Leadership Final Report 022813

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Sponsored by:

transforming healthcare through IT

2013 HIMSS Leadership SurveySenior IT Executive Results

March 4, 2013

www.himss.org


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2 2013 Healthcare Information and Management Systems Society

24th

Annual HIMSS Leadership SurveyFinal Report: Healthcare Senior IT Executive

Sponsored by Infor

The 24thAnnual 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. About Infor Healthcare

14. About Infor

15. How to Cite This Study

16. For More Information


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Figures

Figure 1. Participant ProfileTitle

Figure 2. Participant ProfileFacility Type

Figure 3. Participant ProfileType of Hospital

Figure 4. Participant ProfileRevenue

Figure 5. Participant ProfileRegionFigure 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 LocationFigure 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 Organizations Executive Committee

Figure 21. Senior IT Executive Responsibilities

Figure 22. Organizations Approach to IT Spending Based on Meaningful Use

Figure 23. Percent of Organizations that Expect to Qualify for Stage One Meaningful Use

Figure 24. Level of Investments Made by Healthcare Organizations in Meaningful Use

Stage 1Figure 25. Percent of Organizations that Expect to Qualify for Stage 2 Meaningful Use

Figure 26. Level of Investment Made by Healthcare Organizations in Meaningful Use

Stage 2

Figure 27. Anticipated ROI for Meeting Meaningful Use Stage 1 Requirements


Figure 29. Preparedness to Meet ICD-10 Conversion

Figure 30. Level of Investment Made in ICD-10 Conversion

Figure 31. Expected Change in IT Staff in Next 12 Months

Figure 32. Number of IT FTEs Budgeted to be Added

Figure 33. 2013 IT Staffing Needs (Top Ten)Figure 34. Additional Functions Managed by Senior IT Executives

Figure 35. Projected Change in IT Operating Budget

Figure 36. Reason for Increase in Budget

Figure 37. Reason for Decrease in Budget


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1. Executive Summary

The findings from this years Annual HIMSS Leadership Survey, sponsored by Infor,

strongly suggest that the federal governments efforts to impact provider investments in

information technologies to qualify for Meaningful Use (MU) and ICD-10 conversions,

are paying off. To illustrate, two-thirds of survey respondents have already qualified for

Stage 1 Meaningful Use while three-quarters indicated they expect to qualify for Stage 2in 2014. Additionally, 87 percent of respondents indicated they expect to complete their

conversion to ICD-10 by October 2014.

Now that a majority of IT executives report having achieved Meaningful Use Stage 1,

many leaders have turned their attention to MU Stage 2. In fact, findings reveal that

more than one-quarter (28 percent) of organizations have identified the implementation

of the systems needed to achieve Meaningful Use as their key IT priority. One-quarter

(25 percent) of respondents also reported that they will invest a minimum of $1 million to

achieve Stage 2.

Respondents also continue to express concerns about IT staffing shortages. While half

of the respondents (51 percent) indicated they plan to increase their IT staff in the next

year, 21 percent are concerned that they wont be able to secure the IT staff needed to

successfully achieve their IT objectives. 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): Approximately half of respondents (51 percent)reported their organization participates in at least one HIE in their area, a finding that is

slightly increased from last years participation level.

ICD-10: Approximately half (47 percent) of respondents to this study indicated that

implementing CPT-10/ICD-10 continues to be the top focus for financial IT systems.

Impact of IT on Patient Care:Respondents were most likely to indicate that 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.


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Securit y Concerns:Nineteen (19) percent of respondents indicated that their

organization has experienced a security breach in the past year. Respondents were

most likely to indicate that securing information on mobile devices was the top security

concern at their organization.

Organizational Infrastructure: Almost one-quarter of respondents (22 percent)

indicated that a focus on security systems was their current key infrastructure priority.

IT Governance: There continues to be a strong level of integration between an

organizations 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.

Senior IT Executive Responsibilit ies: Executives were most likely to report that they

play a role in contributing to overall business strategy and driving value from IT

investments.

External Areas of Responsibilit ies: Nearly all senior IT executives reported that theywere responsible for at least one IT area outside of the traditional IT department,

primarily telecommunications.

