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Meaningful use – a concept introduced only a year ago – appears to be spurring an increase in healthcare information-technology (IT) spending, along with a brightening economy, suggests results of the 21st annual Healthcare Information and Management Systems Society (HIMSS) leadership survey. The American Reinvestment and Recovery Act (ARRA) promises fi nancial incentives to providers and hospitals for the “meaningful use” of certifi ed health- care IT products. Although criteria for meaningful use will not be established until later this year, 59 percent of the 398 respondents to this year’s survey said they plan to make additional investments to position them- selves to qualify for the incentives.


Healthcare IT spending expected to increase

Medicaid security audits.

Nearly three quarters (72 percent) of respondents said they expect their IT operating budgets to increase, bringing that response back to the levels of two years ago. Last year, only 55 percent of respondents expected an increase in their budgets. Forty-nine percent of those who said their budgets would increase this year reported that meaningful use would be a driver. An- other 45 percent reported the increase would be due to an overall growth in the number of systems and technologies at their organization.

Asked to identify their single IT priority during the next two years, 42 percent of respondents identifi ed meeting meaningful-use criteria. When asked to iden- tify their organization’s primary clinical IT focus, 35 percent said it would be ensuring their organization has a fully functional electronic medical record (EMR) in place, and 27 percent said it would focus on installing a computerized provider order-entry (CPOE) system. Meaningful use was reflected in other answers throughout the survey. More than one-third (38 per- cent), for example, said government issues would have the biggest impact on healthcare in the next two years; whereas last year, only 6 percent thought that was the case. Financial considerations were identifi ed as the top business issue last year, chosen by 54 percent of respondents. This year, 23 percent identifi ed it as the top business issue.

Security concerns continue to remain consistent. One third of respondents (34 percent) said an internal breach of security was their top security concern, and nearly one-quarter (23 percent) said their organization had a security breach in the past year. Thirty percent said their major security concern was compliance with Health Insurance Portability and Accountability Act security regulations and Centers for Medicare &


April 2010

Nearly half (48 percent) of the healthcare organiza- tions surveyed said they have a fully operational EMR in at least one facility, compared to 41 percent last year. Nearly a quarter (22 percent) said they have a fully op- erational EMR throughout their entire organization, up from 17 percent last year. Almost a third (32 percent) have begun to install an EMR in at least one facility. Asked about what area of patient care on which IT could have the most impact, more than a third (37 percent) said it could improve clinical and quality outcomes. Another quarter (28 percent) felt the big- gest impact would be in reducing medical errors and improving patient safety. The 2009 survey identifi ed the same top two items, with the order reversed. Ad- ditionally, nearly all (95 percent) said clinicians play a role in the IT process at their organizations.

HIMSS: Embrace technology

Excerpts from the keynote address given by Barry Chaiken, M.D., chairman of the board of directors, HIMSS.

“Our great country is on an unsustainable healthcare cost curve that threatens our ability to bounce back from the severe economic challenges we now face. Healthcare information technology is the instrument that will transform healthcare and it is we – the infor- maticists, clinicians, management engineers, senior IT executives, IT specialists and the diverse talents of so many others – who will create the applications, pro- cesses and work fl ows that will improve quality, safety, access and cost effi ciency.

“In many respects, our healthcare system still operates like the typical business of 1969 – it is still largely paper based, it ignores information tools that can facilitate evidence-based best practices, and it func- tions without analytics to qualify and quantify the care we provide. Medical decisions are made according to implicit criteria – hidden internal knowledge – rather than explicit criteria – external knowledge that can be checked, evaluated and updated. Too many providers are not taking advantage of 21st-century technologies to access 21st-century information, choosing instead to provide care the same way it was done 40 years ago. “Today, we must begin to change healthcare by creating healthcare IT solutions that are so compelling, so irresistible, that people just want to use them. We cannot rely on incentive programs or executive orders.

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