2012 final leadership survey with cover

2012 HIMSS Leadership Survey
Senior IT Executive Results

February 21, 2012

www.himss.org
transforming healthcare through IT™

23rd Annual HIMSS Leadership Survey
Final Report: Healthcare Senior IT Executive

The 23rd Annual 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. How to Cite This Study
14. For More Information

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© 2012 Healthcare Information and Management Systems Society

Figures

Figure 1. Participant Profile—Title
Figure 2. Participant Profile—Facility Type
Figure 3. Participant Profile—Type of Hospital
Figure 4. Participant Profile—Revenue
Figure 5. Participant Profile—Region
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
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 Location
Figure 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 Organization’s Executive Committee
Figure 21. Senior IT Executive Responsibilities
Figure 22. Percent of Organizations that Expect to Qualify for Meaningful Use – Stage One
Figure 23. Level of Investments Made by Healthcare Organizations in Meaningful Use
Figure 24. Anticipated Return on Investment for Meeting Meaningful Use Requirements
Figure 25. Preparedness to Meet ICD-10 Conversion
Figure 26. Level of Investment Made in ICD-10 Conversion
Figure 27. Expected Change in IT Staff in Next 12 Months
Figure 28. 2012 IT Staffing Needs (Top Ten)
Figure 29. Additional Functions Managed by Senior IT Executives
Figure 30. Projected Change in IT Operating Budget
Figure 31. Reason for Increase in Budget

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1. Executive Summary

The U.S. Federal government’s impact on the provider community’s information
technology (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 Health
Act (HITECH) provision in 2009’s American Recovery and Reinvestment Act (ARRA)
and 2010’s Patient Protection and Affordable Care Act (PPACA) have challenged
providers to enhance their IT capabilities like never before.

Based on the feedback of 302 healthcare IT professionals, nearly three quarters of the
participants in this year’s Annual HIMSS Leadership Survey indicated that Federal
mandates, including meeting Stage One of Meaningful Use and a conversion to ICD-10
would be the issues driving their efforts in the next two years. At this time, more than
one-quarter of respondents have already attested to stage one meaningful use and
another third expect to attest by June 2012. In order to prepare to attest for stage one
meaningful use, nearly half of respondents have invested more than $1 million.

Respondents also expressed concerns about IT staffing shortages. Considered to be a
key barrier in addressing their IT priorities, approximately two-thirds of the respondents
indicated they plan to increase their IT staff in the next year. 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): Almost half of respondents reported their
organization participates in an HIE. However, 22 percent of respondents reported that
there 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 the
top area of focus for financial IT systems at their organization. In addition, nearly 90
percent of respondents indicated they expected to complete their ICD-10 conversion by
the October 2013 deadline.

Impact of IT on Patient Care: Three-quarters of respondents indicated that they believe
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. Each of these items was selected by at least 80 percent of
respondents.

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Security Concerns: Approximately one-quarter of respondents indicated that their
organization has experienced a security breach in the past year. Respondents indicated
that compliance with HIPAA security regulations and CMS security audits were their top
concerns with regard to security at their organizations.

IT Governance: There appears to be a strong level of integration between an
organization’s 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.

Organizational Infrastructure: Nineteen percent of respondents indicated that their
primary infrastructure focus was their server environment, to include virtual services.

Senior IT Executive Responsibilities: Nearly all senior IT executives reported that they
were responsible for at least one IT area outside of the traditional IT department,
primarily telecommunications.

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2. Methodology

A total of 302 valid responses were received for this year’s Web-based survey. Data was
collected in December 2011 and January 2102. Survey respondents represent more
than 600 hospitals throughout the United States. The average bed size of the hospitals
in this survey is 479; the median bed size is 240.

3. Profile of Survey Respondents

Approximately 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). Another
42 percent of respondents reported their title to be Director of IS/IT. The remaining
respondents 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 of
respondents work at an outpatient setting with the remaining working for other types of
healthcare facilities including mental/behavioral health facilities, long-term care facilities
and home care agencies.

Respondents working in an acute care hospital-based environment were asked to
characterize the type of their hospital organization. Most respondents (two-thirds) noted
their organization was (at least partly) comprised by community hospitals, 21 percent
reported working in an academic medical center, and 19 percent of respondents working
in a critical access hospital. Seventeen percent reported that they work for a rural
hospital and 15 percent reported that they work for a general medical/surgical hospital.

