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24th Annual HIMSS Leadership Survey
March 4, 2013
Panelists
• Steve Lieber – CEO HIMSS
• Willa Fields, DNSc, RN, FHIMSS– Professor in the School of Nursing, San Diego State University– HIMSS Board Chair
• Mitzi Cardenas– Sr. VP Strategy, Business Development/CIO, Truman Medical Center
• Milisa Rizer, MD– CMIO, Ohio State University
• Mike Rozmus– VP & CIO, RMH Healthcare
• Steve Fanning – Vice President, Healthcare Industry Strategy, Infor
• Jennifer Horowitz– Senior Director, Research
Methodology
• Data collected from December 2012 to February 2013– Web-based survey
• 298 respondents – Senior IT executives– Represent nearly 600 hospitals in the United States
Survey Headlines
• Healthcare organizations are making strong progress towards federal mandates– Two-thirds have already qualified for Meaningful Use Stage 1– Three-quarters expect to qualify for Stage 2 in 2014– 87 percent expect to complete ICD-10 conversion on time
• IT staffing is still a concern– 21 percent are concerned they won’t be able to secure IT staff– Need is greatest for clinical applications– 51 percent plan to increase staff in the next year
FEDERAL INITIATIVES
Business Issue with Most Impact on Healthcare
Hospital Infrastructure NeedsStaffing Issues
Privacy/Security IssuesConsumer Considerations
Technology Considerations Shifting Healthcare LandscapeHealth Information Exchange
Policy MandatesFinancial Considerations
Healthcare Reform
0%
2%
3%
3%
5%
3%
8%
23%
14%
40%
1%
2%
4%
4%
4%
7%
8%
14%
16%
37%
20132012
N = 298
Primary Clinical IT Focus
Focus on Nursing SystemsFocus on Consumer Technology
Installing/Upgrading AncillaryInstalling/Upgrading CDR
Certification of EHREstablishing Clinical Protocols
Closed Loop Medication AdministrationCreating Continuity of Care RecordData Warehouse/Clinical Analytics
Installing CPOELinking Clinical Systems to Quality Measures
Focus on Physician SystemsFully Operational EHR in Place
2%
1%2%
4%2%
3%0%
9%16%
15%16%
25%
2%2%
2%2%2%
3%3%
7%10%10%
16%16%
19%
20132012
Not Applicable
N = 298
Area that IT Can Most Impact Patient Care
Ensuring that Data is Secure/PrivateImproving Patient Access to Information
Providing Remote Monitoring of PatientsProviding Competitive Advantage
Enabling Remote Access of DataSharing Information Externally
Supporting Staff ProductivityStandardizing Clinical Care
Reducing Medical ErrorsImproving Quality Outcomes
0%
0%
6%
3%
5%
7%
16%
22%
38%
1%
2%
3%
4%
5%
7%
8%
12%
25%
31%
20132012
Not Applicable
N = 298
Top IT Priority – Next Two Years
Integration of IT and Medical DevicesSecuring Patient Information
Focus on Ambulatory SystemsHealthcare Consumer Issues
Exchange Info with Other EntitiesInteroperability
Completing ICD-10 ConversionFocus On Clinical Systems
Leveraging InformationOptimizing Use of Current Systems
Achieving Meaningful Use
0%
1%
2%
1%
1%
3%
11%
15%
13%
12%
38%
1%
1%
2%
2%
2%
6%
9%
11%
17%
20%
28%
20132012
N = 298
Percent of Organizations that Expect to Qualify for Meaningful Use Stage 1
Don't Know
Not Planning to Attest
Expect to Attest by end of 2012
Will until by 2013 to Attest
Have Already Attested
5%
1%
4%
24%
66%
N = 297
Level of Investment Made by Healthcare Organizations in Meaningful Use Stage 1
Don't KnowNot Applicable
Prefer Not to Disclose$20 Million or More
$10 Million to $19 Million$5 Million to $9 Million$3 Million to $4 Million$1 Million to $2 Million
$500,000 to $999,999$250,000 to $499,999
Under $250,000No Investment Made
8%2%
8%3%
4%10%
13%14%
7%11%
14%5%
7%3%
7%5%
6%6%
11%17%
10%9%
14%5%
20132012
N = 297
Expected Return on Investment From Meaningful Use Stage 1
Don't Know
Prefer Not to Disclose
Not Applicable
$10 Million or More
$8 Million to $9 Million
$6 Million to $7 Million
$4 Million to $5 Million
$2 Million to $3 Million
Less than $2 Million
6%
9%
1%
7%
3%
5%
16%
23%
30%
N = 255
Expected Timeline to Qualify for Meaningful Use Stage 2
Don't Know
No Plans
2016 or Later
2015
2014
6%
4%
1%
15%
75%
N = 297
Expected Timeline to Qualify for Meaningful Use Stage 2
Not ApplicableDon't Know
Prefer Not to Disclose$20 Million or More
$15 to $19 Million$10 to $14 Million
$5 to $9 Million$3 to $4 Million$1 to $2 Million