Consumer Attitudes on Health IT: On a scale of one to seven, where one is of no

importance and seven is a high degree of importance, IT executives recorded an

average score of 4.94 with regard to the importance that patient/consumer attitudes

have on adoption of new technology.


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2. Methodology

A total of 298 valid responses were received for this years Web-based survey. Data was

collected between December 2012 and February 2013. Survey respondents represent

nearly 600 hospitals throughout the United States. The average bed size of the

hospitals represented in this survey is 468 (median = 200 beds).

3. Profile of Survey Respondents

More than half of respondents (55 percent) identified themselves as a Chief Information

Officer (CIO), at either the corporate-level (36 percent) or the facility level (19 percent).

Another third (31 percent) of respondents indicated they were a Director of Information

Systems/Information Technology (IS/IT) and six percent of the respondents were Chief

Medical Information Officers (CMIOs). The remaining respondents include Chief

Nursing Information Officer (CNIO) and Manager of ITs.

Nearly 90 percent of survey respondents reported working for an acute care hospital-based environment, either at a stand-alone hospital (48 percent), a healthcare system

(27 percent) or hospital as a part of a multi-hospital system (14 percent). Another six

percent of respondents work at an outpatient setting. The remaining respondents

reported working for other types of healthcare facilities including mental/behavioral

health facilities, long-term care facilities and home care agencies.

Respondents working for an acute care, hospital-based environment were asked to

identify the types of hospitals that were part of their organization. Approximately two-

thirds of respondents (64 percent) noted that at least one facility in their organization

was a community hospital. One-quarter of respondents indicated that their organizationcontained at least one critical access hospital and 17 percent reported working for an

academic medical center. Thirteen (13) percent reported that they work for a general

medical/surgical hospital.

Annual gross operating revenues for the provider organizations represented in this

years survey were:

$50 million or less25 percent;

$51 million to $200 million23 percent;

$201 million to $350 million11 percent;$351 million to $500 million7 percent;

$501 million to $1 billion10 percent;

More than $1 billion15 percent; and

Dont Know/Not Applicable10 percent.


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Respondents were most likely to work in the East North Central1region of the United

States (17 percent), followed by the Mid Atlantic2and South Atlantic3regions (16 percent

each). New England4had the fewest number of respondents (six percent).

Figures:

Figure 1. Participant ProfileTitle

Figure 2. Participant ProfileFacility TypeFigure 3. Participant ProfileType of Hospital

Figure 4. Participant Profile Revenue

Figure 5. Participant Profile Region

4. IT Priorit ies

Healthcare reform5was identified as the key issue that would most impact

healthcare delivery in the next two years. In this context, IT executives reported

their organizations were focused on achieving Meaningful Use, optimizing

currently installed systems and leveraging information housed in existingsystems to improve healthcare.

IT Priorities

When asked to identify the top IT priority to be addressed at their organization in the

next two years, respondents were most likely to identify implementing the systems

needed to achieve Meaningful Use (28 percent). However, the number of respondents

identifying this area as a top IT priority continues to drop from a peak of half of

respondents (50 percent) in 2011 and 38 percent in 2012.

Another twenty percent of respondents indicated their top IT priority was to optimize the

effective use of their currently installed systems. A focus on leveraging information

housed in data warehouses and business intelligence systems rounds out the top three

for the second consecutive year. This was identified by 17 percent of respondents.

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 a

focus on revenue cycle management (RCM) or supply chain systems as a top IT priority

in the next two years.

1Illinois, Indiana, Michigan, Ohio, Wisconsin2New Jersey, New York, Pennsylvania3Delaware, Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia, Washington, DC, West Virginia,4Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont5Referred to in this study as ACOs, new care models or payment structures


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To more fully understand the areas on which IT executives were focusing their attention,

respondents were also asked to identify the primary focus their organization has with

regard to clinical IT, financial IT and infrastructure at their organizations.

Primary Clinical IT Focus

In 2013, respondents indicated that ensuring their organization has a fully functionalEHR is their primary clinical IT focus (19 percent). However, the number of respondents

indicating this to be the case declined from the 25 percent reported in 2012. A focus on

physician systems, such as physician documentation or clinical decision support tools,

was identified by 16 percent of respondents as a priority; another 16 percent of

respondents indicated a focus on linking clinical systems with quality measures and

outcomes.

