.
One survey section jumped out. In it, the data was sliced into seven cohorts by group size, from 201 or more physicians in the largest cohort, to three or fewer docs in the smallest. The survey showed from 27% to 40% of physician information technology leaders expressed some level of interest in receiving IT services from a hospital, even if they had no affiliation with it.
Interest in group-hospital IT partnerships rose dramatically--to a range of 38% to 78%--for those practices that have some affiliation with the hospital that would provide the IT services. Generally, the smaller the group, the higher interest levels in partnerships ran.
Leaders surveyed said cost--nearly 3-to-1 over clinician acceptance--is the biggest barrier to implementing IT upgrades. Of seven healthcare IT types to choose among, clinical systems were what these physician leaders said they desired most.
In the past two months, hospitals in Arkansas, Idaho and Ohio have stripped medical privileges from a total of 28 physicians for the newly minted sin of owning shares of competing hospitals. An economic credentialing war is escalating, folks, and it will consume resources and create enmities no one in healthcare can afford.
I hope all the peace-loving hospital chief medical officers, vice presidents of medical affairs and medical informaticists can see the opportunity our survey numbers represent. Hospitals have the size and the IT staffs and infrastructures to help their local groups navigate the treacheries of IT selection and implementation. Hospitals could help guide physician groups in their communities toward tomorrow's connectivity and build lasting bonds with them. Medical groups need to spend billions of dollars in the next five years on these systems. Busy group leaders want help choosing the right system and implementing it.
Leslie Hall wears several hats at St. Alphonsus Regional Medical Center, Boise, Idaho, including chief information officer and vice president of information technology, marketing and communication. She guides her hospital as it uses IT to build bridges in its service area, including making a master patient index accessible to 12 independent healthcare organizations, providing almost a half-million dollars in IT support per year. Another method of IT outreach at St. Alphonsus is to extend picture archiving and communication systems services to radiology practices in joint ventures that sometimes compete with services provided by the hospital.
By working together, providing access to each other's images, "We were growing each other's business," Hall said. "What we found was together we were better."
The government should take steps to facilitate the growth of IT connectivity ventures like those at St. Alphonsus by helping subsidize clinical IT services and equipment, not only within the hospitals' walls, but also when hospitals extend connectivity to partnerships with physician-led medical groups. Naturally, the government also should create safe harbors from federal antikickback laws for these arrangements.
Physician groups should have access to federal aid for clinical IT independent of hospital partnerships. There needs to be a level playing field financially. But with the expertise and staffs that hospitals already possess, a federally supported partnership model should become an effective way to rapidly promulgate healthcare IT connectivity on a regional basis, a level needed for IT to be most effective in reducing costs and improving patient care. It's time for the much discussed "Hill-Burton Act for IT" to be put into legislative form, allotted adequate funding and passed.
In Canada, the provincial government of Alberta is encouraging physicians to use electronic medical records by offering to pay for 70% of their costs. About 1,300 of the 5,000 active physicians in the province are using EMRs. Provincial leaders hope the copayments will induce the remaining physicians to buy them within the next few years.
We need to match that effort in the United States.