Medical Device Daily Executive Editor

ORLANDO – One of the annual rituals of the yearly conference of the Healthcare Information and Management Systems Society (HIMSS; Chicago) is its leadership survey, a poll of top hospital HIT staffers intended to indicate the major IT trends in this sector.

The survey exercise this year was again pitched as doing this – but a press conference designed to highlight this year’s results tended to emphasize what wasn’t in the survey.

One of the presenters at the session was John Wade, chair of HIMSS, who earlier at the conference had emphasized patient safety as the over-arching goal of the nation’s HIT players (Medical Device Daily, Feb. 26, 2008). But he and other presenters had to do some fast talking to explain why the survey apparently demonstrated less interest in 2008 in patient safety by respondents.

The survey results for “Top Business Issues Facing Healthcare” rated Improving Quality of Care in 2008 as listed by 56% of respondents, putting it at the top of this list, but this compared to 69% of respondents who put it as the Top Business Issues concern in 2007.

Additionally, of the eight of these Top Business Issues, four others showed less interest in 2008 than in 2007 – and one other was a new item (Creating New Revenue Sources), thus with no comparison to 2007 (see box for complete list and percentages).

More than one reporter in the room noted this in the figures and asked presenters why the slackening interest.

The answer was two-fold: the addition of survey items may have diluted the “Top” list; and, more importantly, they said, it indicated a “maturation” of HIT – Wade’s word for it.

He and the other presenters encouraged the view that the apparent “lessening” of concern for improving quality care — and also markedly, for Patient (Customer) Satisfaction, the other big drop from 2008 to 2007 — indicated that hospitals were in the process of putting quality systems into place and that they had “moved on” to other issues.

This explanation was offered in several ways by the panel, emphasizing that the Quality of Care item still remained No. 1 on this list.

Other qualifiers to this view must be noted, however: a fairly slim total of IT professionals, 300, as respondents to the survey, and no comparable data from the vast arena of small practices.

Presenters said that they had no information concerning this large sector of medical practice, though they acknowledged that it certainly lags far behind the hospital sector.

Two other data sets from the survey also suggest some against-the-stream trends for HIT.

Various governmental representatives at the HIMSS meeting are emphasizing the need for guaranteed, assured security of HIT systems, and the need to revamp reimbursement systems to provide incentives for HIT adoption.

The survey indicated trends to the reverse.

Fourth in the “Top Issues” list was Demand for Capital, at 34%, a 3% increase over 2007, and at the top of the list of “Most Significant Barriers to Implementing IT” was Lack of Financial Support, with other survey items indicating that reductions in Medicare/Medicaid funding are constricting hospital HIT budgets.

And the security issue continues to pop up as troubling – especially if HIT professionals want to demonstrate to the general public that their healthcare information won’t be unduly accessed, tampered with or used against them by unauthorized private or public entities (read, for this last, government).

A full 24% of respondents said their systems had experienced a “Security Breach” in the previous 12 months and 16% reported a “Security Breach” in the past six months.

In the category of “Top Concerns – Security of Computerized Medical Information,” Internal Breach of Security was listed first, 51% in 2008, 57% in 2007; 12% reported no “Active Management of Security Risk” (2% Don’t Know).

Overall, it seems that while HIT “maturity” may be suggested by the latest Leadership Survey, the totality of responses also would suggest that this maturity is that of a teenager rather than young adult.

Following are other major responses from the survey:

Projected IT Priorities for next two years:

• Inpatient Clinical Information Systems, 40% for 2008, 23% for 2007;

• Reduce Medical Errors/Promote Patient Safety, 39% for 2008, 23% for 2007;

• Implement an EMR, 38% for 2008, 26% for 2007.

Status of Electronic Medical Record Implementation:

• Fully Operational System, 44% for 2008, 32% for 2007, 24% for 2006;

• Installation Begun, 27% for 2008, 37% for 2007, 36% for 2006.

Technology Adoption (Next Two Years):

• Identity Management, 45% for 2008, 54% for 2007;

• RFID Technology, 43% for 2008, 42% for 2007;

• Security Technologies, 42% for 2008, 47% for 2008;

• Data Warehouse/Data Mining, 40% for 2008, 49% for 2007;

• Web-enabled Business Transactions, 38% for 2008, 35% for 2007;

• Speech Recognition, 36% for 2008, 55% for 2007;

• Automated Alerts/Paging to Clinicians, 35% for 2008, 47% for 2007;

• Bar Code Technology, 35% for 2008, 74% for 2007.

Most Important Applications (Next Two Years):

• Clinical Information systems, 45% for 2008, 46% for 2007;

• Computer Based Practitioner Order Entry, 42% for 2008, 47% for 2007;

• Electronic Medical Record, 31% for 2008, 47% for 2007.