Less than one percent of respondents indicated that creating clinical documentation flow

sheets was a primary clinical focus. None of the respondents indicated that installing a

PACS system was a top clinical focus at this time.

Primary Financial IT Focus

Implementing CPT-10/ICD-10 continues to be the top focus for financial IT systems

among the respondents to this study. Approximately half of respondents (47 percent)

indicated this to be their top financial IT focus; this is a decrease from the two-thirds of

respondents who reported this to be the case in 2012. Another 15 percent of

respondents indicated their organizations key financial IT focus was to upgrade financial

analytics systems to support Accountable Care Organizations (ACOs) and a bundled

payment system. Rounding out the top three is upgrading the patient billing system,identified by 12 percent of respondents.

One percent of respondents or fewer indicated that the following items were a top IT

priority with regard to financial systems at their organizations.

Implementing claims transactions directly with payers (no clearinghouse);

Web-enabling the patient scheduling process to improve patient self-service;

Implementing direct eligibility transactions with payers; and

Upgrading the encoding system.

None of the respondents indicated their organization had a present focus on web-

enabling the bill payment process to improve patient self-service functions.


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Primary Infrastructure Focus

With regard to their top infrastructure priority, nearly one-quarter of respondents

identified a focus on security systems (22 percent), up from 16 percent in 2012. This is

followed by last years top response, servers/virtual servers, which was identified by 18

percent of respondents. Rounding out the top three is a focus on mobile devices, which

was identified by 16 percent of respondents.

Respondents were least likely to identify that either deploying a vendor neutral archive

system or telemedicine were key infrastructure priorities at their organizations. Each of

these was identified by less than three percent of respondents.

Key Business Objective

When asked to identify the single key business objective their organization was trying to

achieve in the next 12 months, nearly one quarter of respondents (21 percent) indicated

sustaining financial viability. This represents an increase from the 15 percent ofrespondents that selected this response in the 2012 study.

Rounding out the top three key business objectives are improving patient care/quality of

care and improved outcomes and improved operational efficiencies. These were

selected by 19 and 17 percent of respondents, respectively. Last years top response,

achieving Meaningful Use dropped to fourth place, identified by only 15 percent of

respondents.

For the past several years, very few respondents have indicated that attracting qualified

staff or improving supply chain dynamics are key business objectives for theirorganizations. This continues to be the case in 2013, when these items were selected

by a combined total of one percent of respondents.

Business Issue Driving Healthcare

This years survey respondents continue to identify healthcare reform as the top

business issues that would have the most impact on healthcare in the next two years.

This option, which includes items such as ACOs, new care models and payment

structures was selected by 37 percent of respondents.

Rounding out the top three responses are financial considerations such as the demand

for capital (16 percent) or creating new revenue sources and policy mandates such as

ICD-10 and Meaningful Use (14 percent). These items also rounded out the top three

responses in 2012. No other option was selected by more than 10 percent of

respondents.


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Respondents were least likely to indicate hospital non-IT infrastructure needs, such as

facility upgrades and mergers or acquisitions (one percent), would be a business issue

impacting 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 second consecutive year, respondents indicated that the ability to hire thenecessary staffing resources was the key barrier to being able to implement IT at

their organizations today. Having the appropriate financial resources also

continues to be a key barrier to IT implementation.

Respondents indicated that being able to hire adequate staffing resources was the top

barrier to successfully implementing IT at their organizations for the second year in a

row. This was selected by 21 percent of respondents.

Rounding out the top three responses are lack of financial support (15 percent) and

vendors inability to effectively deliver products or services to respondents satisfaction(13 percent). These responses also rounded out the top three in the 2012 survey. No

other response was identified by more than 10 percent of respondents.

One percent of respondents indicated that laws and regulations prohibiting technology

sharing with referring providers was a barrier to IT implementation at their organizations.

The same number of respondents indicated that the ability to secure data was a barrier

to IT implementation. Only one respondent noted that his/her organization had no

barriers to IT implementation.

Figures:Figure 12. Most Significant Barriers to Implementing IT


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6. IT and Patient Care

IT leaders continued to indicate that IT positi vely impacts patient care through

improved clinical/quality outcomes, reduced medical errors or standardized care

by allowing for the use of evidence-based medicine. IT professionals also

reported that clinicians continue to be widely engaged in the IT process, including

participation in the evaluation and selection of IT systems.

