The focus among IT professionals at hospitals and large health systems has definitively shifted to clinical systems and medical issues, both for the present and in the longer term, according to the 2007 results of the 18th annual survey of chief information officers by the Healthcare Information and Management Systems Society (HIMSS), released last week.
Improving quality of care shot to the top of the list of business issues facing healthcare. Among the 360 CIOs queried, 69 percent named quality improvement as a major business-related concern, nearly double last year’s total of 36 percent. That easily eclipsed patient satisfaction on the list, which remained relatively stable at 55 percent.
Nine of the top 10 healthcare applications deemed important by respondents for the future were clinical systems, led by both electronic medical records (EMR) and computerized physician order entry (CPOE), each named by 47 percent of the CIOs. Clinical information systems in general are close behind, as is bar-coded medication management.
Indeed, uptake of electronic medical records has accelerated considerably, as 32 percent of CIOs say they have a fully operational EMR system this year, up from 24 percent last year and 18 percent in 2005. Just 8 percent of respondents report no EMR implementation plans, compared to 17 percent two years earlier.
While interoperability between health systems appears to remain a far-off goal for national policy-makers, interest has picked up at the hospital level. Although slightly more than half of respondents have no plans to participate in a regional health information organization (RHIO), that share is down from 74 percent a year ago, while actual participation in RHIOs jumped to 23 percent this year from 14 percent.
The industry-wide concern about privacy and security that has permeated health-IT meetings and discussions in the last year is reflected in the survey as well. A surprising 18 percent of CIOs report an IT security breach at their facilities within the last 12 months, and another 14 percent are unsure if they had a security lapse.
Internal breaches remain the top concern for the security of electronic medical data, named by 57 percent of survey takers, though HIPAA compliance has moved into the second spot, as 30 percent express worries in this area. Similarly, the survey reflects growing concern about unauthorized use of data by third parties and, to a lesser extent, lack of confidence among patients that their health information is adequately protected.
As usual, money — specifically the lack of financial support — is, in the opinion of hospital CIOs, the greatest barrier to IT implementation, named by 20 percent of respondents. About one in six chose lack of staffing resources as the No. 1 roadblock, but 65 percent of all respondents expect their IT staff to increase this year and nearly 75 percent say IT operating budgets will go up in 2007.
CIOs appear to have moved beyond having to convince higher-ups that IT can produce quantifiable financial benefits, though the survey does not delve into the trickier issue of demonstrating a return on investment with EMRs.
Reflecting the heightened importance CIOs and their institutions are placing on clinical systems, 32 percent say their 2007 staffing needs include clinical informaticists, more than any other category. Application support is second at 29 percent, followed at 28 percent by process and workflow design, often cited elsewhere as a central tenet of clinical transformation.
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