The federal stimulus incentives to adopt health IT are a "nice add-on," however they are not driving hospitals' overall IT initiatives, hospital executives said last week at a healthcare summit here.

Scott Whyte, senior director of Catholic Healthcare West's physician and ambulatory IT strategy, said CHW is not using the American Recovery and Reinvestment Act (ARRA) to set its IT goals. Executives at UMass Memorial Health Care and University of Pittsburgh Medical Center said the same.

While CHW has done cost and benefit modeling analysis on ARRA and provided commentary on the Centers for Medicare and Medicaid Services' definition of meaningful use, ARRA is not driving the healthcare system's IT schedule, Whyte said.

CHW's IT adoption and community interoperability efforts are "good for CHW and our patients," he said. CHW's EHR Alliance Program is focused on health outcomes, operational excellence and service, he added. Thus far, seven out of its 41 hospitals have comprehensive electronic health record systems, including CPOE. The eighth is scheduled to go live in October, and more than 80 percent of orders are through CPOE, Whyte said.

More than 300 physicians in CHW's multiple markets use the EHR. "This is not just an e-filing cabinet," Whyte said. "There is widespread and deep use of the system."

The fundamental goal of UMass' HIT Strategic Initiative 2009-2015 is to move from a predominantly paper to a primarily electronic core ambulatory electronic medical record, said Richard Cramer, senior director of HIE and ambulatory integration.

While UMass was 10 years behind in IT implementation, the health system understood the business requirement to develop an IT strategy, he said. UMass has studied ARRA closely and may move up certain functionalities such as CPOE on its implementation schedule. Adjustments aside, Cramer said, "We're doing it beyond the federal dollars."

If UMass were to meet the ARRA requirements, it could receive up to $20 million in federal stimulus funds. The initiative, however, would cost UMass approximately $100 million over five years, he said. Ultimately, the goal of implementing an EMR system is for quality outcomes, Cramer said.

UPMC assessed its existing IT systems and determined that it needed to seek solutions that met its goal of having a "complete patient picture," said James Venturella Jr., CIO of UPMC's Hospital and Community Services Division.

The ability for UPMC's systems to be interoperable has made a positive clinical impact, including increasing efficiency of care in the form of a 50 percent improvement in patient readiness for the OR, he said.

"A well-implemented, well-designed interoperability solution that delivers Web-based, actionable, organized information to the point of care can deliver return on investment opportunities" in the areas of cost savings, cost/loss avoidance and revenue expansion, he said.

The health system's future goals include developing "game-changing applications," among other IT innovations and integration projects, he said. UPMC is "well positioned" to meet requirements to obtain ARRA funding and achieve its interoperability goals, Venturella said.