As always in surveys of healthcare leaders on the topic of information technology, cost remains the biggest barrier to adoption of electronic medical records systems, according to a recent polling of 84 executives by consultant Capgemini.
But the news in this survey is that a substantial majority of the top executives at hospitals, physicians, payers and healthcare technology companies were so bullish on IT investments.
Of those queried, 71% indicated the financial impact of EMRs on their organizations would be positive in contrast with 11% who cited unclear or intangible benefits as a barrier to adoption. A whopping 88% reported they were either currently implementing an EMR project, or planning to do so within the next 6 months.
"There is wind behind the sails here," said Lewis Redd, national leader for Capgemini's health practice. "Ten years ago, IT was probably not top of mind with any CEO in healthcare unless they had some problem they were trying to work out. Other than that, it was an in-the-basement, cost-of-doing-business sort of thing.
"In today's world, just about every executive will be talking about implementing a clinical IT system. It's a CEO item for sure. That's a huge shift.
"Far and away the number one area of investment in healthcare is on clinical systems, and the forecast of expenditures is up dramatically," Redd said. "Spending on clinical systems has double-digit growth. For years, IT was 2% (of budgets). Predictions are that will double to 4%."
A couple of things are driving the mindset change, Redd said.
One of them is a growing body of work by IT pioneers who blazed the trail on the IT frontier, leaving records of clinical and financial successes. Their case studies have given executives two arguments for investing in IT: because it's the right thing to do from the patient safety and quality of care perspective, and because it will pay off in shorter lengths of stay, a reduction of redundant tests and more.
"People can believe there is a financial return as well as a quality return," Redd said. "You will have a mixed feedback on the length and amount of the payback. This one might get a five-year payback, and this one might get a return but not a payback. There are a lot of variables."
The other factor driving a change in executive attitudes towards IT has been a "huge impetus from the government," evidenced by, among other things, the creation in April of the position of national coordinator for healthcare information technology, a job now held by David Brailer, M.D.
Bottom line, though, Redd said, "I think the industry believes there is huge advantage in having comprehensive clinical systems in their operations, from competitive, efficiency and quality standpoints."
Among the "greatest barriers" to IT adoption named by respondents, capital costs were tops, cited by 58%, followed by obtaining physician adoption, 46%; lack of technical standards, 30%; adding more work to an already overburdened staff, 17%; and privacy concerns, 12%.
Of the leaders surveyed, 73% were from hospitals or hospital systems and 6% were from physician practices, 10% from insurance plans and 11% from IT companies.