Respondents continue to indicate that IT can most impact patient care by improving

clinical and quality outcomes. This was selected by 31 percent of respondents and was

also the most frequently identified response for the past two years. One-quarter of

respondents (25 percent) indicated that IT can impact patient care by reducing medical

errors/improving patient safety, while 12 percent indicated that standardization of clinical

care using evidence-based medicine would be a benefit. These items also rounded out

the top three responses last year.

Less than two percent of respondents indicated the greatest impact that IT could haveon patient care would be to ensure that patient data is private and secure. This was also

the least frequently identified option in the 2012 study.

Nearly all of survey respondents noted that clinicians play some role in the IT process as

four percent of the respondents indicated that clinicians have no role in the IT process.

This is consistent with the data collected in 2012. Respondents were most likely to

report that clinicians participate in IT systems evaluation and selection (76 percent).

Nearly three-quarters of respondents (74 percent) also reported that clinicians act as

project champions to educate and lead other clinicians. These were also the top two

responses identified in the 2012 study.

Approximately one-third of respondents (32 percent) indicated that their organization

employs a Chief Medical Information Officer (CMIO). This is a slight decrease in the

number of respondents who reported this to be the case in 2012 (36 percent). The

number of respondents reporting that their organizations employ a Chief Nursing

Information Officer (CNIO) has also decreased slightly in the past year (seven percent

compared to nine percent).

When asked which individuals have remote access to secure, on-line clinical patient

information, physician mentions are almost universal; 97 percent of respondentsreported this to be the case. This is consistent with what was reported in 2012. The

percent of respondents indicating that different groups of individuals have access to this

type of information is noted below.


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Physicians 97 percent;

Physician extenders 81 percent;

Non-clinical staff (i.e. transcriptionists) 65 percent;

Nurses 57 percent;

Other clinical professionals (i.e. occupational therapists) 52 percent; and

Patients 28 percent.

While the availability to access data remotely has remained relatively constant for most

of the groups identified above, there has been a steady increase in the number of

organizations that are making this type of information available to patients. The percent

of respondents indicating this to be the case has increased from 19 percent in 2011 to

the current 28 percent.

Finally, on a scale of one to seven, where one is of no importance and seven is a high

degree of importance, IT executives recorded an average score of 4.94 with regard to

the importance that patient/consumer attitudes have on adoption of new technology.

This question was not asked in 2012.

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 Secur ity

IT Securi ty breaches continue to plague organizations but the reduction in actual

violations reported this year suggests efforts to secure patient information may beworking. Respondents were most likely to indicate that securing information on

mobile devices was the top security concern at their organization.

Nineteen (19) percent of respondents noted their organization had experienced some

type of security breach in the past 12 months. In 2012, 22 percent of respondents

reported this to be the case.

Respondents were also asked to identify no more than two concerns that they had

regarding the security of electronic medical information at their organizations. Only three

percent of respondents indicated that they did not have any concerns at this time.

More than one-third of respondents (36 percent) indicated that securing information on

mobile devices was the top security concern at their organization; this is a substantial

increase from the six percent of respondents who indicated this to be a top security

concern in 2012. Compliance with HIPAA security regulations and CMS security audits

was identified as a top concern by 28 percent of respondents. Rounding out the top


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three responses was an internal breach of security, identified by 27 percent of

respondents.

The percent of respondents indicating that funding/financial support for the security

process is a barrier continues to decline. This was identified by eight percent of

respondents in 2013, compared to 13 percent in 2012 and 17 percent in 2011.

Respondents were least likely to indicate concerns about the ability of their business

associates to comply with existing business associate agreements; this was selected by

three percent of respondents.

Figures:

Figure 16. Security Breach

Figure 17. Top Concerns Security of Computerized Medical Information

8. Health Information Exchange (HIE) Participation

Approximately half of respondents repor ted their organizat ion part ic ipates in at

least one HIE in their area, a finding that is slight ly increased from last years

participation level.

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-seven percent) hadsome degree of familiarity with the concept of an HIE. More than half of respondents (51

percent) reported their organization participates in at least one HIE in their area, a

finding that is slightly increased from last years participation level. Only six percent

claimed their participation was mandated by some level of government.