Annual gross operating revenues for the provider organizations represented in this
year’s survey were:

• $50 million or less—22 percent;
• $51 million to $200 million—23 percent;
• $501 million to $1 billion—11 percent;
• More than $1 billion—17 percent; and
• Don’t Know/Not Applicable—9 percent.

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The majority of individuals responding to this year’s survey represented the South
Atlantic 1, East North Central 2 and West North Central 3 regions. At least 15 percent of
respondents came from each of these regions. Only five percent of respondents were
located in the Mountain 4 region.

Figures:
Figure 1. Participant Profile—Title
Figure 2. Participant Profile—Facility Type
Figure 3. Participant Profile—Type of Hospital
Figure 4. Participant Profile—Revenue
Figure 5. Participant Profile—Region

4. IT Priorities

Healthcare reform 5 and policy mandates 6 continue to shape the future business
priorities for healthcare IT executives, with achieving meaningful use as the most
commonly cited key business objective for the next year.

When asked to identify the single information technology (IT) priority to be addressed at
their organization in the next two years, more than one third (38 percent) identified
achieving meaningful use. While still the top response, the findings this year represent a
notable decline when compared to the 2011 survey results. Last year, half of the
respondents identified meaningful use as their top IT priority. Beyond meaningful use,
approximately 15 percent of respondents identified a focus on clinical systems, such as
computerized practitioner order entry (CPOE), electronic health records (EHRs) or e-
prescribing as their organizations’ top IT priority. This response also placed second in
the 2011 survey.

Rounding out the top three responses was leveraging information through the use of a
data warehouse, clinical decision support or evidence-based medicine. Thirteen percent
of respondents identified this item.

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 the
below 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, Wisconsin
3
Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota
4
Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, Wyoming
5
Referred to in this study ass new care models or payment structures
6
Referred to in this study as compliance with regulations like ARRA, ICD-10 or HIPAA 5010
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Respondents were also asked to identify the primary focus their organization has with
regard to clinical IT, financial IT and infrastructure at their organizations.

One quarter of respondents (25 percent) indicated that their primary clinical IT focus was
to ensure the presence of a fully-operational EHR; also the top choice in 2011 (25
percent). Focusing on physician systems (physician documentation; clinical decision
support systems; installing a CPOE system) were other top focus areas, each issue
selected 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 the
patient billing system, identified by approximately six percent of respondents.

With regard to their top infrastructure priority, respondents were most likely to a focus on
servers/virtual servers. This item was selected by 19 percent of respondents. It was
also the top response in 2011. Rounding out the top three are a focus on mobile
devices (18 percent) and virtual desktops/laptops (16 percent). Security systems were
also identified by 16 percent of respondents.

Least frequently selected were cloud computing and telemedicine. These items were
identified by three and two percent of respondents, respectively.

When asked to identify the single key business objective their organization was trying to
achieve 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 the
2011 survey. Nearly one-quarter of respondents (21 percent) selected improving patient
care/quality of care, followed by sustaining financial viability (15 percent).

As with the 2011 study, less than one percent of respondents indicated that attracting
qualified staff was the key business objective their organization was trying to achieve in
the next year. None of the respondents indicated that their key business objective was
improving supply chain dynamics.

In the 2011 study, respondents were most likely to identify healthcare reform and policy
mandates as the top business issues that would have the most impact on healthcare in
the next two years. These responses did not change in the 2012 survey.

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When given a group of categories from which to select, approximately 40 percent of
respondents identified healthcare reform, which includes items such as accountable care
organizations (ACOs), new care models and payment structures. Nearly another quarter
(23 percent) identified policy mandates such as ICD-10 and meaningful use, as a
business 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. No
other option was selected by more than 10 percent of respondents.

Respondents were least likely to indicate staffing issues, such as the
availability/retention of IT or clinical staff. Only two percent of respondents indicated that
this would be a top business issue driving 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 first time in years, respondents did not identify a lack of adequate financial
support for IT as the top barrier to IT implementation. Instead, nearly one-quarter
reported that they are concerned about staffing resources needed for
implementation.

For the past several years, respondents have identified the lack of adequate financial
support as the top barrier to IT implementation. That is, until now. This year, 22 percent
of respondents cited adequate staffing resources as their top challenge, followed by the
lack of adequate financial support (14 percent) and vendors’ inability to effectively deliver
products or services to respondents’ satisfaction (12 percent). No other response was
identified by more than 10 percent of respondents.

