2012 final leadership survey with cover

transforming healthcare through IT™

2012 HIMSS Leadership SurveySenior IT Executive Results

February 21, 2012

www.himss.org

2 © 2012 Healthcare Information and Management Systems Society

23rd Annual HIMSS Leadership Survey Final Report: Healthcare Senior IT Executive

The 23rd Annual HIMSS Leadership Survey reflects the opinions of information technology (IT) professionals in U.S. healthcare provider organizations regarding the use of IT in their organizations. This study covers a wide array of topics crucial to healthcare IT leaders including IT priorities, issues driving and challenging technology adoption, IT security, as well as IT staffing & budgeting plans. Contents 1. Executive Summary 2. Methodology 3. Profile of Survey Respondents 4. IT Priorities 5. IT Barriers 6. IT and Patient Care 7. IT Security 8. Health Information Exchange (HIE) Participation 9. IT Governance 10. Federal Initiatives 11. IT Budget and Staff 12. About HIMSS 13. How to Cite This Study 14. For More Information


Figures Figure 1. Participant Profile—Title Figure 2. Participant Profile—Facility Type Figure 3. Participant Profile—Type of Hospital Figure 4. Participant Profile—Revenue Figure 5. Participant Profile—Region Figure 6. Top IT Priority – Next Two Years Figure 7. Primary Clinical IT Focus Figure 8. Primary Financial IT Focus Figure 9. Primary IT Infrastructure Focus Figure 10. Key Business Objective Figure 11. Business Issue with Most Impact on Healthcare Figure 12. Most Significant Barriers to Implementing IT Figure 13. Area that IT Can Most Impact Patient Care Figure 14. Role of Clinicians Figure 15. Access to On-line Patient Information from Remote Location Figure 16. Security Breach Figure 17. Top Concerns – Security of Computerized Medical Information Figure 18. Health Information Exchange (HIE) Adoption Figure 19. Alignment of Organizational & IT Strategic Plan Figure 20. Member of Organization’s Executive Committee Figure 21. Senior IT Executive Responsibilities Figure 22. Percent of Organizations that Expect to Qualify for Meaningful Use – Stage One Figure 23. Level of Investments Made by Healthcare Organizations in Meaningful Use Figure 24. Anticipated Return on Investment for Meeting Meaningful Use Requirements Figure 25. Preparedness to Meet ICD-10 Conversion Figure 26. Level of Investment Made in ICD-10 Conversion Figure 27. Expected Change in IT Staff in Next 12 Months Figure 28. 2012 IT Staffing Needs (Top Ten) Figure 29. Additional Functions Managed by Senior IT Executives Figure 30. Projected Change in IT Operating Budget Figure 31. Reason for Increase in Budget


1. Executive Summary The U.S. Federal government’s impact on the provider community’s information technology (IT) operations has never been greater than it has been in the last few years. Initiatives such as the Health Information Technology for Economic and Clinical Health Act (HITECH) provision in 2009’s American Recovery and Reinvestment Act (ARRA) and 2010’s Patient Protection and Affordable Care Act (PPACA) have challenged providers to enhance their IT capabilities like never before. Based on the feedback of 302 healthcare IT professionals, nearly three quarters of the participants in this year’s Annual HIMSS Leadership Survey indicated that Federal mandates, including meeting Stage One of Meaningful Use and a conversion to ICD-10 would be the issues driving their efforts in the next two years. At this time, more than one-quarter of respondents have already attested to stage one meaningful use and another third expect to attest by June 2012. In order to prepare to attest for stage one meaningful use, nearly half of respondents have invested more than $1 million. Respondents also expressed concerns about IT staffing shortages. Considered to be a key barrier in addressing their IT priorities, approximately two-thirds of the respondents indicated they plan to increase their IT staff in the next year. The leading areas in which respondents need staff are in the areas of clinical application support, network/architecture support and clinical informatics professionals. Other key survey results include: Health Information Exchanges (HIEs): Almost half of respondents reported their organization participates in an HIE. However, 22 percent of respondents reported that there was an HIE in their area but they were not participating in it at this time. ICD-10: Two-thirds of respondents reported that implementing CPT-10/ICD-10 was the top area of focus for financial IT systems at their organization. In addition, nearly 90 percent of respondents indicated they expected to complete their ICD-10 conversion by the October 2013 deadline. Impact of IT on Patient Care: Three-quarters of respondents indicated that they believe IT can impact patient care by improving clinical/quality outcomes, reducing medical errors or helping to standardize care by allowing for the use of evidence-based medicine. Role of Clinicians: Clinicians are active participants in many aspects of IT use at their organizations, including selecting IT systems for use in their department and acting as project champions. Each of these items was selected by at least 80 percent of respondents.