Similar to previous surveys, approximately 21 percent of respondents indicated there

was an HIE in their area, but have chosen not to participate in it at this time. Three

percent of respondents reported that they participated in an HIE in the past, but that HIE

has failed.

One-quarter (25 percent) of respondents noted their organization had yet to start

planning to participate in an HIE. This is consistent to what was reported in 2012.

Figures:

Figure 18. Health Information Exchange (HIE) Adoption


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9. IT Governance

There continues to be a strong level of integration between the IT strategic plan at

respondents organizations and their organizations overall strategic plans.

Senior IT executives also play a key role in contributing to overall business

strategy at their organizations.

Respondents were asked to characterize the level of integration between their IT plans

and their organizations strategic operating, clinical and capital plans. The vast majority

of respondents claimed their IT strategies were aligned with the organizations overall

strategy with almost half of respondents (46 percent) indicating that the IT plan at their

organization is a specific component of the organizations overall strategic plan; and

another 37 percent reporting that their organizations IT strategic plans are integrated

with overall strategic plan, even though the two plans are separate. These findings are

consistent with feedback from previous HIMSS Leadership surveys.

Nine percent of respondents indicated that their organization does not have an ITstrategic plan. Another eight percent of respondents indicated that while their

organization has a strategic plan, the IT strategic plan is not integrated with the

organizations overall strategic plan.

Sixty (60) percent of respondents claimed they are a member of their organizations

executive committee, defined in this study as the leadership team that drives overall

organization strategy and direction. This is slightly higher than the 57 percent of

respondents that reported this to be the case in 2012.

Individuals identifying themselves a senior IT executive were asked to identify whichresponsibilities they assume on a regular basis as part of their job. Contributing to

overall business strategy was most frequently identified (89 percent). Last years most

frequently identified response, driving value from IT investments, was identified by 88

percent of respondents.

The percent of respondents identifying each option is listed below.

Contribute to overall business strategy 89 percent;

Drive value from IT investments 88 percent;

Enable the CEO/executive team to improve management through IT 86 percent;Support Business and clinical process owners 86 percent;

Manage IS department operations 82 percent; and

Responsible for process change management to be supported by IT 77 percent.


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Figures:

Figure 19. Alignment of Organizational & IT Strategic Plan

Figure 20. Member of Organizations Executive Committee

Figure 21. Senior IT Executive Responsibilities

10. Federal Init iatives

Investments in technologies to help posi tion organizations to qualify for

meaningful use and the conversion to ICD-10 are paying off . Sixty percent of

respondents reported that they have already qualif ied for Stage 1 and three-

quarters indicated that they expect to qualify for Stage 2 in 2014. Nearly all

respondents, 87 percent, indicated they expect to complete their conversion to

ICD-10 October 2014.

Respondents were asked to identify their approach to the investments that will be made

to achieve Meaningful Use. The majority of respondents (60 percent) indicated that

because they have already achieved Stage 1, they are focusing their investments onachieving Stage 2. Less than one-third of respondents (30 percent) indicated that they

are making additional investments to qualify for Meaningful Use incentives, while four

percent are identifying the gaps in their environment, but waiting to invest at this time.

Only one percent of the respondents indicated that they are not making any investments

to qualify for Meaningful Use at this time.

Meaningful Use Stage 1

Two-thirds (66 percent) of respondents indicated their organization has already attested

to Stage 1 of Meaningful Use. Another four percent of respondents reported theyexpected to attest by the end of 2012 (and presumably have since the time they

completed this survey). Another quarter (24 percent) of respondents reported that they

expect to attest by the close of 2013. Less than two percent will not attest at any time.

Regarding the amount of money spent (or will spend) to achieve Stage 1, approximately

five percent of respondents indicated their organization made no additional investment.

One-third (33 percent) reported they will ultimately invest less than $1 million, while 28

percent reported that their organization will invest between $1 million and $4 million to

achieve Stage 1 requirements. Eighteen (18) percent will invest $5 million or more on

achieving Stage 1 Meaningful Use. The remaining respondents either did not know theanswer to this question or chose not to disclose this information.

Respondents working for an organization that includes at least one hospital were asked

to identify how much money their organization would receive for meeting Stage 1

Meaningful Use requirements. Less than one percent of respondents reported that they


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would not receive incentives in Stage 1. The below list identifies the money that

organizations anticipate that they will receive for their investment.

