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Much like the old real estate adage — location, location, location — hospital leaders seem to understand what they'll need to survive as the delivery system transforms."Data, data, data … the more we understand, the better off our decision-making can be on what areas we really dedicate attention and resources to," says Roger Neal, vice president and chief information officer, Duncan (Okla.) Regional Hospital, a 122-bed rural hospital.

Fifteen years ago, H&HN launched the Most Wired Survey and Benchmarking Study as a national inventory on hospital use of information technology to improve operations and patient care. Hospitals and health systems participate in the program to see how they compare with other organizations nationwide, learn from the best and get recognized for their achievements. One-third of the Most Wired organizations report using the benchmarking studies as documentation for other award programs such as the Malcolm Baldrige National Quality Award. Not surprisingly, 10 of the 16 hospitals and health systems that have received the prestigious Baldrige award are Most Wired recipients as well.

Coincidentally, this is also the 15th anniversary of the patient safety movement. In 1999, the Institute of Medicine released "To Err is Human: Building a Safer Health System" with the goal of reducing preventable medical errors. The medication process was pinpointed as an example of where better systems can yield better human performance, especially implementing automated medication order entry systems. Today, 69 percent of Most Wired hospitals report that medication orders are entered electronically by physicians, a significant jump from 2004 when less than one-third of Most Wired hospitals had implemented computerized physician order entry.

Back in 2007, before the HITECH Act was signed into law to promote the adoption and meaningful use of health information technology, Most Wired hospitals were struggling with real-time quality reporting alerts and alert fatigue. Nearly 60 percent of the Most Wired already were performing drug-to-drug interaction checks. The transition to the electronic health record had begun and with that came the need for a robust infrastructure to ensure its availability: 91 percent of the Most Wired organizations could restore clinical information systems operations within 72 hours in the event of a disaster in which the primary data center is wiped out. Today, this is a requirement for Most Wired organizations and 84 percent are now equipped to restore data within 24 hours.

The building blocks in Stage 1 meaningful use may be set, but even the Most Wired are struggling with Stage 2 and interoperability. "Hospitals are swamped just trying to meet their own requirements. The timelines are tough to make, and I think the ability to truly share data is lacking because of it," cautions Neal. "As the Affordable Care Act roles out, IT will play a major role in how organizations meet or fall short of the challenges ahead. It will be a necessity for IT to identify and manage patient populations, drive down costs across the continuum of care, and manage all aspects of the business with greater intensity.  The ability to weather the cuts is not in massive growth across the organization. The ability to weather is in our data."