Whether it’s the controversial public option, long-term costs to taxpayers or so-called “death panels,” health care reform has taken its place as the most divisive topic in politics.

As the debate rages on in Washington, D.C., those who stand to be most affected — patients, physicians and major health care providers — remain on the sidelines, waiting to see how the final product will look before it reaches President Obama’s desk.

Almost as uncertain as the structure of the bill is its timing, and health organizations nationwide are already making preparations for any large-scale changes that might come their way. Medical records are going electronic, and coordinated efforts among health care professionals are flourishing. But many hospitals are unwilling to speculate on just how different things might be if and when health care reform is passed.

“As the ever-changing debate over health care reform evolves, we continue to monitor the situation,” said Rachel Robinson, spokeswoman for Parker Adventist Hospital. Centura Health, Colorado’s largest health care provider, is “eager to see how these changes will impact the health care system, our hospital and community.”

Representatives for Sky Ridge Medical Center and Swedish Medical Centerl declined to comment for this story.

It is difficult for officials at each medical facility to keep an eye on the health care discussion while sorting through the rhetoric that often dominates headlines. That’s where Steven Summer comes in. As the president and chief executive officer of the Colorado Health and Hospital Association, it is his job to make sure every health organization in the state is aware of the benefits, or in some cases, ramifications of changes to the system. Just as important is consistency, essentially making sure everyone is one the same page. That part, Summer says, could take years to implement.

The technology piece is moving along before any final decisions are made in health care reform, with computer advancements being a natural progression as hospitals transition into the future. Perhaps the largest impact on hospitals is the potential flood of new patients who were previously uninsured or underinsured.

Sweeping changes to existing payment systems are possible, including an all-inclusive — or bundled — payment instead of paying physicians on a fee-for-service basis, Summer said. Doctors are often on a separate payment delivery system than the hospital, and some facilities are now bringing physicians onto the payroll “in anticipation of what might happen,” Summer said.

Bolstering communication among physicians is key to comprehensive treatment and limiting the number of office visits for each patient.

“It could be coordinated care post-hospital,” Summer said. “Those discussions are ongoing and whether or not something comes out remains to be seen.”

The changes could also necessitate an increase in patient responsibility and education so doctors and nurses are not expected to carry the entire load. But physicians are seen as the first line of defense in making sure the patient is properly cared for. Under the current, fractured system, the patient is “no one’s responsibility” and most doctors treat individual symptoms without conferring with, for example, the patient’s regular practitioner. Patients can become confused about the relation between medications or the reasons behind a particular method of treatment.

The Colorado Health and Hospital Association is often tasked with providing input for discussions on Capitol Hill, and state congressional members will ask Summer for his opinion on certain components of bills that are in the process of being drafted.

Summer regularly keeps in touch with his federal contacts and notifies CEOs, senior management and boards of directors of any changes that might directly impact their organization. He speaks to nursing directors, patient safety directors and chief medical officers, and reads daily updates on the debate in Washington. Summer also speaks publicly at health care forums and summits to inform the public about specific impacts on Colorado.

The debate is far from over, but local officials are making sure proper steps are being taken to ensure Colorado is in a good position to undergo potentially widespread changes.

“It’s going to be complicated to implement, but it will all have to be sorted out at some point,” Summer said.

“It’s going to be complicated to implement, but it will all have to be sorted out at some point.” Steven Summer, president of Colo. Hospital Assoc.