Less than $2 million 30 percent;

$2 million to $3 million 23 percent;


$6 million to $7 million 6 percent;$8 million to $9 million 3 percent; and

$10 million or more 7 percent.

The remaining respondents either preferred not to disclose the level of money they

expected to receive or did not know the amount.

Meaningful Use Stage 2

Respondents were also asked to identify when they expected that their organization

would qualify for the Stage 2 Meaningful Use requirements. Three-quarters (75 percent)of respondents indicated that they anticipated that their organization would qualify for the

incentives available through Stage 2 in 2014. Another 15 percent noted that they would

qualify for these incentives in 2015. One percent indicated that their organization would

qualify for Stage 2 in 2016 or later and four percent indicated they had no plans to

qualify for Stage 2. Six percent were unsure of their plans at this time.

As to how much money spent (or will spend) to achieve Stage 2, 11 percent of

respondents indicated that their organization will make no additional investment in IT at

this time. More than one third (38 percent) indicated that their organization will invest

less than $1 million to achieve Stage 2, while 18 percent will make an investment of $1to $4 million. Seven percent expect their organization to make an investment of at least

$5 million to achieve Stage 2. A large percent of respondents (17 percent) also

indicated that they were unsure of the level of investment that would be needed at their

organization at this time.

When asked to project the amount of money they anticipated their organization will

receive as a result of Stage 2, two percent of respondents working for a hospital-based

organization did not believe they would receive any incentive. The below list identifies

the money that organizations anticipate that they will receive for their investment.

Less than $2 million 38 percent;




$8 million to $9 million 2 percent; and

$10 million or more 4 percent.


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The remaining respondents either preferred not to disclose the level of money they

expected to receive or did not know the amount.

ICD-10

In the past year, the date by which healthcare organizations needed to convert fromICD-9 to ICD-10 was deferred one year, to October 1, 2014. Respondents were very

optimistic they would be able to achieve this objective, as 87 percent of respondents

indicated that they expect to complete their conversion by this deadline.

Respondents were also asked to identify the level of investment they were making in

their ICD-10 conversion efforts. More than one-third (39 percent) of respondents

indicated they were investing less than $1 million in this conversion. Another 13 percent

indicated they were spending between $1million and $4 million, and three percent spent

$5 million or more. While these numbers represent, in general, a lower level of

investment than was reported last year, a very large percent of respondents (33 percent)were unsure of the level of investment they made in their ICD-10 conversion.

Figures:

Figure 22. Organizations Approach to IT Spending based on Meaningful Use

Figure 23. Percent of Organizations that Expect to Qualify for Stage 1 Meaningful Use

Figure 24. Level of Investments Made by Healthcare Organizations in Meaningful Use Stage 1

Figure 25. Percent of Organizations that Expect to Qualify for Stage 2 Meaningful Use

Figure 26. Level of Investments Made by Healthcare Organizations in Meaningful Use Stage 2


Figure 28. Anticipated ROI for Meeting Meaningful Use Stage 2 RequirementsFigure 29. Preparedness to Meet ICD-10 Conversion

Figure 30. Level of Investment Made in ICD-10 Conversion

11. IT Budget and Staff

Driven by an overall increase in the number of systems they need to manage, IT

leaders expect both their operating budgets and the number of individuals

employed in the IT department to increase in the next year. Staffing needs are

greatest in the area of clinical application support.

IT Staffing

According to the 2012 HIMSS AnalyticsDatabase, U.S. hospital IT departments

employed an average of 35 IT FTEs (median six IT FTEs). Half of respondents (51

percent) in this years survey indicated they anticipated to increase the number of IT staff

at their organization in the next 12 months. This represents a reduction from the 61

percent who reported this to be the case in 2012.


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More specifically, seven 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 28 percent believe the increase will be less than 10 percent.

More than one-third (38 percent) of respondents indicated that staffing levels would

remain the same over the next 12 months, while seven percent of respondents indicatedthey expected a staffing decrease in the next 12 months.

