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2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
2012 final leadership survey with cover
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2012 final leadership survey with cover

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Some Key lessons For HIT Testing, from 2012 HIMSS Leadership Survey Senior IT Executive Results

Some Key lessons For HIT Testing, from 2012 HIMSS Leadership Survey Senior IT Executive Results

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  • 1. 2012 HIMSS Leadership SurveySenior IT Executive ResultsFebruary 21, 2012 www.himss.org transforming healthcare through IT™
  • 2. 23rd Annual HIMSS Leadership Survey Final Report: Healthcare Senior IT ExecutiveThe 23rd Annual HIMSS Leadership Survey reflects the opinions of informationtechnology (IT) professionals in U.S. healthcare provider organizations regarding the useof IT in their organizations. This study covers a wide array of topics crucial to healthcareIT leaders including IT priorities, issues driving and challenging technology adoption, ITsecurity, as well as IT staffing & budgeting plans.Contents1. Executive Summary2. Methodology3. Profile of Survey Respondents4. IT Priorities5. IT Barriers6. IT and Patient Care7. IT Security8. Health Information Exchange (HIE) Participation9. IT Governance10. Federal Initiatives11. IT Budget and Staff12. About HIMSS13. How to Cite This Study14. For More Information 2 © 2012 Healthcare Information and Management Systems Society
  • 3. FiguresFigure 1. Participant Profile—TitleFigure 2. Participant Profile—Facility TypeFigure 3. Participant Profile—Type of HospitalFigure 4. Participant Profile—RevenueFigure 5. Participant Profile—RegionFigure 6. Top IT Priority – Next Two YearsFigure 7. Primary Clinical IT FocusFigure 8. Primary Financial IT FocusFigure 9. Primary IT Infrastructure FocusFigure 10. Key Business ObjectiveFigure 11. Business Issue with Most Impact on HealthcareFigure 12. Most Significant Barriers to Implementing ITFigure 13. Area that IT Can Most Impact Patient CareFigure 14. Role of CliniciansFigure 15. Access to On-line Patient Information from Remote LocationFigure 16. Security BreachFigure 17. Top Concerns – Security of Computerized Medical InformationFigure 18. Health Information Exchange (HIE) AdoptionFigure 19. Alignment of Organizational & IT Strategic PlanFigure 20. Member of Organization’s Executive CommitteeFigure 21. Senior IT Executive ResponsibilitiesFigure 22. Percent of Organizations that Expect to Qualify for Meaningful Use – Stage OneFigure 23. Level of Investments Made by Healthcare Organizations in Meaningful UseFigure 24. Anticipated Return on Investment for Meeting Meaningful Use RequirementsFigure 25. Preparedness to Meet ICD-10 ConversionFigure 26. Level of Investment Made in ICD-10 ConversionFigure 27. Expected Change in IT Staff in Next 12 MonthsFigure 28. 2012 IT Staffing Needs (Top Ten)Figure 29. Additional Functions Managed by Senior IT ExecutivesFigure 30. Projected Change in IT Operating BudgetFigure 31. Reason for Increase in Budget 3 © 2012 Healthcare Information and Management Systems Society
  • 4. 1. Executive SummaryThe U.S. Federal government’s impact on the provider community’s informationtechnology (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 HealthAct (HITECH) provision in 2009’s American Recovery and Reinvestment Act (ARRA)and 2010’s Patient Protection and Affordable Care Act (PPACA) have challengedproviders to enhance their IT capabilities like never before.Based on the feedback of 302 healthcare IT professionals, nearly three quarters of theparticipants in this year’s Annual HIMSS Leadership Survey indicated that Federalmandates, including meeting Stage One of Meaningful Use and a conversion to ICD-10would be the issues driving their efforts in the next two years. At this time, more thanone-quarter of respondents have already attested to stage one meaningful use andanother third expect to attest by June 2012. In order to prepare to attest for stage onemeaningful use, nearly half of respondents have invested more than $1 million.Respondents also expressed concerns about IT staffing shortages. Considered to be akey barrier in addressing their IT priorities, approximately two-thirds of the respondentsindicated they plan to increase their IT staff in the next year. The leading areas in whichrespondents 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 theirorganization participates in an HIE. However, 22 percent of respondents reported thatthere 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 thetop area of focus for financial IT systems at their organization. In addition, nearly 90percent of respondents indicated they expected to complete their ICD-10 conversion bythe October 2013 deadline.Impact of IT on Patient Care: Three-quarters of respondents indicated that they believeIT can impact patient care by improving clinical/quality outcomes, reducing medicalerrors or helping to standardize care by allowing for the use of evidence-basedmedicine.Role of Clinicians: Clinicians are active participants in many aspects of IT use at theirorganizations, including selecting IT systems for use in their department and acting asproject champions. Each of these items was selected by at least 80 percent ofrespondents. 4 © 2012 Healthcare Information and Management Systems Society
