Take two tablet PCs and call me in the morning

For IT executives in large healthcare organizations, compliance with the Health Insurance Portability and Accountability Act is, surprisingly enough, last year's business. With HIPAA under control, IT executives are turning to a more pressing issue: how to improve patient care on a tight budget.

Jeff Pelot, CTO for 350-bed Denver Health (formerly known as Denver General), has an astounding 120 projects underway. "My biggest challenge is keeping up with what we are doing,'' he says. Pelot's priorities are creating Web-based access to imaged medical records, providing high-speed access to the medical records department so employees can work from home, and updating his Oracle server back end.

Denver Health has invested 8% to 9% of its budget in IT, which has become "a very strategic part of the organization," Pelot says. IDC says that most healthcare organizations only spend about 2% of their budgets on IT, while the average across other industries is about 5%.

Even though Pelot has a higher percentage of his company's budget allocated for IT than most healthcare providers in the U.S, he still can't implement everything he wants. A voice recognition project recently was delayed because of lack of funding.

Jocelyn Young, an analyst at IDC, says that healthcare organizations tend to invest in areas that will help their mission, which is providing patient care. And technology is one of the key enablers of improved healthcare, she adds.

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A Modern Healthcare study conducted by PricewaterhouseCoopers and R. Marreal and Associates reinforces this. It concludes that improving patient-care capabilities through IT is the No. 1 priority of 63% of the CEOs, CFOs and CIOs who responded.

In Network World interviews with more than 20 IT executives in healthcare, the top two projects were electronic medical records (EMR) and computerized physician order entry systems (CPOE), plus installing and fostering the use of wireless tablets and handheld PCs.

Mark Moroses, senior director of technical services and security officer at Maimonides Medical Center in New York City, is trying to improve patient care by upgrading his electronic medical record system, despite facing budget cuts.

"We were affected by the proposed Pataki cuts [in Medicare and Medicaid reimbursements], and we are starting a five-year renovation process," Moroses says, referring to Gov. George Pataki's proposed $1.9 billion reduction in the New York state healthcare budget.

"To get Housing and Urban Development financing, you have to maintain certain cash levels, which has also restricted our capital budget," Moroses says. "We've put several IT projects on the back burner because of that." Moroses is using an older Eclipsys 7000 for EMR - a way of keeping patient health information online rather than in paper-based charts.

"At one time, we were going to move to the newer Eclipsys SunRise Medical Record platform," Moroses says. "We also wanted to expand use of the ambulatory medical record and looked at implementing a new anesthesia medical record. Those got pushed back or postponed."