Healthy ways to spend $40 billion

Much has been written about the $40 billion in stimulus funds the U.S. federal government has allocated for healthcare IT. The American Recovery and Reinvestment Act of 2009 (ARRA) allows Congress to begin releasing money in 2010 to healthcare providers and related organizations that can show they have "meaningful use" planned for the funds. Given that the healthcare industry has one of the lowest rates of investment in IT -- only about 2.3% of revenues, compared to 8% to 13% for other industries -- there should be no shortage in the need for IT-based solutions.

We've been told that electronic health records are on the top of the list when it comes to funding, but I wondered what else might be on the wish list for hospitals, clinics and other providers. Two experts in this field gave me their insights on how the stimulus and other funds could be used to improve healthcare, especially in the areas of communications and collaboration.

I recently talked to Danny Sands, M.D., chief medical officer and director of the Internet Business Solutions Group at Cisco, and Todd Brinegar, chief marketing officer, Presidio Networked Solutions. Sands and Brinegar are entrenched in bringing IT-based solutions to healthcare organizations. Although Sands works for Cisco, he is also an active physician with a primary care practice. His knowledge of health information technology combined with his actual hands-on experience as a physician gives him a unique perspective on what kinds of IT solutions can provide the greatest benefit to medical practitioners.

Sands says that healthcare is different from other industries, largely because of the complexity of bringing people together to collaborate on a patient's care. There may be numerous people involved in providing care, and they have very different knowledge, skill sets and -- often -- employers. You have doctors, nurses, specialists, pharmacists, administrators, interpreters for non-English speaking patients and the patients themselves. Some of them work for the same hospital or clinic, but others do not. Finding effective ways to link these people together and let them share information and expertise is critical and challenging.

IT varies greatly from one hospital to the next, according to Sands. Complicating that even further, the hospitals have little leverage to get doctors to use the technology if they don't want to because doctors are typically independent contractors rather than employees of the hospital.

Brinegar emphasizes how important it is, then, to get a deep understanding of the prospective technology users and their environments. He often works with a hospital's technology review board, which is comprised of all levels of users, to understand the needs of the business and the problems the business is trying to solve.

There are several areas where Cisco solutions are bringing value to healthcare environments. One is the networking infrastructure that allows multiple systems to be layered on top. Sands says a medical grade network requires maximum security, resiliency, redundancy and expandability. "Everything depends on performance," he says. "Doctors won't wait on a slow network to get the information they need. If they have a good experience [with the network], they will use it again. If they have a bad experience, such as their data getting lost, then they won't use it again." He reiterates that doctors don't have to use the IT solutions that a hospital provides.

Linda Musthaler is a principal analyst with Essential Solutions Corporation.