Security Concerns: Approximately one-quarter of respondents indicated that their organization has experienced a security breach in the past year. Respondents indicated that compliance with HIPAA security regulations and CMS security audits were their top concerns with regard to security at their organizations. IT Governance: There appears to be a strong level of integration between an organization’s overall strategic plan and their IT strategic plan as half of respondents reported that their IT plan is part of their overall organizational strategic plan. Organizational Infrastructure: Nineteen percent of respondents indicated that their primary infrastructure focus was their server environment, to include virtual services. Senior IT Executive Responsibilities: Nearly all senior IT executives reported that they were responsible for at least one IT area outside of the traditional IT department, primarily telecommunications.


2. Methodology A total of 302 valid responses were received for this year’s Web-based survey. Data was collected in December 2011 and January 2102. Survey respondents represent more than 600 hospitals throughout the United States. The average bed size of the hospitals in this survey is 479; the median bed size is 240. 3. Profile of Survey Respondents Approximately half of respondents reported to hold title of Chief Information Officer (CIO), at either the corporate-level (36 percent) or the facility level (15 percent). Another 42 percent of respondents reported their title to be Director of IS/IT. The remaining respondents reported a variety of titles including Chief Medical Information Officer (CMIO), Chief Nursing Information Officer (CNIO) and other IT professionals. More than 80 percent of survey respondents reported working for an acute care hospital-based environment, either at a stand-alone hospital (46 percent), a healthcare system (27 percent) or hospital as a part of a multi-hospital system (14 percent). Five percent of respondents work at an outpatient setting with the remaining working for other types of healthcare facilities including mental/behavioral health facilities, long-term care facilities and home care agencies. Respondents working in an acute care hospital-based environment were asked to characterize the type of their hospital organization. Most respondents (two-thirds) noted their organization was (at least partly) comprised by community hospitals, 21 percent reported working in an academic medical center, and 19 percent of respondents working in a critical access hospital. Seventeen percent reported that they work for a rural hospital and 15 percent reported that they work for a general medical/surgical hospital. Annual gross operating revenues for the provider organizations represented in this year’s survey were: • $50 million or less—22 percent; • $51 million to $200 million—23 percent; • $201 million to $350 million—11 percent; • $351 million to $500 million—9 percent; • $501 million to $1 billion—11 percent; • More than $1 billion—17 percent; and • Don’t Know/Not Applicable—9 percent.


The majority of individuals responding to this year’s survey represented the South Atlantic1, East North Central2 and West North Central3 regions. At least 15 percent of respondents came from each of these regions. Only five percent of respondents were located in the Mountain4 region. Figures: Figure 1. Participant Profile—Title Figure 2. Participant Profile—Facility Type Figure 3. Participant Profile—Type of Hospital Figure 4. Participant Profile—Revenue Figure 5. Participant Profile—Region 4. IT Priorities Healthcare reform5 and policy mandates6 continue to shape the future business priorities for healthcare IT executives, with achieving meaningful use as the most commonly cited key business objective for the next year. When asked to identify the single information technology (IT) priority to be addressed at their organization in the next two years, more than one third (38 percent) identified achieving meaningful use. While still the top response, the findings this year represent a notable decline when compared to the 2011 survey results. Last year, half of the respondents identified meaningful use as their top IT priority. Beyond meaningful use, approximately 15 percent of respondents identified a focus on clinical systems, such as computerized practitioner order entry (CPOE), electronic health records (EHRs) or e-prescribing as their organizations’ top IT priority. This response also placed second in the 2011 survey. Rounding out the top three responses was leveraging information through the use of a data warehouse, clinical decision support or evidence-based medicine. Thirteen percent of respondents identified this item. Less than one percent of respondents indicated that securing patient information was a top IT priority at their organization at this time. None of the respondents identified the below items as a top IT priority in the next two years:

• Focus on RCM solutions; • Focus on supply chain systems; and • Integrating IT and medical devices.

1 Delaware, Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia, West Virginia and Washington, D.C. 2 Illinois, Indiana, Michigan, Ohio, Wisconsin 3 Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota 4 Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, Wyoming 5 Referred to in this study ass new care models or payment structures 6 Referred to in this study as compliance with regulations like ARRA, ICD-10 or HIPAA 5010


Respondents were also asked to identify the primary focus their organization has with regard to clinical IT, financial IT and infrastructure at their organizations. One quarter of respondents (25 percent) indicated that their primary clinical IT focus was to ensure the presence of a fully-operational EHR; also the top choice in 2011 (25 percent). Focusing on physician systems (physician documentation; clinical decision support systems; installing a CPOE system) were other top focus areas, each issue selected by 16 percent of respondents. These were also top items in the 2011 survey. Each of these items was selected by one percent of respondents or less.

• Installing or upgrading ancillary applications; • Installing PACS (radiology or cardiology); and • Creating clinical documentation flow sheets.

