In a conversation I had with Steve Prather, CEO at Dizzion, he made a really interesting observation about meaningful use causing delays in upgrading infrastructure at many healthcare organizations. It’s not hard to see how spending millions, hundreds of millions or even billions of dollars on EHR and related services in order to meet the meaningful use requirements could cause budget cuts in other areas like upgrading infrastructure.
Of course, the opposite can be true as well. I know when we first implemented an EHR, a good portion of the EHR budget was to upgrade some of the infrastructure needed to support the new software. I’m sure that probably means that some infrastructure benefited from the EHR upgrade and meaningful use, but I’m sure some infrastructure spending also got cut or delayed.
In my conversation with Steve he went on to observe that much of the hardware in healthcare organizations had gotten so old, indecision and delays were no longer a choice. Having talked to many CIOs, they feel this in their organizations. While many CIOs want to move on to more strategic efforts, there’s still a big part of any CIOs job that requires them to maintain and upgrade their IT infrastructure. Although, it seems that many of them are looking to push this responsibility off to a kind of IT COO position.
I’ll be interested to watch and see how these organizations approach their infrastructure upgrades. Will most continue to do all the work in house or will they start to outsource this essentially commodity task to an outside company? There’s a really interesting case for why organizations should outsource this work as opposed to continuing to do it in house. All of this points back to the CIO becoming a vendor management organization.
Has your infrastructure upgrades been delayed by meaningful use? Is your organization looking to finally upgrade or is MACRA going to delay things further?
When you say “infrastructure,” do you mean computer hardware? If so, how much do a few computers cost in relation to the extremely expensive equipment that health care organizations need to deliver care? I believe that, for most modern organizations, the ever-decreasing costs of computer hardware are quite manageable in relation to other costs. Software is generally getting cheaper, too, everywhere except health care, thanks to free and open source software and improved programming practices. Cloud computing offers another option, although not necessarily a cheaper one.
Yes, it’s generally computer hardware, but could be other IT infrastructure investments as well. Relative doesn’t matter too much when you’re fighting for budget. At least not relative to other purchases. The cost matters relative to what you paid before and the cost of waiting. I think computer prices have stayed relatively steady the past couple years. Although, that’s just my gut experience. I wonder if there’s a study out there that shows. Either way, many computer budgets were cut because of other MU expenses. We’ll see if they start making those purchases now.