  • 5. Security Concerns: Approximately one-quarter of respondents indicated that theirorganization has experienced a security breach in the past year. Respondents indicatedthat compliance with HIPAA security regulations and CMS security audits were their topconcerns with regard to security at their organizations.IT Governance: There appears to be a strong level of integration between anorganization’s overall strategic plan and their IT strategic plan as half of respondentsreported that their IT plan is part of their overall organizational strategic plan.Organizational Infrastructure: Nineteen percent of respondents indicated that theirprimary infrastructure focus was their server environment, to include virtual services.Senior IT Executive Responsibilities: Nearly all senior IT executives reported that theywere responsible for at least one IT area outside of the traditional IT department,primarily telecommunications. 5 © 2012 Healthcare Information and Management Systems Society
  • 6. 2. MethodologyA total of 302 valid responses were received for this year’s Web-based survey. Data wascollected in December 2011 and January 2102. Survey respondents represent morethan 600 hospitals throughout the United States. The average bed size of the hospitalsin this survey is 479; the median bed size is 240.3. Profile of Survey RespondentsApproximately 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). Another42 percent of respondents reported their title to be Director of IS/IT. The remainingrespondents 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 ofrespondents work at an outpatient setting with the remaining working for other types ofhealthcare facilities including mental/behavioral health facilities, long-term care facilitiesand home care agencies.Respondents working in an acute care hospital-based environment were asked tocharacterize the type of their hospital organization. Most respondents (two-thirds) notedtheir organization was (at least partly) comprised by community hospitals, 21 percentreported working in an academic medical center, and 19 percent of respondents workingin a critical access hospital. Seventeen percent reported that they work for a ruralhospital and 15 percent reported that they work for a general medical/surgical hospital.Annual gross operating revenues for the provider organizations represented in thisyear’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. 6 © 2012 Healthcare Information and Management Systems Society
  • 7. The majority of individuals responding to this year’s survey represented the SouthAtlantic 1, East North Central 2 and West North Central 3 regions. At least 15 percent ofrespondents came from each of these regions. Only five percent of respondents werelocated in the Mountain 4 region.Figures:Figure 1. Participant Profile—TitleFigure 2. Participant Profile—Facility TypeFigure 3. Participant Profile—Type of HospitalFigure 4. Participant Profile—RevenueFigure 5. Participant Profile—Region4. IT PrioritiesHealthcare reform 5 and policy mandates 6 continue to shape the future businesspriorities for healthcare IT executives, with achieving meaningful use as the mostcommonly cited key business objective for the next year.When asked to identify the single information technology (IT) priority to be addressed attheir organization in the next two years, more than one third (38 percent) identifiedachieving meaningful use. While still the top response, the findings this year represent anotable decline when compared to the 2011 survey results. Last year, half of therespondents identified meaningful use as their top IT priority. Beyond meaningful use,approximately 15 percent of respondents identified a focus on clinical systems, such ascomputerized practitioner order entry (CPOE), electronic health records (EHRs) or e-prescribing as their organizations’ top IT priority. This response also placed second inthe 2011 survey.Rounding out the top three responses was leveraging information through the use of adata warehouse, clinical decision support or evidence-based medicine. Thirteen percentof respondents identified this item.Less than one percent of respondents indicated that securing patient information was atop IT priority at their organization at this time. None of the respondents identified thebelow 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, Wisconsin3 Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota4 Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, Wyoming5 Referred to in this study ass new care models or payment structures6 Referred to in this study as compliance with regulations like ARRA, ICD-10 or HIPAA 5010 7 © 2012 Healthcare Information and Management Systems Society
