The use of information technology in the nation's hospitals is growing, but remains fairly low with only 10% having fully implemented systems, according to an American Hospital Association survey of more than 900 community hospital chief executive officers.
Chantal Warzala, the AHA's senior associate director for policy, said the survey -- conducted between April and June of this year -- "may not be earth-shaking," but is the most in-depth study of its kind to date and provides a good snapshot of the current hospital IT picture.
Use of IT will be "evolutionary," Warzala said, meaning that hospitals are adopting technology in incremental steps -- usually one department at a time -- and installing new systems that address their specific priorities.
What impressed Warzala the most was that 92% of the hospitals surveyed said they were either using, testing or actively considering adopting an IT system. "I think we were encouraged by the real commitment to IT," she said.
Of the 8% of the hospitals that are not even considering adopting IT, 99% were nonteaching institutions, 93% had fewer than 200 beds, 82% were in rural areas and 70% were not affiliated with a hospital system.
Of the hospitals using IT, 36% said they were just getting started (using zero to three functions), 27% reported low use (four to seven functions), 27% reported moderate use (eight to 11 functions), and 10% said they were fully implemented (using 12 to 15 functions).
More than half (53%) of the hospitals had fully or partially implemented a bar-coding system for laboratory specimen management, 40% for management of supplies and 37% for patient identification.
In general, nurses and other clinical staff reported higher IT use than physicians. Warzala said that was because, as new systems evolve, their first users may be lab technicians or pharmacy staff while doctors usually require a more tailored product and don't get involved until systems are more advanced. She added that about 30% of hospitals have fully or partially implemented systems in which physicians use personal digital assistants.
The median capital investment hospitals are making each year on IT was more than $700,000 and represented 15% of all capital expenses. IT operating costs were found to be even higher -- $1.7 million - but represented only 2% of all operating expenses.
Not surprisingly, initial costs were seen the No. 1 barrier to adoption, followed by ongoing costs. With this in mind, the report concluded that hospitals need some outside help to accelerate IT use.
"These survey results suggest that accelerating the forward momentum and achieving universal adoption of IT will require a shared investment between providers, payers and purchasers," the report stated. "Hospitals currently bear almost all the costs of IT investment, with no increases in payments. But many of the financial benefits of IT, such as decreased need for repeat tests, lower readmission rates and shorter lengths of stay, accrue to those who pay for the care."
"We're really looking for a shared investment here where all these parties can chip in," Warzala said.
Mohit Ghose, spokesman for America's Health Insurance Plans, said payers are helping out in a variety of ways, including streamlining systems to provide savings, promoting pay-for-performance initiatives and providing direct assistance to physician groups.
"Without getting into who's paying what percentage for which providers, what's important to focus on is that the (healthcare) community works together for the system that will provide the best value for the consumer," Ghose said. "We need to look at this from a longer-term perspective and not just short-term gain on investments."
He added that IT use should lead to cost savings for all parts of the healthcare system and that "the key is improvement in quality of life and quality of care."
View the report.