2. 4 Categories of System
Functionalities
1) Clinical Documentation
2) Test and Imaging Results
3) Computerized Provider Order Entry (CPOE)
4) Decision Support
3. Stakeholders
Inpatient Systems
Outpatient Systems
Regional Health Information Organizations (RHIOs)
Physicians
Patients
Payers
Policy Makers
4. Interest versus Influence
Influence
Low Medium High
Interest
High Outpatient
Systems
Physicians
Payers
Inpatient Systems
Policy Makers
Medium Patients RHIOs
Low
5. Degree of Challenge to
Implementing Health IT (HIT)
Economic Structural Organizational Technical
Stakeholders:
Inpatient
Systems
High High High High
RHIOs High High High High
Outpatient
Medium Medium Medium High
Systems
Physicians Low Low Medium Low
Policy Makers Medium Low Low Low
Payers Medium Low Low Low
Patients Low Low Low Low
6. Inpatient Systems
Complex – lots of departments and units
$20 - $50 million upfront for hardware and software
Indirect Costs – Lost Personnel Time
Top Barriers to Implementation:
74% cite inadequate capital
36% cite physician resistance
32% cite uncertain ROI
7. Outpatient Systems
$20,000 to $50,000 per physician
Not as complex so costs are lower
Top Barriers:
50% uncertain ROI
54% cite challenges of finding EHR system
Lack of trained staff
Real savings accrue to payers not providers
8. RHIOs
Have relied on local and regional efforts
Large upfront costs of technical infrastructure
High rate of failure
Complexity of technical standard setting
Issues with privacy, security, data ownership and
liability
9. Physicians
Face longer hours and/or
decreased efficiency from
implementation
Redundant tests = profit for
labs and physicians
As individuals, overall
influence is low but their
importance to hospitals can
make their resistance to
change influential on
adoption of Health IT
10. Patients, Payers and Policy Makers
Overall, present the least amount of challenge to
implementation
Would incur least amount of cost and highest savings
Higher cost efficient and quality healthcare is in their
best interest
11. Conclusion
Due to the complexity of a Health IT system with all the
desired functionalities, it will be expensive
The exchange of information between different systems
is an important part of making this system beneficial
and cost-effective but also adds significantly to the
upfront costs
Incentives and rewards need to be structured to
support the objectives of Health IT
Standards need to be set and agreed upon for the
system to function properly