IT vendors and pharmaceutical reps may see a lot of each other, as hardware and software companies beat a path to healthcare providers’ doors. A surprising number of healthcare providers and related medical organizations have made only limited investments in their technology infrastructure. In this comparatively virginal market, Windows 7 will have an easier entry: Healthcare providers will be forced to buy PCs, notebooks, servers, and more to support the federally mandated electronic medical records and health information exchanges.
The federal government’s IT-intensive prescription for medical providers is rushing many healthcare providers into the world of electronic medical records (EMRs) and health information exchanges (HIEs) in order to earn lucrative rebates and ensure regulatory compliance. Windows 7 may play a part.
As part of the American Recovery and Reinvestment Act (ARRA), the government set aside $1.2 billion in Health Information Technology for Economic and Clinical Health Act (HITECH) grants to encourage physicians and hospitals to establish and use EMRs and HIEs. Under terms of the grants, doctors can receive up to $44,000 each beginning Oct. 1, 2011 if they prove “meaningful use” of data such as electronic laboratory results using certified solutions. Medical providers that delay investing in this technology will receive a lesser amount and, by 2015, healthcare professionals will be fined for not using these technologies, according to the government.
Not surprisingly, the lure of millions of dollars is generating interest from all corners of the IT community. Microsoft CEO Steve Ballmer, for example, spoke recently at the Nashville Healthcare Council’s annual breakfast meeting. Other speakers included top-level execs from Dell Perot Systems, Emdeon, Vanguard Health Systems, and Allscripts. Microsoft — which acquired several healthcare IT firms over the past 12 months, including its most recent acquisition of Sentillion — also hosted a one-day series of meetings in a Microsoft Health Users Group Exchange at the Healthcare Information and Management Systems Society’s confab and included comments about healthcare during the keynote at the Consumer Electronics Show.
“The potential savings are enormous — tens of billions of dollars a year,” Ballmer told the CES crowd. “Even more important are the opportunities to improve care and reduce errors by giving consumers access to their own health care information, while ensuring that doctors can quickly see the patient information they need to make the best patient care decisions -medication history, test results, and evidence-based treatment recommendations — based on the most current research for a given medical issue.”
The Facts — Stat
EMR adoption already is increasing, but there is room for more expansion. In 2009, 44% of office-based physicians used some form of EMR, according to the Centers for Disease Control’s National Center for Health Statistics. That’s up from 24% in 2005.
Last year, about one-fifth of those polled use EMRs with features such as clinical notes, lab results, and prescription orders, while only 6% use fully functional EHRs with capabilities including digital reminders, drug interaction alerts, and electronic order transmissions.
When it comes to the as-yet undefined “meaningful use” criteria, 32% of hospitals claim to meet that evolving standard, a Computer Sciences Corp. study found. Large hospitals represented 49% of those meeting the standard, while 30% of midsize and 16% of small hospitals claim that status.
Out with the Old?
Since healthcare providers — from the largest hospitals to sole practitioners’ offices — must invest in EMR and HIE software solutions, many also must invest in hardware, better networks and enhanced security tools. This, then, could generate demand for Windows 7 and third-party applications.
But physicians and hospital administrators do not really care which OS is running their IT machinery. They just want to be sure the systems work, integrate, and keep data secure. Some will rely on in-house systems, some will rely on their larger medical partners such as regional hospitals, and some will depend on a SaaS partnership to power their technologies.
Although a viable Microsoft OS alternative will not exist soon, the past may haunt Microsoft, says Emil Novélo , a veteran of the healthcare IT industry and founder of EMRtechBiz. Despite Windows 7′s rave reviews, some medical professionals are wary after experiences with Vista sent them scurrying back to Windows XP.
“Many institutions are still using XP. It’s still working. It has a web browser. They can access what they need,” says Novélo. “Vista made large medical centers gun-shy. It was very difficult and many organizations went back to XP.”
Microsoft’s marketing muscle, advertising dollars, and breadth of third-party applications should ease some of these concerns. If EMR and HIE developers fully enable compatibility with XP, that could slow Windows 7 adoption, although end-of-life security concerns should counter complacency.
In addition to ensuring the confidentiality of patients’ records on-site, the Department of Health and Human Services expanded the Health Information Portability and Accountability Act (HIPAA) to expanded HIPAA to EMR vendors and related groups such as those businesses that transmit EMRs within HIEs, e-prescribing organizations and labs. It’s hard to imagine that these organizations will entrust patient data to an elderly operating system. And it’s equally easy to imagine that medical professionals will be encouraged to acquire Windows 7 to ensure end-to-end security, compatibility and maximum use of the data housed with EMRs and HIEs. If their large hospital partners buy into Windows 7, it is likely that smaller practices will follow suit to ensure 100% compatibility, compliance, and support.
“It’s not so much technology; it’s the liability of having so much patient information,” Novélo says.
This could bode well for the adoption of Windows 7 and its inclusion of BitLocker, which protects sensitive data on internal and external drives; AppLocker, which prevents unauthorized software running on PCs; and Windows 7’s Encrypted File System to safeguards private information.
A Touchy Subject
Microsoft and its partners could assuage update worries, something they’ve successfully accomplished in other vertical markets. To push, rather than pull, demand, the technology industry should create applications and devices that truly deliver a benefit that requires Windows 7, Novélo says. Solutions that fully leverage Windows 7′s touchscreen capabilities would succeed in time-pressed, often typing-shy healthcare centers, says Novélo.
“Microsoft has to come out with a touchscreen to compete against the iPad,” he notes. “Medical professionals are not going to walk around, keying in information.”
However, unlike the latest member of Apple’s iFamily, Microsoft’s technology does not force a doctor to use multiple products. Instead, medical professionals can tap one device for their notebook, tablet, and touchscreen.
Microsoft also is focusing part of its Surface touchscreen efforts on the healthcare industry, recommending the solution as a tool to improve patient relationships and enhance collaboration in an emergency room or medical center. Windows Touch — available in Windows 7 Home Premium, Professional, and Ultimate editions — enables users to page flick through pages of documentation, zoom into medical images, and open a new file with only the fingers.
These features are attractive to Texas Health Resources, a 13-hospital business, that is working with Microsoft to build healthcare applications that use the developer’s multi-user, multi-touch Surface computers. Microsoft is investing heavily in Amalga and HealthVault, using both organizations to encourage the adoption of its software and touchscreen technologies in the healthcare arena.
Surface also could “be immensely important to clinical workflows demanding a more hands-free, no-touch solution such as might be desirable during surgery or certain medical procedures,” Dr. Bill Crounse, worldwide health director at Microsoft, writes in his blog.
Handwriting recognition in tablet PCs — which have enjoyed early success in the medical community — get a boost from Windows 7. As the OS learns a practitioner’s writing habits, it learns and improves. This also is the case with the software’s speech recognition skills. “I just talk to my machine and it does what I want, from opening applications to dictating a letter,” Crounse says.
Spurred on by smartphones and the iPad, IDC predicts more than 1 billion mobile devices will access the Internet by the end of the year. Surely tablet PCs with business or healthcare-specific applications could be another major factor in the expanding market for mobile devices?
A Healthy Outlook
It may suffer some bumps and bruises, but the healthcare community is on a fast-track to expanded IT adoption. The promise of improved patient care, enhanced productivity and cost savings, coupled with the government’s heavy hand, will spur implementation at most medical facilities in the nation. With its simpler interface, additional yet less onerous security, touchscreen and voice recognition technologies, Windows 7 could be the cure-all for many physician’s IT ills.
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