Implementing CPT 10/ICD-10 continues to be the top focus for financial IT systems. Two-thirds of respondents (67 percent) indicated this to be their top financial IT focus. The only other option selected by at least five percent of respondents was upgrading the patient billing system, identified by approximately six percent of respondents. With regard to their top infrastructure priority, respondents were most likely to a focus on servers/virtual servers. This item was selected by 19 percent of respondents. It was also the top response in 2011. Rounding out the top three are a focus on mobile devices (18 percent) and virtual desktops/laptops (16 percent). Security systems were also identified by 16 percent of respondents. Least frequently selected were cloud computing and telemedicine. These items were identified by three and two percent of respondents, respectively. When asked to identify the single key business objective their organization was trying to achieve in the next 12 months, approximately one quarter of respondents (24 percent) indicated achieving stage one meaningful use. This was also the top response in the 2011 survey. Nearly one-quarter of respondents (21 percent) selected improving patient care/quality of care, followed by sustaining financial viability (15 percent). As with the 2011 study, less than one percent of respondents indicated that attracting qualified staff was the key business objective their organization was trying to achieve in the next year. None of the respondents indicated that their key business objective was improving supply chain dynamics. In the 2011 study, respondents were most likely to identify healthcare reform and policy mandates as the top business issues that would have the most impact on healthcare in the next two years. These responses did not change in the 2012 survey.


When given a group of categories from which to select, approximately 40 percent of respondents identified healthcare reform, which includes items such as accountable care organizations (ACOs), new care models and payment structures. Nearly another quarter (23 percent) identified policy mandates such as ICD-10 and meaningful use, as a business issue that will most impact healthcare in the next two years. Once again, financial considerations such as demand for capital or creating new revenue sources, rounds out the top three responses; this was selected by 14 percent of respondents. No other option was selected by more than 10 percent of respondents. Respondents were least likely to indicate staffing issues, such as the availability/retention of IT or clinical staff. Only two percent of respondents indicated that this would be a top business issue driving healthcare. None of the respondents indicated that external threats or hospital infrastructure needs were drivers that will have a significant impact on healthcare in the next two years. Figures: Figure 6. Top IT Priority – Next Two Years Figure 7. Primary Clinical IT Focus Figure 8. Primary Financial IT Focus Figure 9. Primary IT Infrastructure Focus Figure 10. Key Business Objective Figure 11. Business Issue with Most Impact on Healthcare 5. IT Barriers 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 staffing resources needed for implementation. For the past several years, respondents have identified the lack of adequate financial support as the top barrier to IT implementation. That is, until now. This year, 22 percent of respondents cited adequate staffing resources as their top challenge, followed by the lack of adequate financial support (14 percent) and vendors’ inability to effectively deliver products or services to respondents’ satisfaction (12 percent). No other response was identified by more than 10 percent of respondents. Less than one percent of respondents indicated that laws and regulations prohibiting technology sharing with referring providers was a barrier to IT implementation. None of the respondents indicated that an ability to secure data was a barrier to IT implementation. This is consistent with what was identified in the 2011 study.


Figures: Figure 12. Most Significant Barriers to Implementing IT 6. IT and Patient Care As would be expected, IT leaders by and large believe IT can have a positive impact on patient care by improving clinical/quality outcomes, reducing medical errors or helping to standardize care by allowing for the use of evidence-based medicine. Clinicians are also seen to be playing a more expansive role in shaping the use of IT in their organizations. When asked to select from a list of choices indicating areas where IT could have the most impact on patient care, 38 percent of respondents indicated improvements in clinical and quality outcomes. This item was also most frequently selected in the 2011 study. Approximately another quarter of respondents (22 percent) indicated reducing medical errors/improving patient safety, followed by standardization of clinical care using evidence-based medicine (16 percent). Respondents were least likely to select remote monitoring of patients and ensuring that patient data is private and secure. As with the 2011 study, nearly all of survey respondents (98 percent) noted that clinicians play some role in the IT process. At least 80 percent of respondents indicated that clinicians played a role in IT systems evaluation/selection (84 percent) and acted as project champions to educate and lead other clinicians (81 percent). These were both top items selected in the 2011 survey. The survey findings suggest that a growing number of organizations are employing clinical information executives. In the 2011 survey, approximately 30 percent of respondents reported to have a Chief Medical Information Officer (CMIO) at their organization. In 2012, this number increased to 36 percent. The growth among Chief Nursing Information Officers is less pronounced, moving from eight percent of respondents in 2011, to nine percent in 2012. Respondents also reported a growth in remote access to secure, on-line clinical patient information. Nearly all respondents (97 percent) reported that physicians have this type of access, representing a slight increase from the 2011 survey. Approximately 85 percent of respondents reported that physician extenders (physician assistants, nurse practitioners) had remote access to patient information; two-thirds reported that non-clinical staff (finance staff, transcriptionists) had this type of remote access, while roughly 60 percent noted that both nurses and other clinical professionals such as occupational therapists have remote access secure patient information.


