Analyzing the HIMSS Leadership Survey of Healthcare CIOs

The Health Information and Management Systems Society’s 25th annual HIMSS Leadership Survey, released at the HIMSS14 conference, offers much insight into the top concerns and challenges of healthcare CIOs and other IT executives.

What follows is an in-depth look at the survey results as well as occasional comments from Jennifer Horowitz, the senior director of research for HIMSS Analytics, the division of HIMSS that conducted the survey in December 2013.

The biggest factor is healthcare’s changing payment models (23 percent), though this is down from 37 percent in 2013’s survey. Right behind it, at 22 percent, are policy mandates such as the ICD-10 conversion, which much be completed by Oct. 1, 2015. (Note: At the time of the survey, the ICD-10 deadline was Oct. 1, 2014; March’s Congressional votes pushed it back one year. Again.) Demand for capital and creating new revenue sources checks in at 17 percent. Non-IT infrastructure needs such as facility upgrades aren’t important; neither are outside threats such as terrorism or natural disasters.

For 25 percent of respondents, it’s meaningful use. This is down from 28 percent in 2013 and 50 percent in 2011 — not surprising, given that meaningful use enters Stage 2 in 2014 and given that the Government Accountability Office reports that hospitals and physicians are dropping out of meaningful use.

Additional priorities include more efficient use of existing IT systems (19 percent) and big data analytics using what’s in BI systems and clinical data warehouses. Several initiatives are of little concern: Personal health information (PHI) security, identity management, medical device integration, consumer-focused solutions, revenue cycle management and supply chain management.

According to HIMSS Analytics, the average IT operating expense in U.S. hospitals is 3.08 percent of total expense. Among survey respondents, 65 percent say their IT budget would increase in 2014, 19 percent expect an unchanged budget and 12 percent expect a decrease.

Several factors drive budget increases: Growing systems and technology adoption (58 percent), compliance (49 percent), overall budget increase (46 percent), infrastructure upgrades (41 percent) and additional staffing or consulting needs (39 percent).

Lower IT budgets, meanwhile, are easier to explain: 65 percent of respondents expecting smaller budgets attribute it to overall budget decreases, while 35 percent blame it on reductions in revenue.

Better patient care (and patient engagement) ranks with improving efficiency and lowering costs as key goals for most hospitals. Healthcare IT leaders aim to boost patient care by improving clinical and quality outcomes (37 percent), reducing medical errors and improving patient safety (18 percent) and using evidence-based medicine to standardize clinical care (13 percent). Obtaining data from remote locations, such as patient homes, didn’t register — though as mobile health demands rise, and as wearable technology catches on, hospitals may have no choice but to respond.

Sixty-four percent of respondents are part of a health information exchange, which HIMSS defines as “an organization which brings together healthcare stakeholders to oversee and govern the exchange of health-related information according to nationally recognized standards.” Such organizations can be private or state-run — and 12 percent of respondents take part in a state-run HIE. (These received funding under the HITECH Act, but this money runs out this year.)

The number of organizations participating in HIE represents an increase from 51 percent in 2013. Among the remainder, 16 percent of organizations have chosen not to participate, 14 percent have yet to start planning and 3 percent participated in a failed HIE organization.

For 49 percent of healthcare organizations, IT’s strategic plan is part of the larger operating, clinical and capital strategic plans. Among the remainder, 37 percent say the IT plan is integrated with, but separate from, the organizational strategic plan, 7 percent have unintegrated IT and organizational plans and 6 percent startlingly don’t have an IT strategic plan at all.

Horowitz says, overall, this reflects a “very high degree of cohesion and interconnectedness,” since 86 percent of strategic and IT operating plans are in fact integrated. She adds that the numbers haven’t moved much in the last few years. Organizations that haven’t changed, then, aren’t likely to do so.

At this point, Horowitz says, it’s “almost a foregone conclusion” that IT can be instrumental in impacting patient care. This impacts the bottom line, too: Organization that aren’t financially viable can’t provide high quality patient care and vice versa.

Horowitz plans to keep an eye on a few things this year:

* Will even more organizations appoint a chief nursing informatics officer? * Will clinicians’ increasing role as “project champions” — 74 percent evaluate technology before an organization buys — lead to better IT investments? * As healthcare’s reimbursement model changes, and sustained business viability remains a key business objective, will financial resources continue to outpace staffing as the top barrier to implementing IT?