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Live from HIMSS: HIMSS Leadership Survey Finds a Mix of Continuity and Change

February 21, 2012
by Mark Hagland
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Meaningful use continues to be a major focus for healthcare IT leaders nationwide

Tuesday morning, Feb. 21, at the HIMSS12 Conference being held at the Venetian Sands Expo Center in Las Vegas, leaders of the Chicago-based Health Information and Management Systems Society (HIMSS) unveiled to the news media the results of the 23rd Annual HIMSS Leadership Survey. The web-based survey of 302 healthcare IT leaders, of whom 51 percent self-identified as CIOs, was conducted in December 2011 and January 2012, and encompassed responses from 600 U.S. hospitals.

Not surprisingly, achieving meaningful use was the IT priority that the largest number of survey respondents cited as their top priority. Still, the percentage who cited achieving meaningful use as the number-one priority dropped this year to 38 percent from more than half who had said so one year ago, perhaps reflecting on the progress being made by hospitals nationwide in that area. The next-highest priorities cited by survey respondents were focusing on clinical systems (15 percent), and leveraging information through the use of a data warehouse, clinical decision support, or evidence-based medicine (13 percent).

Survey respondents were also asked to identify the primary focus of their organization with regard to clinical IT, financial IT, and infrastructure at their organizations. Within the clinical category, 25 percent of respondents indicated that their primary clinical IT focus was to ensure the presence of a fully operational EHR; that response was identical to the result from one year ago. Focusing on physician systems, including physician documentation, clinical decision support, and installing CPOE, were the other top focus areas, each issue selected by 16 percent of respondents.

With regard to financial information systems, survey respondents cited implementing the ICD-10 coding system as their top priority by a very wide margin. In fact, while 67 percent of respondents indicated this to be their top financial IT focus, only one other option selected by more than 5 percent of respondents was that of upgrading the patient billing system, identified by 6 percent of respondents.

When it came to identifying the top business issues that respondents believed would have the most impact on healthcare in the next two years, survey respondents cited healthcare reform and policy mandates as the top two issues, in a result identical to that of one year ago.

Financial barriers: falling a bit?

Interestingly, for the first time in years, respondents did not identify a lack of adequate financial support for IT as the top barrier to IT implementation, instead, nearly one-quarter reported that they are concerned about the staffing resources needed for implementation. This year, 22 percent of respondents cited adequate staffing resources as their top challenge, followed by a lack of adequate financial support (14 percent), and vendors’ inability to effectively deliver products or services to respondents’ satisfaction (12 percent). One year ago, 18 percent cited lack of adequate financial support as their top issue, closely followed by lack of staffing resources (17 percent), and vendor inability to deliver product (11 percent) as the top three implementational barriers facing their organizations.

In another area, with regard to participation in health information exchanges (HIEs), 49 percent of respondents reported that their organization was participating in at least one HIE in their area, a finding that matches last year’s results.

Meaningful use work ramping up

As of the end of 2011, 26 percent of survey respondents indicated that their organization had attested to stage one of meaningful use, and were preparing to meet stage 2 meaningful use requirements, while another 4 percent reported at that time that they expected to attest by the end of 2011 (and presumably, did so after survey data collection had been completed).

In addition, another quarter (27 percent ) of respondents expected to attest within the first six months of 2012, and another 22 percent expected to attest in the second six months of 2012, while 17 percent said their organizations were waiting until 2013 to attest, and 2 percent did not plan to attest at any time.

Survey respondents were asked to identify how much money their hospital organization would receive for meeting the stage 1 MU requirements. Results were as follows:

> Less than $2 million: 20 percent
> $2 million to $3 million: 23 percent
> $4 million to $5 million: 15 percent
> $6 million to $7 million: 10 percent
> $8 million to $9 million: 3 percent
> $10 million or more: 13 percent

At the press conference unveiling the survey’s results, five healthcare IT executives and  H. Stephen Lieber, president and CEO of HIMSS, responded to media questions about the findings. When asked whether any panel members were surprised by the results around progress on attestation to stage 1 of meaningful use, Kay Hix, vice president and CIO of the Roanoke, Va.-based Carilion Clinic integrated health system, said, “I’m really not surprised. If you think about it, your EMR really had to be in solid place by the beginning of 2010 to attest in 2011. If you did the survey in the March or April of this year,  you’d see that percentage bump up by another 15 or 20 percent. There’s still a struggle going on with hospitals trying to get their EMRs in as quickly as they can. And you had to gear up for ICD-10, even though it’s now been delayed,” she added, noting that CIOs and other healthcare IT leaders have had to ramp up around meaningful use while still attending to numerous other priorities.

Added HIMSS’ Steve Lieber, “ I think it’s also a recognition for a lot of hospitals in terms of how far they had to go. For those hospitals that had started long before meaningful use, they’re well on their way. But clearly, if you’re sitting at stages 1 or 2 in terms of the HIMSS Analytics adoption model, you’ve got a pretty long way to go before you’re close to being able to attest on meaningful use.”

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