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Creating a Culture of EMR Adoption

February 7, 2011
by Mark Hagland
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Interview: Kristin Ficery, Management Consulting Senior Executive, Accenture Health

A new survey of CIOs from 15 leading hospitals and health systems nationwide is confirming what numerous industry experts have been warning for some time—that achieving meaningful use under the Health Information Technology for Economic and Clinical Health (HITECH) Act will likely prove far more difficult, expensive, and time-consuming than most healthcare IT leaders in provider organizations may be anticipating. Kristin Ficery, senior executive in the health practice at the New York-based Accenture, and her colleagues, have produced a report based on the survey of leading-organization CIOs.

Among other conclusions in the report:

  • “Most of the health systems in our benchmarking study underestimated (by nearly 100 percent) the time and costs associated with implementing advanced EMR functions, including clinical order entry, nursing and physician documentation, clinical decision support and bar-coding medication.”
  • “IT operating costs will spike, and managing them requires leadership alignment and patience. Benchmarking shows that hospitals experience an 80 percent increase in their IT operating expenses while transitioning to EMR.”
  • “The war for health IT talent is on. There is a significant shortage of qualified health IT professionals to meet the demand associated with EMR implementation and support.”
  • “Supporting EMR means thinking differently about capability and operating model needs… The average hospital had to increase the number of FTEs focused on healthcare IT support by 45 percent as it reached mature levels of functionality and adoption.”

Ficery spoke recently with HCI Editor-in-Chief Mark Hagland regarding the survey and the conclusions of the report that she and her colleagues based on the survey. Below are excerpts from that interview.

Healthcare Informatics: How many people were surveyed?

Kristin Ficery: We interviewed 15 CIOs of leading academic medical centers and community hospitals across the country; these were large, integrated systems—in terms of operations, they represented from $1 billion to $14 billion in annual revenues. They were marquee-name health systems. Our goal was to interview those organizations that are further along [in preparing to achieve meaningful use], so that they could provide lessons learned for those not quite as far along.

HCI: When were the interviews conducted?

Ficery: Between April and August 2010.

HCI: In your report, you and your colleagues determined that fewer than 1 percent of U.S. hospital-based organizations were “mature” when it came to EMR development. How did you define “mature”?

We used stage 7 in the HIMSS Analytics schematic for the definition of “mature.” And there’s a table in the document that showed 0.7 percent of hospitals being at stage 7 in 2009. That was the highest level of maturity, but we assumed there would be some gray, some leeway, so we grouped stages 4 through 7, and found 15 percent were within the meaningful-use strike zone.

HCI: That’s still not very good!

Ficery: Yes, that’s the premise of the article, as you still had 50 percent in the early stages. We surveyed the industry and found it has been taking five to seven years to take an average 500-bed hospital from stage 1 in the HIMSS Analytics schematic through to completion of the meaningful use requirements.

HCI: In other words, the meaningful use process, taken in its entirety, is far more complex than it appears, correct?