Carolyn Scanlan is president of the Harrisburg, Pa.-based Hospital and HealthSystem Association of Pennsylvania (HAP). The statewide membership services organization advocates for nearly 250 Pennsylvania acute and specialty care, primary care, subacute care, long-term care, home health, and hospice providers, as well as the patients and communities they serve.
KG: Can you tell me a little bit about your organization?
CS: We are a statewide hospitals association and we have 250 members — acute care hospitals, rehab hospitals and psych hospitals. Our main core activity is advocacy on behalf those hospitals, both in the Pennsylvania state legislature and state agencies as well as in Washington with our congressional delegation and with other state associations and the American Hospital Association. We are a pretty standard state hospital association trade group.
KG: How long have you been in your position?
CS: For 13 years now.
KG: Where were you before you started with HAP?
CS: I was actually in New York State. I was executive vice president of the Healthcare Association of New York State, which is the sister organization. Before that I worked in a hospital system, and prior to that I worked in the government sector in New York.
KG: As you know, hospitals and health systems all over the country are feeling the impact of the economic downturn. What are you seeing in Pennsylvania; is it pretty much on par with what we’re seeing on the national level?
CS: From what I’ve seen looking at the statewide newspaper clips, I can tell you that what’s happening in Pennsylvania is basically what’s happening across the country. It’s hard to access money, and so it’s hard to finance facility and technology needs. The cost of borrowing money is increased and oftentimes it’s harder to borrow money, even at any price.
At the same time, hospitals are seeing a whole series of changes in the types of admissions that they’re getting. The number and mix of patients is changing. We see lower admissions on elective procedures and outpatient procedures, and rising unemployment is leading to increased uncompensated care.
KG: As far as the ability to borrow money for capital projects, is that one of the bigger impacts that you’re seeing?
CS: We are. We put out a survey to our hospitals, and we had three questions specifically about IT. The first question is, is your hospital reconsidering or postponing capital expenditures in any of the following areas: inpatient capacity, outpatient capacity and clinical or information technology and equipment. We had the highest response for information technology. Forty-eight percent are reconsidering an inpatient capacity; 54 percent an outpatient capacity; and 64 percent in clinical technology and equipment. So across the board, hospitals are reevaluating or in fact postponing capital expenditures that they otherwise were scheduled to make this year.
KG: Those numbers are pretty close to the figures that AHA had in a national poll, with the exception of IT.
CS: Right. For information technology they had 39 percent and for clinical technology and equipment they had 45 percent, and for new capacity or renovations, they had 56 percent. So it’s all within the range. The IT number that we have is a little higher. But the key is that, yes, they’re reconsidering it at high numbers.
KG: So what does this mean for CIOs?
CS: I think it means that they have to look at the systems they have in place, and see where they have probably put off doing adjustments or tweaks. They need to see if their current information system — both their software and hardware — can be accommodated in the short term to do more while the hospital sorts through what they’re able to do in the acquisition of new technology.
KG: From what you’re seeing, are the larger systems like UPMC and Geisinger Health System being impacted as well?
CS: I don’t have the specifics on those organizations, but I can tell you that any prudent management team, which would include a CIO, is looking at exactly what their finances are in an organization. And while they may not change or stop their IT strategic plan, they may slow it down a little bit to match whatever changes are occurring in their investment income and cash flow.
A few months ago, UPMC announced that they were laying off 500 positions. So against that backdrop, I’m sure that management leadership is looking at all issues, including IT. Any prudent leader would do that; it’s the appropriate thing to do at the moment.
KG: You never want to see innovation take a back seat, but it seems like there are situations where organizations don’t have much of a choice.