August 24, 2008

Physicians debate value of ‘Most Wired Hospitals’ survey

BY Dr. Keith J. Kaplan
Healthcare IT News
07/17/08
In a lively panel session Wednesday at the 2008 Physician-Computer Connection Symposium, physician IT leaders discussed the importance of the "Most Wired Hospitals" list – which is based on the annual Most Wired Survey and Benchmarking Study – and disagreed about whether such rankings are useful or simply a marketing tool for hospitals.

"Just how dangerous is this report?" asked William Bria, MD, chairman of the AMDIS board of advisors and chief medical information officer at Shriners Hospitals for Children.

Bria speculated that hospital CEOs and boards of directors might mistakenly believe that the simple installation of healthcare IT would lift quality in a hospital.

"The most wired hospital isn’t necessarily the best decision-making organization," he said.

The Most Wired Survey and Benchmarking Study is conducted annually by Hospitals & Health Networks magazine. In addition to the "100 Most Wired Hospitals and Health Systems" list, the magazine releases lists of the "25 Most Improved," the "25 Most Wireless" and the "25 Most Wired – Small and Rural" hospitals. According to the magazine, the lists are based on a detailed scoring process of the self-reported survey data.

The survey asks hospitals to report on how they use information technology to address safety and quality, business processes, customer service, workforce and public health and safety. This year, 556 U.S. hospitals and health systems completed the survey, representing 1,327 hospitals overall.

The results of the Most Wired survey tend to reflect positively on the overall image of the hospitals making the list, said Turner Billingsley, MD, of the McKesson Corp., which partners with Accenture, the American Hospital Association and the College of Healthcare Information Management Executives to support the survey.

Paul Clark, MD, an internist and member of the clinical informatics team at Concord Hospital in Concord, N.H. , said that while it is probably true that information technology is necessary for clinical improvements, it is not sufficient, and more evidence linking IT use and quality improvement was necessary.

"Information technology alone does not transform care," Clark told the AMDIS 2008 attendees. "There is a danger in interpreting this survey in a way that suggests that IT led to these results. What really makes the difference is having an institutional focus on transformation."

Clark said he believes IT will make a quality difference "in the long run," but that hospitals looking for short-term financial benefits will be disappointed. In fact, he suggested, the most financially secure hospitals will implement IT successfully, while institutions short on funds tend to have difficulty.

Talk of money led some physicians in attendance to suggest that the 100 Most Wired list is simply a marketing ploy for hospitals, and that it offers data that’s of little use to the industry.

"Hospital executives like this survey because it’s a good marketing tool," one physician said. Another attendee agreed, suggesting that hospitals only participate in the survey because they know that it can be used for marketing purposes.

One physician speculated that a possible way to avoid critiques about the survey’s integrity would be for Hospitals & Health Networks to take a "Consumer Reports approach" and not allow survey participants to use the Most Wired label in marketing material.

After hearing this comment, a handful of chief medical information officers admitted that their hospitals would probably not participate in the Most Wired survey if they were not allowed to use the results in marketing campaigns.

Alden Solovy, editor of Hospitals & Health Networks, defended the data in the Most Wired survey, while acknowledging that there might be room for criticism.

"If there is a weakness in the survey, it’s that we have combined an awards program with a benchmark," he said. "But the survey wouldn’t have reached the visibility it has without the awards and ranking aspect. The numbers assigned to the hospitals represent the differences between organizations – they don’t represent anything ‘real.’ And we do use verifications to try to take the gaming out of the responses."

Solovy admitted that large, urban and teaching hospitals tended to have higher participation in the Most Wired survey, but said the sample generally reflected the profile of U.S. hospitals.

What do you think of the survey? Is it valuable, or just a marketing tool? How would you improve upon the process? Send your comments to Associate Editor Richard Pizzi at richard.pizzi@medtechpublications.com.

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