David E. Garets, president and CEO of <a href="/directory/himss-analytics" target="_blank" class="directory-item-link">HIMSS Analytics, says that while there's certainly still a long way to go, providers across the country "are making significant progress in a whole bunch of places" in the implementation and effective use of healthcare IT.

Speaking on a conference call Wednesday that aimed to highlight "trends, glimmers, and opportunities in the healthcare market," Garets compared data from 2005 and 2009 that showed a steady uptick in IT adoption over the past five years. And he looked forward to some exciting developments on the horizon.

For starters, he noted that back in 2005 just 18 percent of hospitals reported an increase in their health IT budgets. Conversely, by the end of 2009, he said, that number had leapt to 52 percent. Going forward, with meaningful use now defined and the economy thawing (albeit slowly), Garets said that it "will be very interesting to see these numbers over the next few quarters."

Anticipates budget increases

Garets indicated that he sees those trends only continuing. "I would be really, really surprised if healthcare organizations don't significantly increase their budgets over the next five to 10 years," he said. "For those who say, 'we're not making much progress,' you're not in full possession of the facts."

As an example, he cited new numbers on EMR adoption in the United States. Barely four years ago, at the end of 2005, "things weren't good," Garets said. Half the hospitals in the country were at Stage 2 of HIMSS's EMR Adoption Model. "There were no Stage 7s, no Stage 6s, just a couple Stage 5s, and there weren't a significant number of Stage 4s."

But by the end of 2009, 0.7 percent of hospitals had achieved Stage 7, 1.6 percent were at Stage 6, and 3.8 percent were at Stage 5. Meanwhile, three times as many providers were at Stage 4 than in 2005, and five times as many were at Stage 3. Clearly, there's been "significant process implementing EMRs," said Garets.

Stage 4 will be critical

A good thing, too, because "we think organizations are going to have to be at Stage 4 in order to have the tools in place to meet the specifications for 2011. For 2013, you'll need to be at Stage 5, and you need to be at Stage 7 by 2015."

That last number, he said, "is where we're going to have some issues. Thirteen percent of the hospitals in the country are [currently] at Stage 4 and above. All the hospitals in the U.S. getting to stage 7 by 2015? That's pretty ambitious."

CPOE adoption

Another area that's making some progress but still has ground to cover is CPOE adoption. Garets noted a statistic that he found "kind of entertaining." In 2005, 13.44 percent of hospitals reported that they'd contracted for CPOE platforms but hadn't installed them yet. At the end of 2009, that number was 13.87 percent. "If they had it on the shelf back in 2005," he surmised, "they've still got it on the shelf."

Garets also expressed surprise that in 2005, just 31 percent of academic medical centers had CPOE implemented. "That meant that 69 percent didn't," he said. "That was a real eye-opener for me." By contrast, the number for community hospitals that same year — just nine percent — was still low, but understandable. In 2009, those numbers have jumped to 61 percent and 22 percent, respectively.

Garets said he was especially excited about "glimmers" — which he called "really cool ideas [that] will happen, but just aren't happening yet."

Among them, he cited RFIDs, "way cool technology" that will nonetheless not be in widespread use for another three to five years, having to become "more standardized, less expensive, before healthcare takes advantage of it."

Garets also highlighted data warehousing, data mining, and business intelligence tools as capabilities that "every hospital and health system in the country is going to need … in order to really get to meaningful use regulations."

Ambulatory EMR services, infrastructure (storage and disaster recovery),  and revenue cycle applications capable of next-gen functionality were other  next-big-things, Garets said.

But he singled out privacy and security — and all the provisions thereof that will need to be met — as an issue that he saw "kind of laying low … it's going to raise up, and it's gonna scare a whole lot of people."

Hospitals, he said, "need to be prepared. The number of organizations with chief security officers is going to go up. You've really got to pay attention to this space."