The Strategy—the Only Strategy

April 11, 2013
I had a hard time finding hospital CIOs to talk about chronic disease management. Well, it suddenly dawned on me why: Most CDM takes place in the primary care setting.

I had a hard time finding hospital CIOs to talk about chronic disease management. Well, it suddenly dawned on me why: Most CDM takes place in the primary care setting. Duh.

Why should that be such a problem? Bad or non-management of CDM often lands these patients in the hospital (or back in the hospital) —needlessly. Isn’t the hospital’s job to make sure this doesn’t happen? This isn’t just an opinion--the way things are looking in Washington, this hospital-centric model is going down the tubes, fast. And it made me stop to think about the CIOs I talk to, all the time. What is their ultimate IT strategy?

If it doesn’t include primary care, that CIO is living in the past.

Unfortunately, for the majority of CIOs I talk to, their IT strategy is mostly about hospital-centric IT—an EMR, CPOE, EDIS, PACS. Sure, there are places where CIOs are doing great work linking their community docs in a variety of ways, including HIEs. And of course, IDNs like Kaiser et al have been doing this for years. But mostly, these hospitals are the exception.

Now, I know our CIOs have a lot on their plates right now. In too many cases they are just trying to keep the dike from breaking. But HITECH dollars are on the table already. Are you thinking about using them to link primary care to your hospital?

If primary care is not at the top of every IT strategy meeting you hold, I think the strategy is doomed.

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