Thank you for asking your readers for their comments on articles in the April 2008 issue of Healthcare Informatics.
I am the Chief Information Officer at a 270-bed hospital in western Connecticut. I have been in healthcare for more than 20 years. During that time I have suffered and appreciated many of the changes.
Mr. Gingrich belies a certain naivety in his vision for healthcare. He talked about the “loosening” of the Stark Bill as a way to provide hardware, software and support to physician offices from their hospitals. Perhaps Mr. Gingrich has forgotten that Medicaid pays 40 percent of cost and Medicare 90 percent. Other businesses are not forced to take such insufficient payments from their customers. As a result hospitals are slowly eroding their access to capital and their replacement of the “factors of production.” There is not excess cash in non-profit hospitals to further support their physicians' needs. Insurance companies, whose net revenue numbers look much better, are not stepping to the forefront to alleviate this situation even though as he points out, they are the true winners in electronic health records. I believe Mr. Gingrich doesn't support government meddling in private business, yet supports another mandate without proper funding, electronic prescribing, from Secretary Leavitt. Mr. Gingrich was involved in HIPAA. It provides for the standard transaction set that would eliminate the middleman from billing and remittance processing. Hospitals all pushed the envelope and now send those standard transaction sets yet are still charged a fee by the middleman because insurers were not forced to change their systems. This type of inequity is wasteful and should be where his efforts are aimed.
Thank you for listening.
Jim Olson, M.B.A., CIO
Has HCI done a recent article on a hospital or system who has undertaken the development of a data warehouse? As clinical systems become more prominent I feel organizations are going to have a rough time getting timely reporting and analysis of clinical data, especially those who are hodgepodge rather than single vendor. If there's been no recent article might this e-mail serve as a request to do one? I'd really like to know what the initial steps are, what questions need to be asked to begin planning and what successes have been realized, especially successes in clinical quality improvement as a result of a data warehouse.
Enterprise Project Manager
Mid Florida Medical Services