Less than one percent of respondents indicated that laws and regulations prohibiting
technology sharing with referring providers was a barrier to IT implementation. None of
the respondents indicated that an ability to secure data was a barrier to IT
implementation. This is consistent with what was identified in the 2011 study.

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Figures:
Figure 12. Most Significant Barriers to Implementing IT

6. IT and Patient Care

As would be expected, IT leaders by and large believe IT can have a positive
impact on patient care by improving clinical/quality outcomes, reducing medical
errors or helping to standardize care by allowing for the use of evidence-based
medicine. Clinicians are also seen to be playing a more expansive role in shaping
the use of IT in their organizations.

When asked to select from a list of choices indicating areas where IT could have the
most impact on patient care, 38 percent of respondents indicated improvements in
clinical and quality outcomes. This item was also most frequently selected in the 2011
study. Approximately another quarter of respondents (22 percent) indicated reducing
medical errors/improving patient safety, followed by standardization of clinical care using
evidence-based medicine (16 percent). Respondents were least likely to select remote
monitoring of patients and ensuring that patient data is private and secure.

As with the 2011 study, nearly all of survey respondents (98 percent) noted that
clinicians play some role in the IT process. At least 80 percent of respondents indicated
that clinicians played a role in IT systems evaluation/selection (84 percent) and acted as
project champions to educate and lead other clinicians (81 percent). These were both
top items selected in the 2011 survey.

The survey findings suggest that a growing number of organizations are employing
clinical information executives. In the 2011 survey, approximately 30 percent of
respondents reported to have a Chief Medical Information Officer (CMIO) at their
organization. In 2012, this number increased to 36 percent. The growth among Chief
Nursing Information Officers is less pronounced, moving from eight percent of
respondents in 2011, to nine percent in 2012.

Respondents also reported a growth in remote access to secure, on-line clinical patient
information. Nearly all respondents (97 percent) reported that physicians have this type
of access, representing a slight increase from the 2011 survey. Approximately 85
percent of respondents reported that physician extenders (physician assistants, nurse
practitioners) had remote access to patient information; two-thirds reported that non-
clinical staff (finance staff, transcriptionists) had this type of remote access, while roughly
60 percent noted that both nurses and other clinical professionals such as occupational
therapists have remote access secure patient information.

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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 Security

IT Security breaches continue to plague organizations but the reduction in actual
violations reported this year suggests efforts to secure patient information are
working. Compliance with HIPAA security regulations and CMS security audits
dominate the IT executive’s security concerns.

Approximately one quarter of respondents (22 percent) noted their organization had
experienced 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 regarding
the security of electronic medical information at their organizations. Only four percent of
respondents indicated that they did not have any concerns at this time.

Approximately 34 percent of respondents indicated that compliance with HIPAA security
regulations and CMS security audits was their top concern. This displaces internal
breach of security (32 percent), which had been identified as a primary security concern
for the past several years. One-third of respondents (32 percent) also indicated they
were concerned their organization’s security systems were inadequate.

Respondents were somewhat less likely to identify funding/financial support for the
security process as a barrier than they were in the past. While selected by 13 percent of
respondents 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 information
devices. Only six percent of respondents indicated that they were concerned about their
organization’s ability to secure information on mobile devices.

Less than one percent of respondents noted that they had concerns about the ability of
their business associates to comply with existing business associate agreements.

Figures:
Figure 16. Security Breach
Figure 17. Top Concerns – Security of Computerized Medical Information

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8. Health Information Exchange (HIE) Participation

The involvement in Health Information Exchanges (HIE) shows mixed results this
year. While the percentage of respondents actually participating in an HIE is flat
when compared to last year, a growing number of non-participating organizations
are involved in some type of an HIE planning effort.

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-eight percent) had some
degree 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 finding
consistent with last year’s participation level. Only six percent claimed their participation
was mandated by some level of government.

Similar to the 2011 findings, approximately 22 percent of respondents indicated there
was an HIE in their area, but have chosen not to participate in it at this time. Four
percent of respondents reported that they participated in an HIE in the past, but that HIE
has failed.

