Gartner: Reforms, Privacy Are Key Healthcare IT Issues

information technology

That's the word from a panel of Gartner analysts and the audience at Everything Channel's Healthcare IT Summit, held this week in La Quinta, Calif.

For healthcare payers, which includes the insurance industry, the ongoing question of healthcare reform currently being debated by the government is really a question of health insurance reform, said Robert Booz, managing vice president of Gartner.

"It's not a reform of how we provide care, but on how we pay for that care," Booz said.

As a result of the reforms, regardless of their final version, some providers will go out of business while others will go through a series of mergers and acquisitions. Furthermore, Booz said, new regulatory mandates and requirements will push a new era of conversion from non-profit to for-profit organizations.

Sponsored post

Through all the changes, IT will have to be more flexible than ever, with providers looking to move away from managing multiple identical applications and consolidate them into a smaller number of applications at a time when neither current architectures nor IT budgets are suitable for such consolidation, he said.

For IT vendors, the big change will come from how they provide services, Booz said. "As you approach deadlines, it will affect not only your ability to find consultants, but what you will pay for them," he said.

Booz also predicted that niche players will continue to chip away at the market share of more established vendors, Booz said.

For providers, healthcare reform is "the opportunity we have been waiting for," said Vi Shaffer, research vice president and global industries services director at Gartner. "But in many ways, we have not yet stepped up to the plate."

The healthcare reforms are adding urgency in terms of implementing electronic healthcare record systems, especially for those providers who are lagging in their implementation, Shaffer said.

The reforms will also add urgency to HIPAA and other compliance initiatives, and will result in an increasing need for surveillance and monitoring to enforce change, she said.

Vendors dealing with the provider side of healthcare have largely finished helping larger providers with their projects, and will increasingly turn their attention to the worldwide community where changes have not happened as fast as in the U.S., Shaffer said.

In the question and answer period following the Gartner presentations, audience members focused on security and privacy issues.

Shaffer, in response to a question about security and privacy when sharing information between providers and payers, said this is an issue that comes up not only because of its "correctness," but because of its political nature. Providers and payers need to be ahead of the rules, and have a sense of what is happening before a new rule is imposed, she said.

Booz said a fundamental issue going forward will be who owns a patient's data. CIOs traditionally think they own it within a provider organization, but the market is moving towards more of a data stewardship model in which patient data is held by a particular organization only while it is needed.

Sharing of information between competitors is also an increasingly important issue, Booz said. And that competition is not only between different companies, but between different parts of the same company. "The success of healthcare initiatives depends on solving this issue," he said.

Humberto Quintanar, CIO of Antelope Valley Hospital in Lancaster, Calif., said that many in the healthcare industry completely ignore the issue of who owns patient data and records, to the possible detriment of the patients' health.

"Everybody talks about interoperability of the data, but no one asks the patient," Quintanar said. "But the patient owns the records. We as providers, and the payers, really don't want to ask the question because we want to own the records."

Quintanar said that insurance companies don't want to share data because once a patient has that data, another insurance company can come along and say it can provide better services. "They don't want to deal with that," he said.

Healthcare providers and payers should put their own concerns aside and ask what they can do for the patient, Quintanar said. By making sure patients control their own records, they can receive better care. "People are dying because of this," he said. "If there's an accident, or an allergy, and the patient doesn't have the right records, he or she could die."