Most health IT professionals are probably more focused on implementing or maintaining systems than they are tracking larger healthcare trends, such as the pace at which hospitals and practices are being bought and sold.
The fact is, however, that information technology -- even if it's not a direct driver of healthcare consolidation -- can certainly be a significant factor in the decision-making of healthcare administrators, affecting both the choice to consolidate and how successfully a consolidation is carried out.
According to Greg Chittim, director of analytics and performance at Arcadia Solutions, a Boston-based IT consulting firm, there are five areas where IT concerns factor into the drive toward, and the success of, consolidation.
Cost. Many smaller provider practices and hospitals have a hard time stepping up to the expense of an EHR implementation, Chittim pointed out, but pressure is building on them to move forward nonetheless. "So far, providers have been seeing the carrot side of meaningful use," he noted, in the form of federal incentive payments. "But they're starting to consider the stick side of it" as the day approaches when Medicare reimbursements start to shrink for providers who haven't gone digital. Consequently, small- and mid-sized organizations are increasingly looking to be purchased in order to alleviate the pressure.
Change management. For providers and hospitals that want to upgrade their systems, perhaps the biggest question, Chittim said, is "How do you manage the challenge of change management? Technology is only a portion of the problem with EHR implementation." Almost invariably, organizational productivity is impacted, and smaller outfits often don't have the expertise to work their way back to previous levels of business. Larger organizations, however, can more easily afford to bring in that expertise, if they don't have it already, and thus have a better chance of realizing the promise of new IT implementation.
Diverse systems. Another key IT consideration, Chittim said, is that as organizations consolidate, "not everyone can go to a unified system where everyone is on a single platform. There needs to be a strategy and approach that allows for a heterogeneous IT landscape."
Privacy. Yet another challenge involves the constant need for vigilance when it comes to protecting electronic patient information. And the fact is, Chittim pointed out, that "the cost of the expertise needed to manage security and privacy concerns is not something small practices can necessarily think about. But large organizations can." He also suggested privacy concerns, and the costs surrounding them, would likely become more of a burden as regulators conduct more extensive audits in the future.
Tech support. Unfortunately, Chittim said, "small practices with single vendor relationships aren't necessarily getting the support they need when it comes to coding questions or maintenance issues. Access to strong service agreements is hard for small practices." But not as hard for large providers and hospitals.
Regardless of whether providers in a small practice want to get bigger, Chittim said, the fact is "the more technology becomes invisible to providers, the more they can focus on patients." Small practices don't usually want to think about IT, but they have to so long as they're on their own.
"When consolidation happens," he said, "you presume that those who are buyers are generally the ones who have sophisticated infrastructure and well-established best practices." Which means, ideally, consolidation will lead to greater efficiencies, as well as a higher quality of care.
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