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Record spending on health information technology is greatly increasing the demand for experts in the field and tops a list of hot issues on the minds of healthcare leaders.

That's according to a survey and report by PricewaterhouseCoopers Health Research Institute, which ranks the top 6 issues facing healthcare leaders in the coming year.

 1.Electronic health records. PwC says federal requirements that hospitals and doctors meet at least one stage-one meaningful use requirement for an electronic health record system  in 2011 in order to receive federal stimulus funds has providers scurrying to order the right software and equipment.  Additionally, FDA rules will require online reporting of adverse events related to medical devices, resulting in deployment of tracking technology throughout the supply chain.
Electronic health record conversion also means upgraded coding, and the use of the new Health Insurance Portability and Accountability Act formats require more than, 1,300 system modifications by Jan. 1, 2012.

2.  Health insurance. Redefining medical loss ratios and insurance exchanges.
Insurance plans are now required to spend 85 cents of every premium dollar on medical care and healthcare quality improvements and if they spend less, they have to issue rebates to their customers.  How will insurers then price their products?  Some are opting to pay out the rebate rather than underprice their products in the first year.

3. Accountable care organizations. The next big thing?
PwC says that whether doctors and hospitals can align to make ACOs improve care and reduce cost depends a lot on Congressional action, how the regulations define what an ACO is and is not, and also depends on whether consumers will buy into them. Consumers may not be willing to seek all their care in an ACO, or make the required commitment to stay healthy.

4.  A reduction in consumers seeking healthcare.
During the recession, many consumers delayed or avoided going to the doctor or having procedures they thought they could put off. That trend is exacerbated by higher health insurance premiums, steeper deductibles and larger co-pays, and the increases are not expected to end now.
PwC "forecasts a trickle-down effect, starting with physicians and pharmaceutical companies as consumers reduce office visits and drug spending, followed by reduced sales of other medical products, fewer lab tests, imaging scans an other diagnostics."

5. Mergers and acquisitions of healthcare organizations.
PwC projects strategic mid-market transactions between $100 million and $500 million. It also sees agreements aligning physicians with hospitals, and hospitals with other hospitals and health systems. In an interesting twist, consumers responding to a PwC survey said they are wary of mergers and acquisitions, but are amenable to retail clinic partnerships with hospitals for primary care services and medication prescriptions.

6. "Always on" healthcare
Mobile health and wireless technologies are connecting patients with their doctors and nurses anytime anywhere, the PwC report says.  Healthcare organizations " are spending tons of resources to produce online content, yet PwC found that consumers are 3.5 times more likely to go to the media and third-party sources for information about treatments and conditions than anywhere else, and they are especially unlikely to visit a pharmaceutical company site to learn about medication.

The annual PwC report was based in part on a fall survey of 1,00 consumers to get their perspective on a variety of health reform topics, including usage practices and payments.  The PwC institute issues periodic reports on perspectives and trends throughout the healthcare industry dealing with issues for providers, pharmaceutical companies, health and life sciences and payers. The full report may be viewed here.

- by Cheryl Clark，senior editor，HealthLeaders Media Online.