Two items of note early this week:

Suzanne Sataline’s article in the August 30, Wall Street Journal proffers a bleak situation for public hospitals. Pinched by cuts in federal aid, a tight credit market that makes getting money difficult, a precedent for offering free or limited-pay services, and limited resources because of a lack of economies of scale, public hospitals run by local governments or non-profits are vanishing.

Compounding this pinch is the on-going, deepening debt caused by rising healthcare costs, payments on bonds floated at flusher times, cuts in Medicare/Medicaid, and an increase in uninsured patients. Two solutions seem most prevalent: close down or sell to for-profit agencies who are betting the HITECH Act will be a boon that will result in more insured, paying customers. These private groups target public/non-profit hospitals that are finding little recourse but to sell to the highest bidder in an attempt to keep healthcare nearby for their citizens.

This trend is alarming because more than 20% of all US hospitals are owned by governments; and non-profit hospitals, often affiliated with religious denominations, comprise nearly 60% of all US hospitals. While meaningful use compliance looms before these hospitals, a potential lack of healthcare threatens the local populations. Stay tuned.

The second item bates the breath as well:

Boston-area researchers Ashish Jha and Catherine DesRoches along with Chicago-based healthcare stakeholders Peter Kralovec and Maulik Joshi released sobering findings about the speed and spread of hospitals adopting MU-compliant IT. The report is available at policy journal Health Affairs, and its abstract is here. Joseph Conn, staff writer for HealthCare Business News, has clearly analyzed the numbers and offered an objective explanation of the survey’s meaning. His article can be found here.

The skinny? For healthcare providers on the road to Meaningful Use, it seems detours are everywhere and are being followed -- in effect, keeping the ultimate destination at bay.

Individuals make laundry lists, “honey-do” lists, grocery lists and task themselves to follow. Consumer rags present “best seller” lists, “sexiest man/woman on earth” lists, “cheapest vacation” lists that divert the attention from those “tasked” individuals. Business magazines publish success lists, “The Fortune 500,” “Top 100 Most Innovative Companies",”Top 100 Franchises" on which companies aspire to appear.

The world runs on lists! Tongues wag over lists. Controversy starts (and, sometimes, ends).  Bragging commences.

And that’s what we’re doing here. Bragging. Not only has VCS landed on the 2010 Inc. 500/5000 list as one of the fastest growing, US-based, independent, private companies (#1597), but we’ve done it for 4 years in a row. A cynic would cite healthcare reform mandates as catalyst for driving VCS’s fortune; but a realist would cite the lingering recession as evidence that, unlike other B2B businesses, VCS continues to experience 3-digit annual revenue growth.

We must be doing something right.

So, we’ll thank our clients for their confidence in us and brag about our vision: to provide exceptional service and maintain unparalleled customer loyalty by providing high-quality, cost-effective solutions while acting with integrity at all times. And we’ll thank our employees for their effort and brag about the second half of our vision: to maintain a culture that cares about our people, their families, and the communities in which they live.

All the survey’s numbers for VCS can be found here. Insights, trends, and commentary associated with the entire Inc. 500/5000 can be found here.

In the rush to follow ARRA’s final meaningful use marching orders, many healthcare providers have been swallowing their fiscal tongues. While the overall incentive pie sounds HUGE, respective slices may only account for 20% or less of EHR-implementation costs. With MU-compliance project costs estimated at $80,000 - $100,000, a CFO – after sharpening a pencil – might plunge it into the organization’s CIO – or its D.C. politicians.

At first blush, the numbers don’t add up and the chasm between project expense and incentive reimbursement might make the less hearty healthcare administrator swoon. But McKinsey’s authors’ assessment, prognosis, and prescription clearly demonstrate the long-term efficiencies and profit of implementing EHR.

The report’s lessons - establish unequivocal governance of the project, streamline decision-making, simplify IT architecture, and embrace mega-project management capability – dovetail with VCS’s mission and best-practices. So, we’re feeling pretty good after reading McKinsey.

You can too. Here’s the report. 

You’ll need to free-register to get entire text.

What’s that low thrum? It’s the sound of the “meaningful use” definition” fading in the distance as healthcare providers now scramble away to put pieces of the EHT compliance puzzle into position. But wait! What’s that shrieking bleat ahead? “EHR PRIVACY,” the next issue du ARRA. The DHHS-convened Tiger group will command the headlines and attract legitimate attention over the next few months especially as the public comment period for proposed modifications to the HIPAA Privacy & Security Rules ends September 13, 2010.

The latest from the Tiger Group’s progress is succinctly captured by Modern Healthcare.com and Healthcare IT New.com. Follow these links to learn the most recent developments.

Tiger Group's EHR Privacy Conundrum: Modern HealthCare News

Privacy and security recommendations approved: Healthcare IT News