One-quarter of respondents noted their organization had yet to start planning to
participate in an HIE. Based on results from previous studies, this finding represents a
continued decrease in the number of organizations that have yet to begin to plan to
participate in an HIE.

Figures:
Figure 19. Health Information Exchange (HIE) Adoption

9. IT Governance

Respondents continue to report that a strong level of integration between the IT
strategic plan at their organization and the organization’s overall strategic plan as
evidenced by the senior IT executive’s involvement on their organization’s
executive committee.

Respondents were asked to characterize the level of integration between their IT plans
and their organization’s strategic operating, clinical and capital plans. The vast majority
of respondents (85 percent) claimed their IT strategies were aligned with the
organization’s overall strategy. Approximately half of respondents (48 percent) claiming
the IT plan is a specific component of the organization’s overall strategic plan and

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another 37 percent reported that their IT strategic plan is integrated with overall strategic
plan, even though the two plans are separate. These findings are consistent with
feedback from previous HIMSS Leadership surveys.

Interestingly, 14 percent of respondents indicated that their organization either does not
have an IT strategic plan (seven percent) or does have an IT strategic plan but that this
plan 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 of
their organization’s executive committee, defined in this study as “the leadership team
that drives overall organization strategy and direction”.

Individuals identifying themselves a senior IT executive were asked to identify which
responsibilities they assume on a regular basis as part of their job. Driving value from IT
investments was the most frequently selected item, identified by 94 percent of
respondents. 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 Plan
Figure 21. Member of Organization’s Executive Committee
Figure 22. Senior IT Executive Responsibilities

10. Federal Initiatives

Organizations are making substantial investments in two major federal initiatives
– meeting Stage One of Meaningful Use and successfully converting from ICD-9 to
ICD-10. Most organizations report to be on target to satisfy the requirements of
both initiatives although a sizeable percentage of respondents expressed
reservations about meeting the ICD-10 deadline.

More than one-quarter of respondents (26 percent) indicated their organization has
attested to stage one meaningful use and were preparing to meet stage two

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requirements. Another four percent of respondents reported they expected to attest by
the end of 2011 (and presumably have since the time they completed this survey). More
than one-quarter (27 percent) expect to attest in the first six months of 2012 and 22
percent expect to attest in the second six months of 2012. Seventeen (17) percent are
waiting 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 or
project to make in order to achieve Stage One of meaningful use. Only five percent of
respondents indicated their organization made no additional investment. One-third
reported they will ultimately invest less than $1 million, 27 percent between $1 million
and $4 million and nearly one-third (29 percent) will invest $5 million or more on
achieving stage one meaningful use. The remaining respondents either did not know
the answer to this question or chose not to disclose this information.

Respondents were asked to identify how much money their hospital organization would
receive for meeting Stage One meaningful use requirements. Less than one percent of
respondents reported that they would not receive incentives in Stage One. The below
list identifies the money that organizations anticipate that they will receive for their
investment.

• Less than $2 million — 20 percent;
• $2 million to $3 million — 23 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 they
expected to receive or did not know the amount.

In addition to achieving meaningful use requirements, healthcare organizations also
need to convert from ICD-9 to ICD-10 by October 1, 2013. Nearly 90 percent of
respondents indicated that they expect to complete their conversion by the deadline.

Respondents were also asked to identify the level of investment they were making in
their ICD-10 conversion efforts. Nearly one-third (29 percent) indicated they were
investing less than one million in this conversion, fifteen percent indicated were spending
between $1 to $4 million, and four percent spent $5 million or more. A very large
percent of respondents (43 percent) couldn’t identify the level of investment they made
in their ICD-10 conversion.

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Figures:
Figure 22. Percent of Organizations that Expect to Qualify for Stage One Meaningful
Use
Figure 23. Level of Investments Made by Healthcare Organizations in Meaningful Use
Figure 24. Anticipated Return on Investment for Meeting Meaningful Use Requirements
Figure 25. Preparedness to Meet ICD-10 Conversion
Figure 26. Level of Investment Made in ICD-10 Conversion

11. IT Budget and Staff

Fueled in part by the need to expand the number of FTEs to meet the growing
number of systems/technologies in place, IT leaders expect their operating
budgets to grow this coming year.

