Health care CIOs: Not ready for paperless hospitals

CIOs from hospitals large and small remain reluctant to deploy paperless medical record and computer physician-order entry (CPOE) systems, despite a 2-year-old push by 90 major U.S. employers for adoption of such systems to help eliminate medical errors.

Speaking on a CIO panel at the annual Healthcare Information and Management Systems Society (HIMMS) here, Paula Anthony, CIO at the East Texas Medical Center (ETMC) Regional Healthcare System, in Tyler, said she remains cautious about outside technology mandates that are global in nature. “Pushing CPOE across a continuum of professionals is scary,” Anthony said.

ETMC operates 13 acute care hospitals with 1,200 beds, as well as rural clinics in East Texas.

The Leapfrog Group, a Washington-based health care consortium formed in 2000 by the Business Roundtable, another Washington-based organization, which draws its membership from the CEOs of Fortune 500 companies, has estimated that CPOE systems would eliminate a half-million medical errors — some of them fatal — per year.

Warren Chandler, CIO at St. Vincent’s Health System, in Jacksonville, Fla., said his 528-bed hospital is “a long way from going paperless. There are a lot of costs and risks [involved].” Chandler said that while it sounds simple to execute CPOE, it’s not.

Pamela McNutt, CIO at Methodist Hospitals of Dallas, which operates a 478-bed hospital, a cancer clinic and four other health care facilities, said CIOs need to get involved with local business organizations to let them know “what is realistic” in terms of developing a CPOE and other paperless medical record systems.

McNutt suggested that electronic patient records could serve as a good starting point for a paperless hospital and the CPOE. Jeff Cooper, CIO at Henry Medical Center in Stockbridge, Ga., said health care institutions need to take a “building block” approach to development of CPOE, starting with patients’ medical records.

Although CIOs at the HIMMS conference are taking a cautious approach to CPOE systems, Kaiser Permanente Health Plan Inc. in Oakland, Calif. — the country’s largest nonprofit health maintenance organization — last week said it plans to roll out a paperless medical system during the next three years, rolling out CPOE to its 11,000 physicians.

Despite concerns about CPOE, CIOs at the conference said they have resolved the IT security and privacy mandates of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which go into effect in April. Meeting the HIPAA security and privacy mandates was “very expensive, but we’re ready for it,” Anthony said. She added that ETMC’s biggest HIPAA expense wasn’t technology but the cost of lawyers to review the privacy and security plans.

In the new technology area, Chandler said, wireless LANs show great promise for increasing operational efficiencies, through processes such as bedside registration for patients. Chandler also said he “still needs to figure out what handheld makes the most sense” for his hospital.

Despite the promise of new technology, health care CIOs said that they, like CIOs in other industries, have been constrained by the sluggish economy in what they can do. Rather than looking at new systems or projects, Cooper said he intends to try and “get the most out of existing systems” with an IT budget that is level at best.

McNutt said her budget would go up only slightly this year, while Anthony described her budget increase as modest and accompanied by a mandate to push services out to rural areas “cheaply and efficiently.”

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