  • 8. Respondents were also asked to identify the primary focus their organization has withregard to clinical IT, financial IT and infrastructure at their organizations.One quarter of respondents (25 percent) indicated that their primary clinical IT focus wasto ensure the presence of a fully-operational EHR; also the top choice in 2011 (25percent). Focusing on physician systems (physician documentation; clinical decisionsupport systems; installing a CPOE system) were other top focus areas, each issueselected 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 thepatient billing system, identified by approximately six percent of respondents.With regard to their top infrastructure priority, respondents were most likely to a focus onservers/virtual servers. This item was selected by 19 percent of respondents. It wasalso the top response in 2011. Rounding out the top three are a focus on mobiledevices (18 percent) and virtual desktops/laptops (16 percent). Security systems werealso identified by 16 percent of respondents.Least frequently selected were cloud computing and telemedicine. These items wereidentified by three and two percent of respondents, respectively.When asked to identify the single key business objective their organization was trying toachieve 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 the2011 survey. Nearly one-quarter of respondents (21 percent) selected improving patientcare/quality of care, followed by sustaining financial viability (15 percent).As with the 2011 study, less than one percent of respondents indicated that attractingqualified staff was the key business objective their organization was trying to achieve inthe next year. None of the respondents indicated that their key business objective wasimproving supply chain dynamics.In the 2011 study, respondents were most likely to identify healthcare reform and policymandates as the top business issues that would have the most impact on healthcare inthe next two years. These responses did not change in the 2012 survey. 8 © 2012 Healthcare Information and Management Systems Society
  • 9. When given a group of categories from which to select, approximately 40 percent ofrespondents identified healthcare reform, which includes items such as accountable careorganizations (ACOs), new care models and payment structures. Nearly another quarter(23 percent) identified policy mandates such as ICD-10 and meaningful use, as abusiness 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. Noother option was selected by more than 10 percent of respondents.Respondents were least likely to indicate staffing issues, such as theavailability/retention of IT or clinical staff. Only two percent of respondents indicated thatthis would be a top business issue driving healthcare. None of the respondentsindicated that external threats or hospital infrastructure needs were drivers that will havea significant impact on healthcare in the next two years.Figures:Figure 6. Top IT Priority – Next Two YearsFigure 7. Primary Clinical IT FocusFigure 8. Primary Financial IT FocusFigure 9. Primary IT Infrastructure FocusFigure 10. Key Business ObjectiveFigure 11. Business Issue with Most Impact on Healthcare5. IT BarriersFor the first time in years, respondents did not identify a lack of adequate financialsupport for IT as the top barrier to IT implementation. Instead, nearly one-quarterreported that they are concerned about staffing resources needed forimplementation.For the past several years, respondents have identified the lack of adequate financialsupport as the top barrier to IT implementation. That is, until now. This year, 22 percentof respondents cited adequate staffing resources as their top challenge, followed by thelack of adequate financial support (14 percent) and vendors’ inability to effectively deliverproducts or services to respondents’ satisfaction (12 percent). No other response wasidentified by more than 10 percent of respondents.Less than one percent of respondents indicated that laws and regulations prohibitingtechnology sharing with referring providers was a barrier to IT implementation. None ofthe respondents indicated that an ability to secure data was a barrier to ITimplementation. This is consistent with what was identified in the 2011 study. 9 © 2012 Healthcare Information and Management Systems Society
  • 10. Figures:Figure 12. Most Significant Barriers to Implementing IT6. IT and Patient CareAs would be expected, IT leaders by and large believe IT can have a positiveimpact on patient care by improving clinical/quality outcomes, reducing medicalerrors or helping to standardize care by allowing for the use of evidence-basedmedicine. Clinicians are also seen to be playing a more expansive role in shapingthe use of IT in their organizations.When asked to select from a list of choices indicating areas where IT could have themost impact on patient care, 38 percent of respondents indicated improvements inclinical and quality outcomes. This item was also most frequently selected in the 2011study. Approximately another quarter of respondents (22 percent) indicated reducingmedical errors/improving patient safety, followed by standardization of clinical care usingevidence-based medicine (16 percent). Respondents were least likely to select remotemonitoring of patients and ensuring that patient data is private and secure.As with the 2011 study, nearly all of survey respondents (98 percent) noted thatclinicians play some role