Survey: Hospitals Committed to Adopting IT, but Implementation Lags

The results of a survey released in October by the American Hospital Association (AHA; Chicago) reveals that although hospitals are eager to embrace modern information technology (IT) systems, implementation varies. Level of actual adoption fluctuates as a function of facility size, financial resources, teaching status, location, and whether the facility is a member of a hospital system.

The survey, Forward Momentum: Hospital Use of Information Technology, was conducted in April 2005 using AHA’s database of 4895 community hospitals located across the United States. Of the facilities contacted for the survey, 940 (19.2%) responded and were found to represent a good demographic match with the profile of the overall survey sample.

Among the respondents to the hospital survey, 92% reported that they are actively considering, testing, or using IT for clinical applications. Cost was seen as the greatest barrier to IT implementation. In the past year, survey respondents spent a median of 15% ($700,000) of their annual capital investment budget and 2% ($1.7 million) of yearly operating expenses on IT. Recognizing the costs involved and that “mistakes are expensive,” hospitals are proceeding on an incremental and somewhat cautionary basis. Interoperability concerns were also cited as a major impediment to greater hospital-wide IT implementation, as administrators fear installing equipment and systems that cannot exchange information.

Resistance to technology among clinical staff, cited as an obstacle in earlier studies on IT implementation, was not seen as a significant issue in the AHA survey. Reportedly, only 19% of physicians do not use IT, followed by just 17% of nurses, and 16% of other clinical staff.

Adoption of electronic heath records (EHRs) was reported to be a major focus of hospital-wide IT initiatives. Among the reporting hospitals, 84% have some degree of EHR deployment. In addition, the report examines the use and implementation rate of a number of other healthcare information technologies, including computerized physician order entry systems , bar coding, radio-frequency identification, personal digital assistants, and telemedicine. More than half of the hospitals reported sharing information electronically with other healthcare providers, laboratories, insurance firms, and health information networks.

Not surprisingly, larger, urban-based hospitals that are typically affiliated with medical schools and have greater financial resources are adopting and implementing a greater range of healthcare IT systems—and at a faster pace—than their smaller, rural, nonteaching counterparts.

AHA laments the fact that “hospitals currently bear almost all the costs of IT investment, with no increases in payments.” Yet the report notes that greater adoption of healthcare IT has many financial benefits, including “decreased need for repeat tests, lower readmission rates, and shorter lengths of stay,” all of which can greatly improve productivity and operational efficiency while yielding greater utilization of both staff and facility resources to treat more patients.

Over the next three years, surveyed hospitals plan to increase their IT spending to an average of 20% of their annual capital equipment budgets and 2.5% of their annual operating expenses. Smaller hospitals with less-advanced systems are planning to devote an even larger share of their budgets to IT investment. In line with this, AHA predicts that the adoption of IT will continue at an “evolutionary” pace. The organization cites the “quality and safety gains that can be realized” as the primary motives for continued IT implementation.

AHA’s Lynn: Healthcare IT in infancy.

Commenting on the survey, George Lynn, chair of AHA and president and CEO of AtlantiCare (Atlantic City, NJ), said, “We have not fully tapped into IT’s potential in the healthcare arena. Other fields, such as banking, have embraced technology, helping to change the way we bank today. While the use of IT in healthcare is still in its infancy, hospitals recognize that IT can help them meet their mission of improving safety and quality. We need to move quickly to remove barriers to widespread IT use.”

The results of the AHA survey were issued at the same time that the Department of Health and Human Services (Washington, DC) issued initial contracts valued at $17.5 million to advance the national health IT adoption initiative.

© 2005 Canon Communications LLC

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