Figures: Figure 13. Area that IT Can Most Impact Patient Care Figure 14. Role of Clinicians Figure 15. Access to On-line Patient Information from Remote Location 7. IT Security IT Security breaches continue to plague organizations but the reduction in actual violations reported this year suggests efforts to secure patient information are working. Compliance with HIPAA security regulations and CMS security audits dominate the IT executive’s security concerns. Approximately one quarter of respondents (22 percent) noted their organization had experienced some type of information security breach in the past 12 months. In 2011, 26 percent of respondents reported this to be the case. Respondents were asked to identify no more than two concerns that they had regarding the security of electronic medical information at their organizations. Only four percent of respondents indicated that they did not have any concerns at this time. Approximately 34 percent of respondents indicated that compliance with HIPAA security regulations and CMS security audits was their top concern. This displaces internal breach of security (32 percent), which had been identified as a primary security concern for the past several years. One-third of respondents (32 percent) also indicated they were concerned their organization’s security systems were inadequate. Respondents were somewhat less likely to identify funding/financial support for the security process as a barrier than they were in the past. While selected by 13 percent of respondents in 2012, 17 percent of respondents selected this same issue in 2011. New to the study this year was the inclusion of security surrounding mobile information devices. Only six percent of respondents indicated that they were concerned about their organization’s ability to secure information on mobile devices. Less than one percent of respondents noted that they had concerns about the ability of their business associates to comply with existing business associate agreements. Figures: Figure 16. Security Breach Figure 17. Top Concerns – Security of Computerized Medical Information


8. Health Information Exchange (HIE) Participation The involvement in Health Information Exchanges (HIE) shows mixed results this year. While the percentage of respondents actually participating in an HIE is flat when compared to last year, a growing number of non-participating organizations are involved in some type of an HIE planning effort. Respondents were asked to identify their current involvement in an HIE, defined as “an organization which brings together healthcare stakeholders to oversee and govern the exchange of health-related information according to nationally recognized standards” (which could include a state-designated health information exchange). As would be expected, the vast majority of respondents (ninety-eight percent) had some degree of familiarity with the concept of an HIE. Nearly half of respondents (49 percent) reported their organization participates in at least one HIE in their area, a finding consistent with last year’s participation level. Only six percent claimed their participation was mandated by some level of government. Similar to the 2011 findings, approximately 22 percent of respondents indicated there was an HIE in their area, but have chosen not to participate in it at this time. Four percent of respondents reported that they participated in an HIE in the past, but that HIE has failed. One-quarter of respondents noted their organization had yet to start planning to participate in an HIE. Based on results from previous studies, this finding represents a continued decrease in the number of organizations that have yet to begin to plan to participate in an HIE. Figures: Figure 19. Health Information Exchange (HIE) Adoption 9. IT Governance Respondents continue to report that a strong level of integration between the IT strategic plan at their organization and the organization’s overall strategic plan as evidenced by the senior IT executive’s involvement on their organization’s executive committee. Respondents were asked to characterize the level of integration between their IT plans and their organization’s strategic operating, clinical and capital plans. The vast majority of respondents (85 percent) claimed their IT strategies were aligned with the organization’s overall strategy. Approximately half of respondents (48 percent) claiming the IT plan is a specific component of the organization’s overall strategic plan and


another 37 percent reported that their IT strategic plan is integrated with overall strategic plan, even though the two plans are separate. These findings are consistent with feedback from previous HIMSS Leadership surveys. Interestingly, 14 percent of respondents indicated that their organization either does not have an IT strategic plan (seven percent) or does have an IT strategic plan but that this plan is not integrated with the organizations’ overall strategic plan (seven percent). In addition, more than half of respondents (57 percent) claimed they are a member of their organization’s executive committee, defined in this study as “the leadership team that drives overall organization strategy and direction”. Individuals identifying themselves a senior IT executive were asked to identify which responsibilities they assume on a regular basis as part of their job. Driving value from IT investments was the most frequently selected item, identified by 94 percent of respondents. This was also the most frequently selected item in the 2011 survey. The percent of respondents identifying each option is listed below. • Drive value from IT investments—94 percent; • Contribute to overall business strategy— 92 percent; • Enable the CEO/executive team to improve management through IT— 90 percent; • Support Business and clinical process owners— 90 percent; • Manage IS department operations— 88 percent; and • Responsible for process change management to be supported by IT— 83 percent.

