HIMSS' H. Stephen Lieber and a panel of other
healthcare IT leaders discuss survey results

On Monday morning, March 4, at the Ernest N. Morial Convention Center in New Orleans, leaders of the Chicago-based Healthcare Information and Management Systems Society (HIMSS) presented results of the 24th Annual HIMSS Leadership Survey at a media brunch. The results of the survey, the most anticipated of its type in healthcare IT, confirm broadly that healthcare IT leaders are rapidly moving forward to meet the requirements of meaningful use under the Health Information Technology for Economic and Clinical Health (HITECH) Act, and are already looking towards leveraging the value from healthcare IT investments, despite ongoing financial, reimbursement, staffing, and IT security challenges.

After announcing the number of attendees at HIMSS13, now underway at the convention center in the Crescent City—32,718 as of Monday morning, versus over 37,000 in 2012 (though the number of vendor exhibitors has reached an all-time high of 1,214 this year), HIMSS president and CEO H. Stephen Lieber led a panel of presenters and discussants who met the working press to talk about the survey’s results.

Among the key findings of this year’s survey (whose data points were collected Dec. 2012- Feb. 2013, with 298 respondents representing nearly 600 U.S. hospitals, and 90 percent of respondents fro hospital-based organizations):

>  Sixty-six percent of respondents had already attested to meaningful use Stage 1 as of December, and another 4 percent were expecting to do so before February.
>  Another 24 percent were planning to attest to Stage 1 by sometime in 2013, while only 1 percent were not planning to attest at all.
>  In terms of the level of financial investment made through Stage 1, 5 percent said their organization had spent $20 million or more, 4 percent had spent $10-19 million, 6 percent had spent $5-9 million, 11 percent had spent $3-4 million, 17 percent had spent $1-2 million, 10 percent had spent $500,000-$999,000, 9 percent had spent $250,000-$400,000, 14 percent had spent under $250,000, and 5 percent had invested zero dollars.
>  With regard to Stage 2 of MU, fully 75 percent of respondents expected to attest during 2014; 15 percent expected to attest during 2015; 1 percent expected to attest in 2016 or later; 4 percent had no plans to attest at all; and 6 percent didn’t know.
> Fully 87 percent of respondents said their organization was prepared to meet the deadline for the transition to the ICD-10 coding system during 2014, while 4 percent said their organization was not ready, and 9 percent said they didn’t know.

An IT staffing crisis ahead?

Significantly, the “single most significant barrier to implementing IT” in the near future cited by survey respondents was 21 percent (in a result identical to that of 2012’s survey), followed by lack of adequate financial support (15 percent), vendor inability to deliver product (13 percent), and difficulty in end-user acceptance (7 percent), followed by other barriers in the small single digits. Given those results, the survey results around staffing planning assume particular importance.

First, in terms of IT staffing change in the next 12 months, 51 percent of survey respondents said their staffs would be increased; 38 percent expected no change; and only 7 percent foresaw a decrease. A year ago, 61 percent had predicted staffing increases, 5 percent had predicted staffing decreases, and 32 percent had predicted no change.

Meanwhile, the top 10 IT staffing needs were as follows:

>  Clinical application support (34 percent)
>  Network/architecture support (21 percent)
>  Clinical informatics (18 percent)
>  IT security (18 percent)
>  System integration (14 percent)
>  Process/workflow (12 percent)
>  PC/server support (12 percent)
>  Clinical transformation (12 percent)
>  Database administration (10 percent)
>  Help desk (10 percent)
>  User training (10 percent)

IT security concerns: sadly, well-founded

When it comes to security, survey results were clear: health IT security remains a huge problem for healthcare IT leaders. Among survey respondents, 10 percent had experienced a security breach in the past six months, while fully 19 percent had experienced a security breach in the past 12 months. Those results compared with 13 percent who in 2012 had experienced a security breach in the six months prior to that survey, and 22 percent who had experienced a breach in the 12 months prior to that survey.

Moving beyond MU

Interestingly, while 28 percent of survey respondents this year said that achieving meaningful use was their top priority, that number was considerably lower than the percentage who had said so a year ago (38 percent). Meanwhile, “optimizing use of current systems” jumped as the second-highest-cited top IT priority, to 20 percent (from 12 percent a year ago). Steve Lieber and others on the discussion panel agreed that those results reflected how the leaders of the more IT-advanced patient care organizations were already looking towards leveraging their clinical IT infrastructure for performance improvement.

Mitzi G. Cárdenas, senior vice president for strategy, business development, and performance integration at the Kansas City, Mo.-based Truman Medical Centers, said, “I think that our organization’s made the investment, and by virtue of our stage 7 achievement [Truman has achieved stage 7 certification according to HIMSS Analytics], our clinicians have adopted the technology, so really, we’re focused on the sustainability and the continued use and advancement, so we’re really looking to the future and what our investment can do in the future.”

 And Milisa K. Rizer, M.D., M.P.H., chief medical information officer at Extern Medical Center/Ohio State University in Columbus, said, “I agree with Mitzi. The meaningful use and the dollars associated with that have really been a byproduct for us as we continue to look at ways that we can achieve” further progress in clinical transformation and performance improvement.