Swedish: Well, this a really remarkable movement on the part of the president and his administration—specific to Trinity Health largely because Trinity Health in the year 2000 embarked upon a very aggressive IT transformation that witnessing where we have arrived almost nine years later compared to where the president wants it to go—we find ourselves in an incredible position of alignment with that agenda. So we certainly will be the beneficiary of some part of that stimulus package in terms of rewards. However, what we have witnessed I think is a great indicator of where our industry can go, and I'll underscore struggles that it will face. What we've witnessed is that IT is an enabler, it's not an end. And for organizations that really haven't embarked upon an aggressive path—and what we know right now is that only 8% of the American hospitals are advanced with electronic health records. So we got a long way to go. But, with respect to this reality in that it is an enabler, it is a huge challenge as hospitals seek to effectively merge people, process and culture. And I think the story's not yet written whether or not we will be as successful as is intended in the coming few years—maybe four to five years—but it's a Herculean task, and I'm hopeful our industry's up to the challenge. And again, I want to congratulate the president for advancing the stimulus and letting it be known that IT is a critical component of the success for healthcare in the future.
Transcript: Joseph Swedish, president and CEO, Trinity Health, Novi, Mich.
Swedish: You know it's a question that we constantly remind ourselves of because we're in so many states—seven—and 23 different markets. And what we have witnessed is this remarkable escalation in charity care and bad debt. We're witnessing people that quite frankly don't know how to be poor by virtue of the unemployment explosion. And we're seeing people in our free clinics, as an example, that are lining up early the night before for care. I think this is just a, you know, unfortunate and sad commentary on the American healthcare system as well as our economy. What we are trying to manage is maybe a clearer definition of our position to service communities through our community benefit initiatives, and I think that's a constant working process, and the challenges are getting greater and greater. The other challenge that we're witnessing is the access to capital dilemma, and we are very challenged in terms of our ability to grow and continue to provide the capital that's necessary to best support technology advancements. I think in the near term, it's very problematic and I think the story's not yet written quite how we're going to be able to continue to access the capital we need given the collapsing economy. And specifically the reality that payment is going to get less and the expectations for transparency are heightened, demand for quality is heightened. And you put all those factors together and more of them, and I think the challenges are very significant. And quite frankly challenges the sustainability of much of what we've managed in the past. So we're going to have to step up and reposition ourselves to be successful in the new era whenever that door opens.
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