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By Michael Eggebrecht
Technology is a very important part of U.S. efforts to lower healthcare costs while simultaneously improving safety and service, says Tufts Medical Center CIO Bill Shickolovich -- but it's only a part.
For healthcare CIOs, electronic health records (EHR) have been a major area of focus, and government incentives are helping to drive adoption. But unless other areas of reform are successfully addressed and harmonized, says Shickolovich, the end result could be a lot of money spent on IT and a healthcare system that still falls short of its ultimate goals.
Tufts, for its part, has launched a major EHR initiative. A Boston-based academic medical institution and the primary teaching hospital of Tufts University School of Medicine, Tufts Medical Center has about 800 physicians, more than 200 of whom are community physicians affiliated with the center. About a year ago, Tufts began working with Dell and eClinicalWorks to bring electronic medical records to those affiliated physicians.
Many of those doctors are at small practices, a group that on a national level has largely balked at the cost of automation. The success of Tufts' business strategy depends on patients moving between community care providers and Tufts with ease, and "it's very difficult, virtually impossible, to do that without a technology architecture which supports various levels of practice automation, support of various quality measures, support of effective coordination of care among the various healthcare providers, and providing full transparency to the patient to help them understand the care plan and what's going on," said Shickolovich on a recent Webcast.
"If we're to achieve our national healthcare reform goals around cost and quality -- we need to find a better way to support the continuum of care," said Shickolovich, who was a managing consultant in the healthcare IT practice at Capgemini Ernst & Young before joining Tufts in 2002.
Based in part on its experience with Tufts, Dell earlier this month introduced a hospital-sponsored offering designed to connect medical institutions with their affiliated physicians and make it more affordable for smaller practices to adopt EHR.
CIOZone recently spoke with Shickolovich about the Tufts EHR initiative and the challenges that face healthcare CIOs in a changing environment.
What is the biggest challenge for healthcare CIOs right now? Is it EMR?
I think the top challenge is access to capital. The capital markets have not treated any business well for the past 12 months. As you know, it's not uncommon for hospitals and healthcare organizations to heavily rely upon the gains they enjoy off the market to help supplement their operating performance, in terms of providing the necessary resources and/or providing a necessary capital infusion to the institution. The operating pressures in this day and age in healthcare -- I think we all understand what those are.
Healthcare reform is there for a reason. When you exacerbate that challenge with access to money it becomes a bigger challenge.
Capital is a challenge across industries.
Healthcare has been somewhat of a laggard with respect to adoption of various technologies. If you look at banking and other sectors, they have had the opportunity and took advantage over the last decade or two, as their businesses grew, to take available capital and continue to infuse. It's almost 2010 and we're still talking about trying to raise the bar of a single percentage of EHR adoption in physicians' offices to a much larger level.
So while it's true capital availability is a challenge for all industries, I like to think that other industries have made significant investments. The capital concerns that they have -- I'm not sure they're as magnified as ours are.
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