in the IT process. At least 80 percent of respondents indicatedthat clinicians played a role in IT systems evaluation/selection (84 percent) and acted asproject champions to educate and lead other clinicians (81 percent). These were bothtop items selected in the 2011 survey.The survey findings suggest that a growing number of organizations are employingclinical information executives. In the 2011 survey, approximately 30 percent ofrespondents reported to have a Chief Medical Information Officer (CMIO) at theirorganization. In 2012, this number increased to 36 percent. The growth among ChiefNursing Information Officers is less pronounced, moving from eight percent ofrespondents in 2011, to nine percent in 2012.Respondents also reported a growth in remote access to secure, on-line clinical patientinformation. Nearly all respondents (97 percent) reported that physicians have this typeof access, representing a slight increase from the 2011 survey. Approximately 85percent of respondents reported that physician extenders (physician assistants, nursepractitioners) had remote access to patient information; two-thirds reported that non-clinical staff (finance staff, transcriptionists) had this type of remote access, while roughly60 percent noted that both nurses and other clinical professionals such as occupationaltherapists have remote access secure patient information. 10 © 2012 Healthcare Information and Management Systems Society
  • 11. Figures:Figure 13. Area that IT Can Most Impact Patient CareFigure 14. Role of CliniciansFigure 15. Access to On-line Patient Information from Remote Location7. IT SecurityIT Security breaches continue to plague organizations but the reduction in actualviolations reported this year suggests efforts to secure patient information areworking. Compliance with HIPAA security regulations and CMS security auditsdominate the IT executive’s security concerns.Approximately one quarter of respondents (22 percent) noted their organization hadexperienced 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 regardingthe security of electronic medical information at their organizations. Only four percent ofrespondents indicated that they did not have any concerns at this time.Approximately 34 percent of respondents indicated that compliance with HIPAA securityregulations and CMS security audits was their top concern. This displaces internalbreach of security (32 percent), which had been identified as a primary security concernfor the past several years. One-third of respondents (32 percent) also indicated theywere concerned their organization’s security systems were inadequate.Respondents were somewhat less likely to identify funding/financial support for thesecurity process as a barrier than they were in the past. While selected by 13 percent ofrespondents 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 informationdevices. Only six percent of respondents indicated that they were concerned about theirorganization’s ability to secure information on mobile devices.Less than one percent of respondents noted that they had concerns about the ability oftheir business associates to comply with existing business associate agreements.Figures:Figure 16. Security BreachFigure 17. Top Concerns – Security of Computerized Medical Information 11 © 2012 Healthcare Information and Management Systems Society
  • 12. 8. Health Information Exchange (HIE) ParticipationThe involvement in Health Information Exchanges (HIE) shows mixed results thisyear. While the percentage of respondents actually participating in an HIE is flatwhen compared to last year, a growing number of non-participating organizationsare involved in some type of an HIE planning effort.Respondents were asked to identify their current involvement in an HIE, defined as “anorganization which brings together healthcare stakeholders to oversee and govern theexchange 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 somedegree 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 findingconsistent with last year’s participation level. Only six percent claimed their participationwas mandated by some level of government.Similar to the 2011 findings, approximately 22 percent of respondents indicated therewas an HIE in their area, but have chosen not to participate in it at this time. Fourpercent of respondents reported that they participated in an HIE in the past, but that HIEhas failed.One-quarter of respondents noted their organization had yet to start planning toparticipate in an HIE. Based on results from previous studies, this finding represents acontinued decrease in the number of organizations that have yet to begin to plan toparticipate in an HIE.Figures:Figure 19. Health Information Exchange (HIE) Adoption9. IT GovernanceRespondents continue to report that a strong level of integration between the ITstrategic plan at their organization and the organization’s overall strategic plan asevidenced by the senior IT executive’s involvement on their organization’sexecutive committee.Respondents were asked to characterize the level of integration between their IT plansand their organization’s strategic operating, clinical and capital plans. The vast majorityof respondents (85 percent) claimed their IT strategies were aligned with theorganization’s overall strategy. Approximately half of respondents (48 percent) claimingthe IT plan is a specific component of the organization’s overall strategic plan and 12 © 2012 Healthcare Information and Management Systems Society