All of these responses are fairly consistent with what was reported in the past. Figures: Figure 20. Alignment of Organizational & IT Strategic Plan Figure 21. Member of Organization’s Executive Committee Figure 22. Senior IT Executive Responsibilities 10. Federal Initiatives Organizations are making substantial investments in two major federal initiatives – meeting Stage One of Meaningful Use and successfully converting from ICD-9 to ICD-10. Most organizations report to be on target to satisfy the requirements of both initiatives although a sizeable percentage of respondents expressed reservations about meeting the ICD-10 deadline. More than one-quarter of respondents (26 percent) indicated their organization has attested to stage one meaningful use and were preparing to meet stage two


requirements. Another four percent of respondents reported they expected to attest by the end of 2011 (and presumably have since the time they completed this survey). More than one-quarter (27 percent) expect to attest in the first six months of 2012 and 22 percent expect to attest in the second six months of 2012. Seventeen (17) percent are waiting until 2013 to attest and two percent will not attest at any time. Respondents were also asked to identify the level of financial investment they made or project to make in order to achieve Stage One of meaningful use. Only five percent of respondents indicated their organization made no additional investment. One-third reported they will ultimately invest less than $1 million, 27 percent between $1 million and $4 million and nearly one-third (29 percent) will invest $5 million or more on achieving stage one meaningful use. The remaining respondents either did not know the answer to this question or chose not to disclose this information. Respondents were asked to identify how much money their hospital organization would receive for meeting Stage One meaningful use requirements. Less than one percent of respondents reported that they would not receive incentives in Stage One. The below list identifies the money that organizations anticipate that they will receive for their investment. • 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; and • $10 million or more — 13 percent.

The remaining respondents either preferred not to disclose the level of money they expected to receive or did not know the amount. In addition to achieving meaningful use requirements, healthcare organizations also need to convert from ICD-9 to ICD-10 by October 1, 2013. Nearly 90 percent of respondents indicated that they expect to complete their conversion by the deadline. Respondents were also asked to identify the level of investment they were making in their ICD-10 conversion efforts. Nearly one-third (29 percent) indicated they were investing less than one million in this conversion, fifteen percent indicated were spending between $1 to $4 million, and four percent spent $5 million or more. A very large percent of respondents (43 percent) couldn’t identify the level of investment they made in their ICD-10 conversion.


Figures: Figure 22. Percent of Organizations that Expect to Qualify for Stage One Meaningful Use Figure 23. Level of Investments Made by Healthcare Organizations in Meaningful Use Figure 24. Anticipated Return on Investment for Meeting Meaningful Use Requirements Figure 25. Preparedness to Meet ICD-10 Conversion Figure 26. Level of Investment Made in ICD-10 Conversion 11. IT Budget and Staff Fueled in part by the need to expand the number of FTEs to meet the growing number of systems/technologies in place, IT leaders expect their operating budgets to grow this coming year. According to the 2011 HIMSS Analytics® Database, U.S. hospital IT departments employed an average of 36 IT FTEs (median seven IT FTEs). Slightly less than two-thirds of respondents (61 percent) in this year’s survey indicated they anticipated to increase the number of IT staff at their organization in the next 12 months. In fact, six percent of respondents indicated their staff would increase by more than 20 percent this coming year, 17 percent are targeting a 10 to 20 percent increase while 38 percent believe the increase to be less than 10 percent. Only five percent of respondents indicated they expected a staffing decrease in the next 12 months, with the remaining respondents (32 percent) projecting their staffing levels to remain the same. Of those respondents expecting staffing increases in 2012, approximately 14 percent reported plans to add more than ten IT FTEs, seven percent planned to add six to ten IT FTEs, 25 percent have budgeted to add three to five IT FTEs, and over one-third (37 percent) claimed their organization had budgeted to add one to two IT FTEs. Another 14 percent reported that the IT FTEs they plan to add to their organization were not budgeted. All respondents were asked to identify the areas in which they have the most critical IT staffing needs. Only eight percent of respondents reported not to have staffing needs at their organization, a slight improvement over last year’s results of five percent. Respondents were most likely to report staffing needs in the area of clinical application support as identified by 43 percent of respondents, followed by network/architecture support professionals (22 percent) and clinical informatics professionals (20 percent). These needs were also in the top three in 2011. Five percent or fewer respondents reported having critical staffing needs in the below areas:


• IT planning (five percent); • IT management (four percent); and • Internet/intranet (less than one percent).