Of those respondents expecting staffing increases in 2012, approximately nine percent

reported plans to add more than ten IT FTEs, 13 percent planned to add six to ten IT

FTEs, 20 percent have budgeted to add three to five IT FTEs, and over one-third (34

percent) indicated their organization had budgeted to add one to two IT FTEs. Fifteen

(15) 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 ITstaffing needs. Six percent of respondents reported that their organization did not have

any IT staffing needs at this time. Clinical application support continues to be the area in

which respondents were most likely to indicate a staffing need, identified by 34 percent

of respondents. This is followed by network/architecture support professionals (21

percent) and clinical informatics professionals (18 percent). These areas have been the

top three areas of need for the past three years.

Five percent or fewer respondents reported having critical staffing needs in the below

areas:

IT management (five percent); and

IT planning (four percent).

Among senior IT executives, 92 percent indicated they were responsible for at least one

area outside of the IT department. Senior IT executives were most likely to report that

they were also responsible for the telecommunications functions at their organizations

(75 percent). Respondents had responsibilities in other areas such as medical/clinical

informatics (51 percent), health information management (26 percent), and

biomedical/clinical engineering (18 percent).

IT Budgets

According to the HIMSS AnalyticsDatabase, the average IS operating expense as a

total expense for U.S. hospitals in 2012, was 2.73 percent. Slightly more than three-

quarters of survey respondents (76 percent) noted their organizations operating budgets

for 2013 would increase over 2012 levels. These findings are consistent with what was


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reported in the 2012 study. Approximately half (47 percent) of the respondents noted

their budget would definitely increase in the next year while 29 percent identified a

probable increase.

Fifteen (15) percent of respondents reported their IT budget would remain unchanged

and eight percent of respondents indicated their budget would decrease in the next year.

These findings are similar to what was reported in 2012.

Respondents continue to report an increase in their organizations IT operating budget is

due to the overall growth in the number of systems and technologies in their organization

(58 percent of respondents). Half of respondents (52 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 2012 survey.

Overall budget increases and a need to comply with regulatory changes were each

identified by 42 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; only five percent of

respondents indicated this to be the case. This area was also least likely to drive an

expected increase in 2012.

Among the handful of respondents noting their budget would decrease, approximately

half (46 percent) indicated that the decrease was tied to a reduction in the organizations

revenues. More than one-third (36 percent) indicated that an IT budget decrease was a

result of a reduction in hospital revenues. None of the respondents indicated that a

decrease in revenue was the result of outsourcing IT services to a low cost provider.

Figures:

Figure 31. Expected Change in IT Staff in Next 12 Months

Figure 32. Number of IT FTEs Budgeted To Be Added

Figure 33. 2013 IT Staffing Needs (Top Ten)

Figure 34. Additional Functions Managed by Senior IT Executives

Figure 35. Projected Change in IT Operating Budget

Figure 36. Reason for Increase in Budget

Figure 37. Reason for Decrease in Budget


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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 whichmore 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. About Infor Healthcare

Infor is an industry-leading provider of healthcare IT solutions that help to standardize,

centralize, and automate business processes across an entire organization. Infors

solutions for healthcare business applications and healthcare integration platforms are

recognized as market leaders by the most recent HIMSS Analytics Vendor Market Share

report. To learn more about Infor Healthcare, please visitwww.infor.com/healthcare.

14. About Infor

Infor is the third-largest provider of enterprise applications and services, helping 70,000

customers in 194 countries improve operations, drive growth, and quickly adapt to

changes in business demands. Infor offers deep industry-specific applications and

suites, engineered for speed, using ground-breaking technology that delivers a rich user

experience, and flexible deployment options that give customers a choice to run their

businesses in the cloud, on-premises, or both. To learn more about Infor, please visit

www.infor.com.

15. 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

24thAnnual HIMSS Leadership Survey, sponsored by Infor.
http://www.himss.org/http://www.himss.org/http://www.infor.com/healthcarehttp://www.infor.com/healthcarehttp://www.infor.com/healthcarehttp://www.infor.com/http://www.infor.com/http://www.infor.com/http://www.infor.com/healthcarehttp://www.himss.org/


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16. For More Information, Contact:

Joyce Lofstrom

Director, Corporate Communications

HIMSS

312/915-9237

[email protected]
mailto:[email protected]:[email protected]


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Leadership Final Report 022813

Documents

Transcript of Leadership Final Report 022813