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Healthcare // Electronic Health Records

Health IT Infrastructure Often Comes Second

CDW Healthcare report shows that caregivers value their electronic tools, but many gripe about network speed. At many hospitals, EHRs come first and infrastructure improvements follow.

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Roughly eight out of 10 health IT executives admit that they have added server, storage, or network program technology after the fact--in other words, after implementing electronic health records (EHRs) and other health information technology systems, according to a new poll. The survey, conducted by CDW Healthcare, suggests that the lack of sufficient infrastructure to support health IT systems diminishes the quality of these systems for many caregivers. Forty-one percent rated their new systems as slower (20%) and harder to use (21%) than old tools.

The Healthcare IT Tipping Point examines the balance between implementing systems such as EHRs and health information exchanges and the supporting technology, such as storage, servers, data security, and other technologies needed to speedily deliver information to caregivers on their PCs, laptops, tablets, smartphones, and other devices. Although caregivers are accomplishing tasks faster because of health IT technologies, they are getting bogged down by their network.

"By delaying IT infrastructure investment, hospitals will see less of a return than they had originally planned for," Bob Rossi, vice president of CDW Healthcare, told InformationWeek Healthcare. "That imbalance hurts in two ways. First, caregivers get less value out of endpoint systems now supported by inadequate infrastructure. Second, hospitals typically overpay for the quick fixes to avoidable problems."

Based on interviews with 200 IT professionals and 202 caregivers at hospitals with 200 beds or more, the report highlighted areas where this imbalance exists. For example, 4% of hospitals deploying an EHR in the last 18 months added no additional storage capacity and 11% invested in no additional IT security. Ten percent of hospitals opened their networks to patients and visitors without adding any wireless network capacity.

[ For more background on e-prescribing tools, see 6 E-Prescribing Vendors To Watch. ]

Caregivers also expressed frustration with using new technologies, with 37% saying there were too many passwords to memorize, 31% noting the process takes longer than it used to, and 25% saying the interface is not user friendly.

"The tail doesn't wag the dog, so ultimately healthcare IT is about enabling caregivers right where they are doing their jobs," Rossi said. "Balancing investment between endpoint solutions and supporting infrastructure ensures that those caregivers get the most effective systems, and that those systems are fast, reliable, and easy to use. The last thing anyone wants to do is slow down a caregiver."

Among the hospitals participating in the survey, 56% have deployed an EHR and 48% have implemented computerized physician order entry. Among the respondents using these technologies, 84% of caregivers find that healthcare IT significantly aids in the delivery of patient care.

Among the tasks doctors and nurses said health IT helped the most, 85% said it makes important information more readily available, 72% said it improved the accuracy of care delivered to patients, and 68% liked the ability to track follow-up care such as scheduling appointments. Another 57% said health IT helps speed care delivery to patients--ostensibly despite network bottlenecks--and 38% said health IT helps them spend more time with patients.

Looking ahead, the report notes that mobile device connectivity promises to be the next wave of IT adoption that will require new infrastructure support. The poll shows that 96% of hospitals with 200 or more beds support mobile devices on the network, 35% have a formal mobile device management program in place, and 18% have an established bring-your-own-device (BOYD) program.

Rossi said CDW Healthcare sees tremendous benefits and some big challenges during the next 18 months.

Despite the lag in infrastructure, caretakers say "healthcare IT is speeding up the delivery of care, increasing accuracy, and making more time available for patient care," he said. "Scale that from the 200 large hospitals in the survey sample to the next layer of adoption and you start to see real, national changes, Rossi said. "The new endpoint solutions hold great promise for patient care, but implementing any of them will require a balanced investment approach."

Healthcare providers must collect all sorts of performance data to meet emerging standards. The new Pay For Performance issue of InformationWeek Healthcare delves into the huge task ahead. Also in this issue: Why personal health records have flopped. (Free registration required.)

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