Senior IT executive respondents were asked to identify areas outside the IT department under their supervision. With nearly all senior IT executives (96 percent) claiming to be responsible for at least one IT area outside of the IT department, telecommunications was the most frequently cited support service identified by 80 percent of respondents. Respondents had responsibilities in other areas such as medical/clinical informatics (52 percent), health information management (28 percent), and biomedical/clinical engineering (22 percent). Approximately 13 percent of respondents mentioned they oversee other areas within their organization to include plant facilities, patient accounting, and physical security. According to the HIMSS AnalyticsTM Database, the average IS operating expense as a total expense for U.S. hospitals in 2011, was 2.40 percent. Approximately three-quarters of survey respondents (75 percent) noted their organizations’ operating budgets for 2012 would increase over 2011 levels. These findings are similar to 2011’s findings. More than half of the respondents noted their budget would definitely increase in the next year (56 percent) while 19 percent claimed the increase was probable. Another 12 percent of respondents reported their IT budget would remain unchanged; this is slightly less than the 14 percent of respondents who reported the same in 2011. Only eight percent of respondents indicated their budget would decrease in the next year, a finding consistent with the 2011 survey. Respondents were most likely to report an increase in their organization’s IT operating budget because of the overall growth in the number of systems and technologies in their organization (68 percent of respondents). More than half (57 percent) indicated the increase would be due to additional staffing or consulting services needed to comply with governmental regulations. These were also the top items reported in the 2011 survey. Overall budget increases and a need to comply with regulatory changes were identified by 43 percent of respondents respectively as a reason for driving an increased IT operating budget. Respondents were least likely to identify business requirements needed to invest in e-business as an item to create an increase in IT operating budget. This area was also least likely to drive an expected increase in 2011. Among the handful of respondents noting their budget would decrease, two-thirds claimed the decrease was tied to a reduction in the organization’s revenues. Nearly two-thirds (61 percent) also indicated that the decrease was linked to overall organizational


budget decreases. None of the respondents indicated that a decrease in revenue was the result of the following items:

• Inability to prove IT return on investment; • Outsourcing IT services to a low cost provider; • A recent merger or partnership with another organization; or • The closing of a facility or clinical/business unit.

Figures: Figure 27. Expected Change in IT Staff in Next 12 Months Figure 28. 2012 IT Staffing Needs (Top Ten) Figure 29. Additional Functions Managed by Senior IT Executives Figure 30. Projected Change in IT Operating Budget Figure 31. Reason for Increase in Budget 12. About HIMSS HIMSS is a cause-based, not-for-profit organization exclusively focused on providing global leadership for the optimal use of information technology (IT) and management systems for the betterment of healthcare. Founded 51 years ago, HIMSS and its related organizations are headquartered in Chicago with additional offices in the United States, Europe and Asia. HIMSS represents more than 44,000 individual members, of which more than two thirds work in healthcare provider, governmental and not-for-profit organizations. HIMSS also includes over 570 corporate members and more than 170 not-for-profit organizations that share our mission of transforming healthcare through the effective use of information technology and management systems. HIMSS frames and leads healthcare practices and public policy through its content expertise, professional development, research initiatives, and media vehicles designed to promote information and management systems’ contributions to improving the quality, safety, access, and cost-effectiveness of patient care. To learn more about HIMSS and to find out how to join us and our members in advancing our cause, please visit our website at www.himss.org. 13. How to Cite This Study Individuals are encouraged to cite this report and any accompanying graphics in printed matter, publications, or any other medium, as long as the information is attributed to the 23rd Annual HIMSS Leadership Survey.

http://www.himss.org/


14. For More Information, Contact: Joyce Lofstrom Director, Corporate Communications HIMSS 312/915-9237 [email protected]

mailto:[email protected]


APPENDIX

Participant Profile – Title

2%

1%

1%

2%

2%

15%

35%

42%

Other

CNIO

Department Head/Director

Manager

CMIO

Facility CIO/VP of IS

Corporate CIO/VP of IS

Director of IS/IT

N = 302

Figure 1

Participant Profile – Facility Type

6%

1%

2%

5%

14%

27%

46%

Other

Mental/Behavioral Health Facility

Long Term Care Facility

Outpatient Setting

Hospital (Part of Multi-Hospital System)