  • 13. another 37 percent reported that their IT strategic plan is integrated with overall strategicplan, even though the two plans are separate. These findings are consistent withfeedback from previous HIMSS Leadership surveys.Interestingly, 14 percent of respondents indicated that their organization either does nothave an IT strategic plan (seven percent) or does have an IT strategic plan but that thisplan 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 oftheir organization’s executive committee, defined in this study as “the leadership teamthat drives overall organization strategy and direction”.Individuals identifying themselves a senior IT executive were asked to identify whichresponsibilities they assume on a regular basis as part of their job. Driving value from ITinvestments was the most frequently selected item, identified by 94 percent ofrespondents. 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 PlanFigure 21. Member of Organization’s Executive CommitteeFigure 22. Senior IT Executive Responsibilities10. Federal InitiativesOrganizations are making substantial investments in two major federal initiatives– meeting Stage One of Meaningful Use and successfully converting from ICD-9 toICD-10. Most organizations report to be on target to satisfy the requirements ofboth initiatives although a sizeable percentage of respondents expressedreservations about meeting the ICD-10 deadline.More than one-quarter of respondents (26 percent) indicated their organization hasattested to stage one meaningful use and were preparing to meet stage two 13 © 2012 Healthcare Information and Management Systems Society
  • 14. requirements. Another four percent of respondents reported they expected to attest bythe end of 2011 (and presumably have since the time they completed this survey). Morethan one-quarter (27 percent) expect to attest in the first six months of 2012 and 22percent expect to attest in the second six months of 2012. Seventeen (17) percent arewaiting 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 orproject to make in order to achieve Stage One of meaningful use. Only five percent ofrespondents indicated their organization made no additional investment. One-thirdreported they will ultimately invest less than $1 million, 27 percent between $1 millionand $4 million and nearly one-third (29 percent) will invest $5 million or more onachieving stage one meaningful use. The remaining respondents either did not knowthe answer to this question or chose not to disclose this information.Respondents were asked to identify how much money their hospital organization wouldreceive for meeting Stage One meaningful use requirements. Less than one percent ofrespondents reported that they would not receive incentives in Stage One. The belowlist identifies the money that organizations anticipate that they will receive for theirinvestment. • 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 theyexpected to receive or did not know the amount.In addition to achieving meaningful use requirements, healthcare organizations alsoneed to convert from ICD-9 to ICD-10 by October 1, 2013. Nearly 90 percent ofrespondents indicated that they expect to complete their conversion by the deadline.Respondents were also asked to identify the level of investment they were making intheir ICD-10 conversion efforts. Nearly one-third (29 percent) indicated they wereinvesting less than one million in this conversion, fifteen percent indicated were spendingbetween $1 to $4 million, and four percent spent $5 million or more. A very largepercent of respondents (43 percent) couldn’t identify the level of investment they madein their ICD-10 conversion. 14 © 2012 Healthcare Information and Management Systems Society
  • 15. Figures:Figure 22. Percent of Organizations that Expect to Qualify for Stage One MeaningfulUseFigure 23. Level of Investments Made by Healthcare Organizations in Meaningful UseFigure 24. Anticipated Return on Investment for Meeting Meaningful Use RequirementsFigure 25. Preparedness to Meet ICD-10 ConversionFigure 26. Level of Investment Made in ICD-10 Conversion11. IT Budget and StaffFueled in part by the need to expand the number of FTEs to meet the growingnumber of systems/technologies in place, IT leaders expect their operatingbudgets to grow this coming year.According to the 2011 HIMSS Analytics® Database, U.S. hospital IT departmentsemployed 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 toincrease 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 20percent this coming year, 17 percent are targeting a 10 to 20 percent increase while 38percent believe the increase to be less than 10 percent. Only five percent ofrespondents indicated they expected a staffing decrease in the next 12 months, with theremaining respondents (32 percent) projecting their staffing levels to remain the same.Of those respondents