While many healthcare providers are scrambling to apply the new Meaningful Use guidelines to their practices in order to qualify for HITECH incentives, RECs charged with assisting providers may want to look beyond financial incentives to other factors that support or inhibit organizational change.
That’s at least one conclusion that can be reached via a recent article by an associate professor in the Department of Health Care Organization and Policy at the University of Alabama at Birmingham.
In his eyes, HITECH’s emphasis on financial incentives may be a matter of too many eggs in one basket. As he puts it, “strategic management theory suggests that organizational strategies (including, for example, EHR adoption) are heavily influenced by the environment and local context of an organization -- not just finances. Failing to address barriers in the environment may unnecessarily attenuate the overall impact of the meaningful use program, which disproportionally (sic) addresses financial, and not environmental, barriers.”
From there, he briefly cites a number academic studies that look at the “environmental conditions” that impact an organization’s ability to change. One study, for example, “found that hospitals in markets characterized by increased uncertainty -- measured by relatively large fluctuations in historic unemployment rates -- were associated with an increased likelihood of EHR adoption.”
That same study “also found that hospitals in areas with greater availability of human and capital resources . . . were more likely to adopt EHRs.”
At the same time, a study of which he was an architect “found that certain environmental characteristics (e.g. munificence, level of competition and degree of dynamic change) significantly predicted whether a hospital was pursuing a "best-of-breed," "single-vendor" or "best-of-suite" health IT adoption strategy.”
“Collectively,” he concludes, “all of these studies demonstrate that the environment and local context of an organization influences health IT-related strategies among both hospitals and physician practices.”
So how should these studies guide a provider’s decision-making process? In broad terms, “rather than hastily adopting expensive technology for quick short-term gains, organizations should apply strategic management tools to best incorporate the context of their local environment into their strategy for adopting EHR and achieving meaningful use.”
Such advice may sound a bit academic to providers scrambling to keep their practices running while deciding to how to implement wholesale HIT change. But it seems that RECs should be able to take advantage of what these studies concluded.
After all, RECs are designed to work in an advisory capacity, so it may fit more neatly within their purview to step back and make the kind of “environmental” analyses these studies recommend.
At the very least, REC advisors should have more than a passing familiarity with the full range of factors which can determine how successfully a healthcare provider can make the jump to the next generation of HIT. When viewed in that light, the studies this academic cites seem like required reading.
Jeff Rowe blogs daily at HITECHWatch.