Healthcare System

Stand Alone Hospital

Figure 2

N = 302


Participant Profile – Type of Hospital

15%

17%

19%

21%

66%

General Med/Surg Hospital

Rural Hospital

Critical Access Hospital

Academic Medical Center

Community Hospital

Figure 3

N =264

Participant Profile – Revenue

9%

17%

11%

9%

11%

23%

13%

7%

2%

Don't Know

More than $1 Billion

$501 Million to $1 Billion

$351 Million to $500 Million





Less than $2 Million

Figure 4

N = 302


Participant Profile – Region

5%

5%

8%

11%

12%

12%

15%

16%

16%

Mountain

East South Central

New England

Pacific

Mid Atlantic

West South Central

West North Central

East North Central

South Atlantic

Figure 5

N = 302

Top IT Priority – Next Two Years

0%

0%

0%

0%

1%

1%

2%

2%

0%

11%

9%

23%

49%

0%

0%

0%

1%

1%

1%

2%

3%

11%

12%

13%

15%

38%

Integration of IT and Medical DevicesFocus on Supply Chain Systems

Focus on RCM SystemsSecuring Patient Information

Providing Patient-Centric SolutionsAbility to Exchange Data

Focus on Ambulatory SystemsInteroperability

Completing ICD-10 ConversionOptimizing Use of Current Systems

Leveraging InformationFocus On Clinical SystemsAchieving Meaningful Use

2012

2011

Figure 6

N = 302


Primary Clinical IT Focus

1%

0%

2%

2%

2%

3%

1%

8%

7%

11%

20%

11%

24%

0%

1%

1%

2%

2%

2%

3%

4%

9%

15%

16%

16%

25%

Creating Clinical Documentation Flow Sheets

Installing PACS

Installing/Upgrading Ancillary

Installing/Upgrading CDR

Focus on Nursing Systems

Establishing Clinical Protocols

Closed Loop Medication Administration

Certification of EHR

Data Warehouse/Clinical Analytics

Linking Clinical Systems to Quality Measures

Installing CPOE

Focus on Physician Systems

Fully Operational EHR in Place

2012

2011

Figure 7

N = 302

Primary Financial IT Focus

2%

2%

0%

4%

3%

3%

2%

2%

4%

14%

48%

0%

0%

1%

1%

1%

1%

2%

2%

2%

6%

67%

Claims Transactions Direct with Payers

Upgrading Encoding System

Web Enabling Patient Scheduling

Medical Necessity Checking Applications

Eligibility Transactions with Payers

Implementing Enterprise Scheduling System

Web Enabling Bill Payment Process

Web Enabling Registration Process

Upgrading Patient Access System

Upgrading Patient Billing System

Implementing ICD-10

2012

2011

Figure 8

N = 302


Primary IT Infrastructure Focus

5%

4%

4%

10%

12%

15%

14%

12%

22%

9%

2%

3%

7%

8%

16%

16%

18%

19%

Other

Telemedicine

Cloud Computing

Wired/Wireless Networking

Storage and Backup

Security Systems

Desktops/Virtual Desktops

Mobile Devices

Servers/Virtual Servers

2012

2011

Figure 9

N = 302

Key Business Objective

0%

1%

5%

10%

17%

17%

21%

25%

0%

1%

4%

8%

12%

13%

15%

21%

24%

Improve Supply Chain Dynamics

Attract Qualified Staff

Improve Patient Satisfaction

Accountable Care Organization

Increase Market Share

Improve Operational Efficiency

Sustain Financial Viability

Improve Patient Care

Achieve Meaningful Use

2012

2011

Figure 10

N = 302

Not Applicable


Business Issue with Most Impact on Healthcare

0%

0%

3%

2%

2%

6%

13%

6%

14%

17%

36%

0%

0%

2%

3%

3%

3%

5%

8%

14%

23%

40%

External Threats

Hospital Infrastructure Needs

Staffing Issues

Privacy/Security Issues

Consumer Considerations

Shifting Healthcare Landscape

Technology Considerations

Health Information Exchange

Financial Considerations

Policy Mandates

Healthcare Reform

2012

2011

Figure 11

N = 302

Most Significant Barriers to Implementing IT

4%

5%

3%

5%

4%

7%

10%

11%

18%

17%

3%

4%

4%

4%

6%

7%

9%

12%

14%

21%

Lack of Strategic IT Plan

Lack of Interoperable Systems

Lack of Top Management Support

Difficulty Proving ROI

Lack of Clinical Leadership

Lack of Time Commitment from Clinicians

Difficulty in End User Acceptance

Vendor Inability to Deliver Product

Lack of Adequate Financial Support

Lack of Staffing Resources

2012

2011

Figure 12

N = 302Top 10 Responses


Area that IT Can Most Impact Patient Care

0%

1%

1%

3%

9%

6%

12%

25%

41%

0%

0%

3%

5%

6%

7%

16%

22%

38%

Providing Remote Monitoring of Patients

Ensuring that Data is Secure/Private

Enabling Remote Access of Data

Sharing Information Externally

Providing Competitive Advantage

Supporting Staff Productivity

Standardizing Clinical Care

Reducing Medical Errors

Improving Quality Outcomes

2012

2011

Figure 13

N = 302

Role of Clinicians

2%

8%

15%

30%

42%

42%

43%

44%

54%

60%

77%

79%

3%

9%

13%

36%

42%

43%

46%

53%

58%

59%

81%

84%

No Role

We have a CNIO

Clinican Department Managers Pick Systems

We have a CMIO

Explore Innovative Ways to Use IT

Business Project Leaders

