Experts Assess Status of Healthcare IT

Medtech companies are beginning to address the technological challenges involved in developing devices that make intense use of information technologies (IT), but a great deal more effort will be required to prepare healthcare settings for the adoption of such products.

In a special roundtable conducted to conclude the MX series on IT in Healthcare, a panel of experts reviews the current shape of the field, challenges related to the adoption of healthcare IT systems, and how medical device manufacturers should be planning to do business in the emerging IT-rich healthcare environment. The wide-ranging discussion, which appears in the November/December issue of MX magazine, highlights financial and policy obstacles that are slowing the adoption of healthcare IT systems and reviews the role that various stakeholders—including medtech companies—can play in overcoming those obstacles.

Markle’s Lansky: An IT paradox.

Panelists agree that shaping the future of healthcare IT will involve a lot more than mere technology. “A paradox that the field hasn’t dealt with sufficiently yet is the fact that healthcare IT initiatives are not primarily about technology at all,” says David Lansky, PhD, health program senior director and executive director of the personal health technology initiative at the Markle Foundation (New York City). “Success is not going to be achieved by merely buying high-end hardware and software and plugging it all in. It’s essential that we look at the issues of work flow, system redesign, and interoperability—but as part of a larger strategy of changing the healthcare system and not only as a basis for adopting raw technology.”

Other members of the panel include Tim Gee, principal of Medical Connectivity Consulting (Beaverton, OR); Lori Hack, executive director of the Health Technology Center (San Francisco); Mark Leavitt, MD, PhD, medical director of the Healthcare Information and Management Systems Society (HIMSS; Chicago); Thomas N. McCausland, CEO of Siemens Medical Solutions USA (Malvern, PA) and chair of the health information technology sector for industry association AdvaMed (Washington, DC); David Merritt, project director at the Center for Health Transformation (Washington, DC); Rod Piechowski, vice president for technology leadership at the National Alliance for Health Information Technology (NAHIT; Chicago); and Jay Srini, founder and president of Strategic Consulting Solutions (Pittsburgh) and vice president of emerging technology at the University of Pittsburgh Medical Center.

Changing the Flow

Srini: Work flow implications.

Changing the work flow of healthcare practices will be an important factor in gaining the benefits promised by healthcare IT systems. “To create a longitudinal electronic health record (EHR) system, the data from medical devices and electronic health records will all have to be treated as a single, seamless entity, and this will certainly have organizational implications,” says Srini. “The difficulties lie not just with the technology, but also in the imp osition of the technology into a work flow that must be radically modified to make use of it.”

Siemens’s McCausland: Enabling IT.

For their part, medical device manufacturers are moving rapidly to create products that meet the demand for clinical information. “Anybody who makes a device today knows that somebody wants to take the information that the device is generating and do something with it electronically,” says Siemens’s McCausland. “They want to put it into some format that goes into a record, whether it’s a short-term record for a specific visit or part of a long-term permanent patient record.”

Nevertheless, many hospitals are still functioning with legacy systems that are unsuited for use with the latest generation of medical devices. “Suddenly all of the equipment that hospitals buy has some kind of digital capacity, and it is dumping huge amounts of information into a network that people never thought about designing to handle that,” says McCausland.

HIMSS’s Leavitt: Limited healthcare resources.

Efforts to move hospitals and independent physicians toward the adoption of newer IT systems raise other issues, including the resources required to implement new products and the standards that such systems should incorporate. “End-users do not have the resources to integrate their devices, their software, and their hardware with the networks within their healthcare systems,” says HIMSS’s Leavitt. “If we don’t get closer to plug and play, we are never going to realize the safety benefits of both digital devices for monitoring and treatment and software for managing the information. It will forever remain a safety-risk area if we do not get the standards implemented and the systems working together smoothly.”

Roundtable participants agree that the adoption of IT systems holds great promise for improving the quality of patient care, but they suggest that such systems will only achieve their full potential if coupled with other incentives. “IT is just a tool to facilitate the process to achieve better quality and to make healthcare more efficient,” says McCausland. “Both Siemens and AdvaMed would like to see an open system that rewards healthcare systems and physicians for quality and good practices.”

“Quality of care is intimately linked to whether physicians have the full information they need when diagnosing and treating their patients,” agrees Srini. “And some of that information has to come from the devices produced by manufacturers feeding directly into the EHR.”

Even so, Srini says, medical device manufacturers have not always been so active in helping to develop product standards for healthcare IT systems. “While medical products play an important role, the real focus of the national healthcare IT initiative is on consumers. So at this point, healthcare product manufacturers are not taking the lead role in developing interoperability standards.”

Paying for IT

Participants in the MX roundtable cite underinvestment in IT as a major problem among both hospitals and independent healthcare providers. But they also indicate that such underinvestment is symptomatic of deeper difficulties. “We lag behind other industries,” admits Leavitt. But, he says, incompatibility issues explain much of the hesitance on the part of healthcare purchasers. “In the auto industry, it simply would not be acceptable if you bought a robot that assembles cars and discovered that it could not talk to your computer-aided manufacturing system. That would not fly for very long.”

NAHIT’s Piechowski: The need for affordability.

“The current system of reimbursement and the margin on which hospitals are operating do not allow them to view IT as a normal cost of doing business, like most other industries do,” says NAHIT’s Piechowski. “In the financial services industry, about 15% of gross income is reinvested in IT. In hospitals it is much, much lower than that. It is under 5%. We have to look at how to move the pieces of the puzzle around in such a way that we do not bankrupt the hospitals as we try to make these systems more accessible to them.”

HealthTech’s Hack: A shift in strategy.

According to Hack, some healthcare providers have begun to adopt new financial strategies that support the adoption of IT systems. “Now that we are starting to see capital planning and strategic models that identify IT as a backbone solution for the whole organization, we are finding that some smarter decisions are being made about technology and its use in some of the more advanced groups.”

Other areas discussed by the MX roundtable participants include current public policy and private-sector initiatives to support the adoption of healthcare IT systems, the growing involvement of consumers, and how the emerging IT environment may influence the development of future medical products. The full transcript of the roundtable discussion can be accessed via the MX Web site at www.devicelink.com/mx.

© 2005 Canon Communications LLC

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