CEO Survival Guide - AHRQ National Resource Center; Health ...

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The EHR Environment Right Nowhospitals has not yet started on this journey.The majority (80 percent) of hospitals havecomputerized laboratory, pharmacy, andradiology systems, and most have clinicaldata repositories that make these dataavailable to clinicians and other authorizedusers. Far fewer hospitals have computerizedclinical documentation and even fewerprovide clinical decision-support to clinicians.Estimates of hospitals with CPOE rangefrom 2 to 4 percent (Gale, 2006; HIMSSAnalytics, 2006).Hospital adoption of clinical HIT iscorrelated with:• More beds• Participation in multi-hospital system• Less Medicare revenue• Not-for-profit status• Managed care involvementwhich have historically yielded higher profitmargins, have been better positioned to investin EHR systems (Fonkych and Taylor, 2005).EHR Systems Developmentson the HorizonSince May 2005, more than a dozen billshave been introduced in the House andSenate containing language to enable thedevelopment and adoption of electronichealth records, and a nationwide HIT infrastructureto support them (DoBias, 2006). Afew of these bills in particular appear as ifthey might move forward in the coming year(see Exhibit 6).In addition, in December 2005,Congress passed the Fiscal Year 2006 DHHSAppropriations Bill, which included $61.7million for ONCHIT to be used for thedevelopment and advancement of an interoperablenational HIT infrastructure.(Fonkych and Taylor, 2005)As was the case for ambulatory practices,greater organizational capacity is stronglyassociated with investment in EHR systems(Fonkych and Taylor, 2005). Larger hospitalsand hospitals participating in multihospitalsystems are further down the road in adoptingEHR systems. Not-for profit hospitals aremore likely than for-profit hospitals to haveinvested in clinical HIT applications, especiallyacademic and pediatric hospitals. Lastly,hospitals that derive a greater proportionof revenues from private insurance sources,www.NQFExecutiveInstitute.org NQF Executive Institute 41
CEO Survival Guide to Electronic Health Record SystemsEXHIBIT 6 Recent Electronic Health Record System Legislation*BillS. 1418 Wired for HealthCare Quality ActDateIntroducedSummary7/18/2005 Facilitates the adoption of a nationwide,interoperable health information technologysystem through uniform privacy and securitypractices and standards for the electronicexchange of health information. Also, solidifiesONCHIT as the leader in coordinating HITefforts.Current StatusPassed by the Senate,referred to HouseSubcommittee on Healthon 12/16/2005 (will likelybe matched with H.R.4157)H.R. 4157 HealthInformation TechnologyPromotion Act of 2005H.R. 4641 AssistingDoctors to ObtainProficient andTransmissible HealthInformation Technology(ADOPT HIT) Act of 200510/27/2005 Facilitates efforts by hospitals to helpphysicians acquire new HIT (currentlyprevented by federal law). Also, calls for theestablishment of uniform confidentiality andsecurity standards. Solidifies ONCHIT as theleader in coordinating HIT efforts.12/18/2005 Provides tax benefits for healthcareprofessionals who invest in HIT.Referred to Subcommitteeon Health on 11/4/2005Referred to Committee onWays and Means on12/18/2005*Current as of close of 109th Congress, 1st session42 NQF Executive Institute www.NQFExecutiveInstitute.org
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