Employed by IS Department

Clinicians are Employed as Hospitalists

Involved in Clinician Training

Participate in Development of Policies

Project Champions for Other Clinicians

Participate in Systems Evaluation

2012

2011

Figure 14

N = 302


Access to On-Line Patient Information From Remote Location

19%

55%

56%

63%

76%

95%

23%

59%

60%

67%

85%

97%

Patients

Other Clinical Professionals

Nurses

Non-Clinical Staff

Physician Extenders

Physicians

2012

2011

Figure 15

N = 302

Security Breach

26%

18%

22%

13%

In Last 12 Months

In Last Six Months

2012

2011

Figure 16

N = 302


Top Concerns – Security of Computerized Medical Information

4%

3%

7%

6%

8%

10%

16%

17%

11%

36%

8%

30%

4%

0%

4%

5%

6%

7%

10%

12%

13%

13%

32%

32%

34%

No Concerns

Lack of Compliance with BAA

Patients' Lack of Confidence in Security Systems

Connecting IT at Remote Locations

Securing Information on Mobile Devices

Unauthorized Use by Third Parties

Limits of Existing Technology

Data Leakage

Inadquate Funding for Security Systems

External Breach of Security

Internal Breach of Security

Inadquate Security Systems in Place

Compliance with HIPAA and CMS Regulations

2012

2011

Figure 17

N = 302

Not Applicable

Health Information Exchange (HIE) Adoption

1%

1%

44%

7%

21%

31%

2%

2%

4%

49%

6%

22%

26%

2%

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

2012

2011

Figure 18

N = 302


Alignment of Organizational & IT Strategic Plan

1%

51%

36%

8%

4%

1%

48%

37%

7%

7%

Other

IT Strategic Plan is Component of Organizational Plan

Plans are Separate but Aligned

Plans Are Not Aligned

No IT Strategic Plan

2012

2011

Figure 19

N = 302

Member of Organization’s Executive Committee

35%

65%

43%

57%

No

Yes

2012

2011

Figure 20

N = 302


Senior IT Executive Responsibilities

83%

80%

88%

90%

89%

92%

83%

88%

90%

90%

92%

94%

Process Change Management

Manage IS Department

Enable Executive Team to Improve Management

Support Business/Clinical Process Owners

Contribute to Overall Business Strategy

Drive Value from IT Investments

2012

2011

Figure 21

N = 257

Percent of Organizations That Expect to Qualify for Stage One Meaningful Use

3%

2%

17%

22%

27%

4%

26%

Don't Know

Not Planning to Attest

Wait Until 2013

Second Six Months of 2012

First Six Months of 2012

Will Attest by End of 2011

Have Already Attested

Figure 22

N =302


Level of Investment Made by Healthcare Organizations in Meaningful Use

11%

3%

8%

6%

4%

10%

9%

14%

9%

6%

12%

8%

8%

2%

8%

3%

4%

10%

13%

14%

7%

11%

14%

5%

Don't Know

Not Applicable

Prefer Not to Disclose

$20 Million or More





$500,000 to $999,999

$250,000 to $499,999

Under $250,000

No Investment Made

2012

2011

Figure 23

N = 302

Anticipated Return on Investment for Meeting Meaningful Use Requirements

8%

0%

13%

3%

10%

15%

23%

20%

0%

Don't Know

Not Applicable

$10 Million or More





Less than $2 Million

None

Figure 24

N =302


Preparedness to Meet ICD-10 Conversion

10%

1%

89%

Don't Know

No

Yes

Figure 25

N =302

Level of Investment Made in ICD-10 Conversion

43%

0%

0%

1%

3%

6%

10%

7%

8%

13%

3%

Don't Know

Not Applicable

$15 Million or More





$500,000 to $999,999

$250,000 to $499,999

Under $250,000

No Additional FundsFigure 26

N =302


Expected Change in IT Staff in Next 12 Months

4%

30%

64%

5%

32%

61%

Decrease

No Change

Increase

2012

2011

Figure 27

N = 302

2012 IT Staffing Needs (Top Ten)

10%

10%

12%

12%

13%

14%

17%

20%

22%

43%

System Design/Implementation

Process/Workflow

PC/Server Support

Database Administration

Clinical Transformation

IT Security

System Integration

Clinical Informatics

Network/Architecture Support

Clinical Application SupportFigure 28

N =302


Additional Functions Managed by Senior IT Executives

4%

27%

42%

84%

22%

28%

52%

80%

Biomedical Engineering

Health Information Management

Medical Informatics

Telecommunications

2012

2011

Figure 29

N = 302

Projected Change in IT Operating Budget

3%

6%

14%

30%

46%

2%

5%

12%

19%

56%

Definitely Decrease

Probably Decrease

No Change

Probably Increase

Definitely Increase

2012

2011

Figure 30

N = 302


Reason for Increase in Budget

4%

7%

9%

10%

18%

38%

43%

43%

57%

68%

Business Requirements to Invest in E-Business

Competitive Market Threats

Ability to Prove ROI

Merger/Partnership

Addition of Facility

Need to Upgrade IT Infrastructure

Need to Comply with Regulatory Changes

Overall Budget Increases

Additional Staffing Needed

Overall Growth in Systems

Figure 31

N = 302

Health & Medicine

2012 final leadership survey with cover