expecting staffing increases in 2012, approximately 14 percentreported plans to add more than ten IT FTEs, seven percent planned to add six to ten ITFTEs, 25 percent have budgeted to add three to five IT FTEs, and over one-third (37percent) claimed their organization had budgeted to add one to two IT FTEs. Another 14percent reported that the IT FTEs they plan to add to their organization were notbudgeted.All respondents were asked to identify the areas in which they have the most critical ITstaffing needs. Only eight percent of respondents reported not to have staffing needs attheir 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 applicationsupport as identified by 43 percent of respondents, followed by network/architecturesupport 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 belowareas: 15 © 2012 Healthcare Information and Management Systems Society
  • 16. • 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 departmentunder their supervision. With nearly all senior IT executives (96 percent) claiming to beresponsible for at least one IT area outside of the IT department, telecommunicationswas the most frequently cited support service identified by 80 percent of respondents.Respondents had responsibilities in other areas such as medical/clinical informatics (52percent), health information management (28 percent), and biomedical/clinicalengineering (22 percent). Approximately 13 percent of respondents mentioned theyoversee other areas within their organization to include plant facilities, patientaccounting, and physical security.According to the HIMSS AnalyticsTM Database, the average IS operating expense as atotal expense for U.S. hospitals in 2011, was 2.40 percent. Approximately three-quarters of survey respondents (75 percent) noted their organizations’ operating budgetsfor 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 thenext 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 nextyear, a finding consistent with the 2011 survey.Respondents were most likely to report an increase in their organization’s IT operatingbudget because of the overall growth in the number of systems and technologies in theirorganization (68 percent of respondents). More than half (57 percent) indicated theincrease would be due to additional staffing or consulting services needed to complywith governmental regulations. These were also the top items reported in the 2011survey. Overall budget increases and a need to comply with regulatory changes wereidentified by 43 percent of respondents respectively as a reason for driving an increasedIT 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 alsoleast likely to drive an expected increase in 2011.Among the handful of respondents noting their budget would decrease, two-thirdsclaimed 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 16 © 2012 Healthcare Information and Management Systems Society
  • 17. budget decreases. None of the respondents indicated that a decrease in revenue wasthe 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 MonthsFigure 28. 2012 IT Staffing Needs (Top Ten)Figure 29. Additional Functions Managed by Senior IT ExecutivesFigure 30. Projected Change in IT Operating BudgetFigure 31. Reason for Increase in Budget12. About HIMSSHIMSS is a cause-based, not-for-profit organization exclusively focused on providingglobal leadership for the optimal use of information technology (IT) and managementsystems for the betterment of healthcare. Founded 51 years ago, HIMSS and its relatedorganizations are headquartered in Chicago with additional offices in the United States,Europe and Asia. HIMSS represents more than 44,000 individual members, of whichmore than two thirds work in healthcare provider, governmental and not-for-profitorganizations. HIMSS also includes over 570 corporate members and more than 170not-for-profit organizations that share our mission of transforming healthcare through theeffective use of information technology and management systems. HIMSS frames andleads healthcare practices and public policy through its content expertise, professionaldevelopment, research initiatives, and media vehicles designed to promote informationand management systems’ contributions to improving the quality, safety, access, andcost-effectiveness of patient care. To learn more about HIMSS and to find out how tojoin us and our members in advancing our cause, please visit our website atwww.himss.org.13. How to Cite This StudyIndividuals are encouraged to cite this report and any accompanying graphics in printedmatter, publications, or any other medium, as long as the information is attributed to the23rd Annual HIMSS Leadership Survey. 17 © 2012 Healthcare Information and Management Systems Society
  • 18. 14. For More Information, Contact:Joyce LofstromDirector, Corporate CommunicationsHIMSS312/915-9237jlofstrom@himss.org 18 © 2012 Healthcare Information and Management Systems Society
  • 19. APPENDIX Participant Profile – Title Figure 1 Director of IS/IT 42% Corporate CIO/VP of IS 35% Facility CIO/VP of IS 15% CMIO 2% Manager 2% Department Head/Director 1% CNIO 1% Other 2%N = 302 Participant Profile – Facility Type Figure 2 Stand Alone Hospital 46% Healthcare System 27% Hospital (Part of Multi-Hospital System) 14% Outpatient Setting 5% Long Term Care Facility 2% Mental/Behavioral Health Facility 1% Other 6%N = 302 19 © 2012 Healthcare Information and Management Systems Society