$500,000 to $999,999$250,000 to $499,999
Under $250,000No Additional Funds
3%17%
6%0%
0%1%
6%6%
12%9%
15%14%
11%
N = 297
Expected Return on Investment From Meaningful Use Stage 2
Don't Know
Not Applicable
Prefer Not to Disclose
$10 Million or More
$8 Million to $9 Million
$6 Million to $7 Million
$4 Million to $5 Million
$2 Million to $3 Million
Less than $2 Million
17%
1%
9%
4%
2%
3%
7%
18%
38%
N = 255
Primary Financial IT Focus
Direct Claims TransactionsUpgrading Encoding System
Web Enabling Patient SchedulingEligibility Transactions with PayersWeb Enabling Registration Process
Medical Necessity Checking SolutionsImplementing Enterprise Scheduling
Upgrading Patient Access SystemUpgrading Patient Billing System
Upgrading Financial Analytics SystemsImplementing ICD-10
0%
0%
1%
1%
2%
1%
1%
2%
6%
67%
0%
0%
1%
1%
2%
2%
4%
4%
12%
15%
47%
20132012
Not Applicable
N = 298
Preparedness to Meet ICD-10 Deadline in 2014
Don't Know
No
Yes
9%
4%
87%
N = 298
Level of Investment in ICD-10 Conversion
Don't KnowPrefer Not to Disclose
Not Applicable$15 Million or More
$10 Million to $14 Million$5 Million to $9 Million$3 Million to $4 Million$1 Million to $2 Million
$500,000 to $999,999$250,000 to $499,999
Under $250,000No Additional Funds
33%6%
1%0%1%2%
4%9%
10%8%
21%4%
N = 296
IT STAFFING
Most Significant Barrier to Implementing IT
Constraints at a Regional LevelDifficulty Proving ROI
Lack of Clinical LeadershipLack of Interoperable Systems
Lack of Strategic IT PlanLack of Time Commitment from Clinicians
Difficulty in End User AcceptanceVendor Inability to Deliver Product
Lack of Adequate Financial SupportLack of Staffing Resources
4%
4%
6%
4%
3%
7%
9%
12%
14%
21%
3%
4%
4%
4%
4%
6%
7%
13%
15%
21%
20132012
N = 298
IT Staffing Change – Next 12 Months
Decrease
No Change
Increase
5%
32%
61%
7%
38%
51%
20132012
N = 296
Top Ten IT Staffing Needs
User TrainingHelp Desk
Database AdministrationClinical Transformation
PC/Server SupportProcess/Workflow
System IntegrationIT Security
Clinical InformaticsNetwork/Architecture Support
Clinical Application Support
10%10%10%
12%12%12%
14%18%18%
21%34%
N = 298
IT BUDGETS
Key Business Objective
Attract Qualified Staff
Grow Through Acquisition
Improve Patient Satisfaction
Increase Market Share
Accountable Care Organization
Achieve Meaningful Use
Improve Operational Efficiency
Improve Patient Care
Sustain Financial Viability
1%
4%
12%
8%
24%
13%
21%
15%
1%
4%
4%
9%
9%
15%
17%
19%
21%
20132012
Not Applicable
N = 298
Change In IT Budget
Definitely Decrease
Probably Decrease
No Change
Probably Increase
Definitely Increase
2%
5%
12%
19%
56%
2%
6%
15%
29%
47%
20132012
N = 298
Reason for Budget Increase
Business Requirements to Invest in E-BusinessAbility to Prove ROI
Competitive Market ThreatsPartnership with another organization
Merger/PartnershipAddition of Facility
Increase in Long-Term IT PlanNeed to Upgrade IT Infrastructure
Need to Comply with Regulatory ChangesOverall Budget Increases
Additional Staffing NeededOverall Growth in Systems
5%8%9%9%
10%18%
23%40%42%42%
52%58%
N = 298
OTHER HEADLINES
Primary Infrastructure IT Focus
Other Deploying Vendor Neutral Archive
TelemedicineWired/Wireless Networking
Cloud ComputingDesktops/Virtual Desktops
Storage and BackupMobile Devices
Servers/Virtual ServersSecurity Systems
9%
2%
7%
3%
16%
8%
18%
19%
16%
6%
3%
3%
3%
5%
10%
12%
16%
18%
22%
20132012
Not Applicable
N = 298
Security Breach
In Last 12 Months
In Last Six Months
22%
13%
19%
10%
20132012
N = 298
Top Security Concerns
No ConcernsLack of Compliance with BAA
Inadequate Security Systems in PlaceConnecting IT at Remote LocationsUnauthorized Use by Third Parties
Patients' Lack of Confidence in Security SystemsInadquate Funding for Security Systems
Limits of Existing TechnologyExternal Breach of Security
Data LeakageInternal Breach of Security
Compliance with HIPAA and CMS RegulationsSecuring Information on Mobile Devices
4%0%
32%5%
7%4%
13%10%
13%12%
32%34%
6%
3%3%4%4%
5%6%
8%8%
10%16%
27%28%
36%
20132012
N = 298
HIE Adoption
Don't Know
Participated in Failed HIE
Participate in HIE
Required to Participate
HIE in our Area/Don't Participate
No Plans to Participate
Don't Know What an HIE Is
2%
4%
49%
6%
22%
26%
2%
2%
3%
51%
6%
21%
25%
3%
20132012
N = 298