Prelude to HIMSS -- follow the money, especially Medicare

On this eve of the annual meeting of the Healthcare Information and Management Systems Society (HIMSS) in Orlando, I'm meditating and getting myself prepared for the next three days at the Orange County Convention Center.

I've attended at least 14 annual HIMSS meetings, so I've come to expect the following: acres of HIT real estate to traverse (thus, comfortable shoes trump anything remotely looking like this Manolo Blahnik, left); overhead signs competing for mindshare (usually paid for by Fortune 100s, the grand HIT players, and those wanting to make a New Big Splash); and, of course, a dose of hype depending on the application.

At 10 am, I will attend the HIMSS press brunch which launches the organization's annual survey of CIOs: their concerns, plans and spending patterns for HIT for this year and next. I have already interviewed representatives from HIMSS and Cisco (the study's sponsor) to discuss the results, about which I will say more tomorrow after the embargo is lifted.

But tonight, there is an underlying theme I want to lay out as we ponder health IT for 2008 and beyond: how to finance the stuff?

We who work with and in health IT talk about financing a lot, of course, and have for years. But this year, with the economy in or near recession, and with the current President in the White House, I've a strong feeling that money for buying HIT will be tight. While there are so many imperatives driving CIOs to invest more in health IT -- from medical error reduction to meeting consumer demands -- capital for doing so will be scant (or at a minimum, scant-er).

Why? Medicare. Last week, President Bush has already announced a budget cutting hospital funding for fiscal year 2008. The President proposes cuts in Medicare and Medicaid spending by $196 billion over five years, with hospitals in the bulls'-eye of the reductions.

Hospitals are a primary target audience attending HIMSS. HIMSS is akin to a shopping mall with stores featuring every conceivable aspect of health IT: from "A" (accounts payable) to "X" (XML toolkits for web development). And hospitals are in an increasingly tough capital environment, according to Fitch Ratings' report on non-profit hospitals published in January 2008.

Health Populi's Hot Points: It is no small irony that President Bush, who vowed in his chicken-in-every-pot moment to get every American an electronic health record by 2014, continues to cut into the flesh of hospitals. I will be following the money over the next three days at HIMSS, and reporting out to you what I learn through this journey.