  • 20. Participant Profile – Type of Hospital Figure 3 Community Hospital 66% Academic Medical Center 21% Critical Access Hospital 19% Rural Hospital 17% General Med/Surg Hospital 15%N =264 Participant Profile – Revenue Figure 4 Less than $2 Million 2% $2 Million to $10 Million 7% $11 Million to $50 Million 13% $51 Million to $200 Million 23% $201 Million to $350 Million 11% $351 Million to $500 Million 9% $501 Million to $1 Billion 11% More than $1 Billion 17% Dont Know 9%N = 302 20 © 2012 Healthcare Information and Management Systems Society
  • 21. Participant Profile – Region Figure 5 South Atlantic 16% East North Central 16% West North Central 15% West South Central 12% Mid Atlantic 12% Pacific 11% New England 8% East South Central 5% Mountain 5%N = 302 Top IT Priority – Next Two Years Figure 6 Achieving Meaningful Use 38% 49% Focus On Clinical Systems 15% 23% Leveraging Information 13% 9% Optimizing Use of Current Systems 12% 11% Completing ICD-10 Conversion 11% 0% Interoperability 3% 2% Focus on Ambulatory Systems 2% 2% Ability to Exchange Data 1% 1% Providing Patient-Centric Solutions 1% 1% Securing Patient Information 1% 0% Focus on RCM Systems 0% 0% Focus on Supply Chain Systems 0% 0% 2012 Integration of IT and Medical Devices 0% 0% 2011N = 302 21 © 2012 Healthcare Information and Management Systems Society
  • 22. Primary Clinical IT Focus Figure 7 Fully Operational EHR in Place 25% 24% Focus on Physician Systems 16% 11% Installing CPOE 16% 20% Linking Clinical Systems to Quality Measures 15% 11% Data Warehouse/Clinical Analytics 9% 7% Certification of EHR 4% 8% Closed Loop Medication Administration 3% 1% Establishing Clinical Protocols 2% 3% Focus on Nursing Systems 2% 2% Installing/Upgrading CDR 2% 2% Installing/Upgrading Ancillary 1% 2% Installing PACS 1% 0% 2012 Creating Clinical Documentation Flow Sheets 0% 1% 2011N = 302 Primary Financial IT Focus Figure 8 Implementing ICD-10 67% 48% Upgrading Patient Billing System 6% 14% Upgrading Patient Access System 2% 4% Web Enabling Registration Process 2% 2% Web Enabling Bill Payment Process 2% 2% Implementing Enterprise Scheduling System 1% 3% Eligibility Transactions with Payers 1% 3% Medical Necessity Checking Applications 1% 4% Web Enabling Patient Scheduling 1% 0% Upgrading Encoding System 0% 2% 2012 Claims Transactions Direct with Payers 0% 2% 2011N = 302 22 © 2012 Healthcare Information and Management Systems Society
  • 23. Primary IT Infrastructure Focus Figure 9 Servers/Virtual Servers 19% 22% Mobile Devices 18% 12% Desktops/Virtual Desktops 16% 14% Security Systems 16% 15% Storage and Backup 8% 12% Wired/Wireless Networking 7% 10% Cloud Computing 3% 4% Telemedicine 2% 4% 9% 2012 Other 5% 2011N = 302 Key Business Objective Figure 10 Achieve Meaningful Use 24% 25% Improve Patient Care 21% 21% Sustain Financial Viability 15% 17% Improve Operational Efficiency 13% 17% Increase Market Share 12% 10% Accountable Care Organization 8% Not Applicable Improve Patient Satisfaction 4% 5% Attract Qualified Staff 1% 1% 0% 2012 Improve Supply Chain Dynamics 0% 2011N = 302 23 © 2012 Healthcare Information and Management Systems Society
  • 24. Business Issue with Most Impact on Healthcare Figure 11 Healthcare Reform 40% 36% Policy Mandates 23% 17% Financial Considerations 14% 14% Health Information Exchange 8% 6% Technology Considerations 5% 13% Shifting Healthcare Landscape 3% 6% Consumer Considerations 3% 2% Privacy/Security Issues 3% 2% Staffing Issues 2% 3% Hospital Infrastructure Needs 0% 0% 2012 External Threats 0% 0% 2011N = 302 Most Significant Barriers to Implementing IT Figure 12 Lack of Staffing Resources 21% 17% Lack of Adequate Financial Support 14% 18% Vendor Inability to Deliver Product 12% 11% Difficulty in End User Acceptance 9% 10% Lack of Time Commitment from Clinicians 7% 7% Lack of Clinical Leadership 6% 4% Difficulty Proving ROI 4% 5% Lack of Top Management Support 4% 3% Lack of Interoperable Systems 4% 5% 3% 2012 Lack of Strategic IT Plan 4% 2011N = 302Top 10 Responses 24 © 2012 Healthcare Information and Management Systems Society
  • 25. Area that IT Can Most Impact Patient Care Figure 13 Improving Quality Outcomes 38% 41% Reducing Medical Errors 22% 25% Standardizing Clinical Care 16% 12% Supporting Staff Productivity 7% 6% Providing Competitive Advantage 6% 9% Sharing Information Externally 5% 3% Enabling Remote Access of Data 3% 1% Ensuring that Data is Secure/Private 0% 1% 0% 2012 Providing Remote Monitoring of Patients 0% 2011N = 302 Role of Clinicians Figure 14 Participate in Systems Evaluation 84% 79% Project Champions for Other Clinicians 81% 77% Participate in Development of Policies 59% 60% Involved in Clinician Training 58% 54% Clinicians are Employed as Hospitalists 53% 44% Employed by IS Department 46% 43% Business Project Leaders 43% 42% Explore Innovative Ways to Use IT 42% 42% We have a CMIO 36% 30% Clinican Department Managers Pick Systems 13% 15% We have a CNIO 9% 8% 2012 No Role 3% 2% 2011N = 302 25 © 2012 Healthcare Information and Management Systems Society