According to the 2011 HIMSS Analytics® Database, U.S. hospital IT departments
employed 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 to
increase 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 20
percent this coming year, 17 percent are targeting a 10 to 20 percent increase while 38
percent believe the increase to be less than 10 percent. Only five percent of
respondents indicated they expected a staffing decrease in the next 12 months, with the
remaining respondents (32 percent) projecting their staffing levels to remain the same.

Of those respondents expecting staffing increases in 2012, approximately 14 percent
reported plans to add more than ten IT FTEs, seven percent planned to add six to ten IT
FTEs, 25 percent have budgeted to add three to five IT FTEs, and over one-third (37
percent) claimed their organization had budgeted to add one to two IT FTEs. Another 14
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 IT
staffing needs. Only eight percent of respondents reported not to have staffing needs at
their 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 application
support as identified by 43 percent of respondents, followed by network/architecture
support 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 below
areas:

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• 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 department
under their supervision. With nearly all senior IT executives (96 percent) claiming to be
responsible for at least one IT area outside of the IT department, telecommunications
was the most frequently cited support service identified by 80 percent of respondents.
Respondents had responsibilities in other areas such as medical/clinical informatics (52
percent), health information management (28 percent), and biomedical/clinical
engineering (22 percent). Approximately 13 percent of respondents mentioned they
oversee other areas within their organization to include plant facilities, patient
accounting, and physical security.

According to the HIMSS AnalyticsTM Database, the average IS operating expense as a
total expense for U.S. hospitals in 2011, was 2.40 percent. Approximately three-
quarters of survey respondents (75 percent) noted their organizations’ operating budgets
for 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 the
next 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 next
year, a finding consistent with the 2011 survey.

Respondents were most likely to report an increase in their organization’s IT operating
budget because of the overall growth in the number of systems and technologies in their
organization (68 percent of respondents). More than half (57 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 2011
survey. Overall budget increases and a need to comply with regulatory changes were
identified by 43 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. This area was also
least likely to drive an expected increase in 2011.

Among the handful of respondents noting their budget would decrease, two-thirds
claimed 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

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budget decreases. None of the respondents indicated that a decrease in revenue was
the 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 Months
Figure 28. 2012 IT Staffing Needs (Top Ten)
Figure 29. Additional Functions Managed by Senior IT Executives
Figure 30. Projected Change in IT Operating Budget
Figure 31. Reason for Increase in Budget

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 which
more 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. 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
23rd Annual HIMSS Leadership Survey.

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14. For More Information, Contact:

Joyce Lofstrom
Director, Corporate Communications
HIMSS
312/915-9237
jlofstrom@himss.org

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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

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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%





$501 Million to $1 Billion 11%

More than $1 Billion 17%

Don't Know 9%
N = 302

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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% 2011
N = 302

21

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% 2011
N = 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% 2011
N = 302

22

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%
2011
N = 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%
2011
N = 302

23

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% 2011
N = 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%
2011
N = 302
Top 10 Responses

24

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%
2011
N = 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% 2011
N = 302

25

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%
2011
N = 302

Security Breach
Figure 16

13%
In Last Six Months
18%

22%
In Last 12 Months
26%
2012
2011
N = 302

26

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% 2011
N = 302

Health Information Exchange (HIE)
Adoption
Figure 18
2%
Don't Know What an HIE Is
2%
26%
No Plans to Participate
31%
22%
HIE in our Area/Don't Participate
21%
6%
Required to Participate
7%
49%
Participate in HIE
44%
4%
Participated in Failed HIE
1%

Don't Know
2% 2012
1%
2011
N = 302

27

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

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%
2011
N = 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%

Don't Know 3%

N =302

29

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%
14%
9%
10%
4%
$20 Million or More 3%
6%
Prefer Not to Disclose 8%
8%
Not Applicable 2%
3% 2012
Don't Know 8%
11% 2011
N = 302

Anticipated Return on Investment for
Meeting Meaningful Use Requirements
Figure 24
None 0%

Less than $2 Million 20%






Not Applicable 0%

Don't Know 8%
N =302

30

Preparedness to Meet ICD-10 Conversion
Figure 25

Yes 89%

No 1%

Don't 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%
Not Applicable 0%
Don't Know 43%
N =302

31

Expected Change in IT Staff in Next 12
Months
Figure 27

61%
Increase
64%

32%
No Change
30%

5%
Decrease
4% 2012
2011
N = 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

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
2011
N = 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%
2011
N = 302

33

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

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