HIMSS: Moving From Stimulus Hope To Real Health-Care IT Projects

"The American Recovery and Reinvestment Act certainly created a lot of interest. The dust is settling right now and we're trying to learn a bit more," said William "Buddy" Gillespie, vice president and CTO for WellSpan Health, a network of physicians, hospitals and clinics in Pennsylvania and Maryland. "Sustainability is the word. The infrastructure is sometimes forgotten, and it needs to be stable, expandable and scalable to protect the integrity of the system and the data."

"It's that piece that's often the last thing considered," added Rick Dallamann, marquee accounts manager at Syracuse, N.Y.-based solution provider CXtec. "That's why we're trying to stay two, three, four years ahead of where the industry is so we can meet it as it happens."

If interoperability is to be achieved, sources agreed, operability needs to happen first.

"We've described the content but beyond that, we need a way to transport it from place to place," said Dr. John Halamka, CIO of CareGroup Health System and CIO and dean for technology at Harvard Medical School.

"Health care is ultimately local," Halamka said. "When we start with the notion of a nationwide health information exchange, we start with cities and towns. But to answer it in a quizzical way, there's too much data and not enough wisdom. We're going to get even more data--just think, you can get 10,000 data points on every patient and look at it all. You'll never sleep again! So there needs to a way to separate the wheat from the chaff and tell you what you need to know. Infrastructure has to get in there. Here's a set of rules--best practices, alerts, reminders. Here are the tests you need. There's going to be an investment in automated Web services to build into EMRs and HIE [health information exchanges] on top of the data."

Rob Israel, CIO of John C. Lincoln Health Network in Arizona, said there's a lot good in the stimulus but EMRs are not going to become a huge, mainstream priority for physicians until incentive payments became penalties.

"You won't see EMR until there's forced usage," Israel said. "The government put a big carrot out there but is right now using a pencil for a stick. That's a big problem."

Israel, who uses Lumension security products through Lincoln Health Network, said the secure data exchange remained his biggest concern.

"There's only so much you can know about what's coming into your system," he said. "With an EMR, that's a huge amount of data. No one notices IT until it goes down, so keeping it seamless is the biggest challenge for any CIO. If anything, this may help us a bit with budget, but in the end, if there's room in the budget for a bone saw or a redundant server, bone saw wins, you know?"

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