  • 26. Access to On-Line Patient Information From Remote Location Figure 15 97% Physicians 95% 85% Physician Extenders 76% 67% Non-Clinical Staff 63% 60% Nurses 56% 59% Other Clinical Professionals 55% 23% 2012 Patients 19% 2011N = 302 Security Breach Figure 16 13% In Last Six Months 18% 22% In Last 12 Months 26% 2012 2011N = 302 26 © 2012 Healthcare Information and Management Systems Society
  • 27. Top Concerns – Security of Computerized Medical Information Figure 17 Compliance with HIPAA and CMS Regulations 34% 30% Inadquate Security Systems in Place 32% 8% Internal Breach of Security 32% 36% External Breach of Security 13% 11% Inadquate Funding for Security Systems 13% 17% Data Leakage 12% 16% Limits of Existing Technology 10% 10% Unauthorized Use by Third Parties 7% 8% Securing Information on Mobile Devices 6% Not Applicable Connecting IT at Remote Locations 5% 6% Patients Lack of Confidence in Security Systems 4% 7% Lack of Compliance with BAA 0% 3% 2012 No Concerns 4% 4% 2011N = 302 Health Information Exchange (HIE) Adoption Figure 18 2% Dont Know What an HIE Is 2% 26% No Plans to Participate 31% 22% HIE in our Area/Dont Participate 21% 6% Required to Participate 7% 49% Participate in HIE 44% 4% Participated in Failed HIE 1% Dont Know 2% 2012 1% 2011N = 302 27 © 2012 Healthcare Information and Management Systems Society
  • 28. Alignment of Organizational & IT Strategic Plan Figure 19 7% No IT Strategic Plan 4% 7% Plans Are Not Aligned 8% 37% Plans are Separate but Aligned 36% IT Strategic Plan is Component of 48% Organizational Plan 51% 1% Other 2012 1% 2011 N = 302 Member of Organization’s Executive Committee Figure 20 57% Yes 65% 43% No 35% 2012 2011 N = 302 28 © 2012 Healthcare Information and Management Systems Society
  • 29. Senior IT Executive Responsibilities Figure 21 94% Drive Value from IT Investments 92% 92% Contribute to Overall Business Strategy 89% 90% Support Business/Clinical Process Owners 90% Enable Executive Team to Improve 90% Management 88% 88% Manage IS Department 80% 83% 2012 Process Change Management 83% 2011N = 257 Percent of Organizations That Expect to Qualify for Stage One Meaningful Use Figure 22 Have Already Attested 26% Will Attest by End of 2011 4% First Six Months of 2012 27% Second Six Months of 2012 22% Wait Until 2013 17% Not Planning to Attest 2% Dont Know 3%N =302 29 © 2012 Healthcare Information and Management Systems Society
  • 30. Level of Investment Made by Healthcare Organizations in Meaningful Use Figure 23 No Investment Made 5% 8% Under $250,000 14% 12% $250,000 to $499,999 11% 6% $500,000 to $999,999 7% 9% $1 Million to $2 Million 14% 14% $3 Million to $4 Million 13% 9% $5 Million to $9 Million 10% 10% $10 Million to $19 Million 4% 4% $20 Million or More 3% 6% Prefer Not to Disclose 8% 8% Not Applicable 2% 3% 2012 Dont Know 8% 11% 2011N = 302 Anticipated Return on Investment for Meeting Meaningful Use Requirements Figure 24 None 0% Less than $2 Million 20% $2 Million to $3 Million 23% $4 Million to $5 Million 15% $6 Million to $7 Million 10% $8 Million to $9 Million 3% $10 Million or More 13% Not Applicable 0% Dont Know 8%N =302 30 © 2012 Healthcare Information and Management Systems Society
  • 31. Preparedness to Meet ICD-10 Conversion Figure 25 Yes 89% No 1% Dont Know 10%N =302 Level of Investment Made in ICD-10 Conversion Figure 26 No Additional Funds 3% Under $250,000 13% $250,000 to $499,999 8% $500,000 to $999,999 7% $1 Million to $2 Million 10% $3 Million to $4 Million 6% $5 Million to $9 Million 3% $10 Million to $14 Million 1% $15 Million or More 0% Not Applicable 0% Dont Know 43%N =302 31 © 2012 Healthcare Information and Management Systems Society
  • 32. Expected Change in IT Staff in Next 12 Months Figure 27 61% Increase 64% 32% No Change 30% 5% Decrease 4% 2012 2011N = 302 2012 IT Staffing Needs (Top Ten) Figure 28 Clinical Application Support 43% Network/Architecture Support 22% Clinical Informatics 20% System Integration 17% IT Security 14% Clinical Transformation 13% Database Administration 12% PC/Server Support 12% Process/Workflow 10% System Design/Implementation 10%N =302 32 © 2012 Healthcare Information and Management Systems Society
  • 33. Additional Functions Managed by Senior IT Executives Figure 29 80% Telecommunications 84% 52% Medical Informatics 42% 28% Health Information Management 27% 22% Biomedical Engineering 4% 2012 2011N = 302 Projected Change in IT Operating Budget Figure 30 56% Definitely Increase 46% 19% Probably Increase 30% 12% No Change 14% 5% Probably Decrease 6% 2% Definitely Decrease 2012 3% 2011N = 302 33 © 2012 Healthcare Information and Management Systems Society
  • 34. Reason for Increase in Budget Figure 31 Overall Growth in Systems 68% Additional Staffing Needed 57% Overall Budget Increases 43% Need to Comply with Regulatory Changes 43% Need to Upgrade IT Infrastructure 38% Addition of Facility 18% Merger/Partnership 10% Ability to Prove ROI 9% Competitive Market Threats 7% Business Requirements to Invest in E-Business 4%N = 302 34 © 2012 Healthcare Information and Management Systems Society

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