Accenture Health CIO Survey on EMR and Meaningful Use

1. Secrets of Success on the EMR
Journey to Meaningful Use:
Leading Hospital CIOs Reveal Key Lessons Learned

2. Passage of the HITECH Act (part of the American Mounting Pressures
Reinvestment and Recovery Act, or ARRA) has prompted on Health Systems
US hospitals to strive to implement and demonstrate US hospitals are facing meaningful
“meaningful use”1 of electronic medical records (EMR). By use requirements in a time of
unprecedented financial pressures.
Accenture’s estimates, nearly 90 percent of hospitals over
According to a recent study
the next three years will invest to install or upgrade their published by the American Hospital
EMRs in an attempt to meet the government’s meaningful Association (AHA), approximately
use requirements. The stakes are high for hospital leaders one-third of all hospitals operated
and healthcare IT teams as they wade into this complex with a loss in 2008.i Even high-
performing hospitals had difficulty
new environment. For those that navigate successfully, navigating the challenging operating
evidence suggests opportunities for great improvements in environment, given reimbursement
patient care delivery, outcomes and operating efficiencies. rate cuts and a sustained period of
Recognizing hospitals’ need for insights and tools, high unemployment. As the economy
eases toward recovery, hospital
Accenture surveyed 15 CIOs from US health systems that executives will continue to confront
are currently EMR exemplars to glean their best practices a series of new obstacles over
for driving a more successful utilization of EMR solutions. the next five to ten years. Exhibit
1 highlights the forces bearing
down on healthcare providers.
Exhibit Pressures on the Operating Margins of Margins of
Exhibit 1: 1: Pressures on the Operating U.S. Hospitals US Hospitals
Impact of Market Forces on Provider Operating Margins
Additional costs
Medicare Rate Cuts Downward and risks of reform
Top Line Impacts
up to 15% from rate pressures requirements
Healthcare Reform from all payers (e.g., ARRA)
Ongoing increases
in medical Severe clinical & IT costs increase
supplies and IT labor shortages due to EMR and
pharmaceutical drive long-term ICD-10
Bottom Line Impacts
costs (~6–8%) cost increases implementation
annually (3–4% increase) costs
Current Reimbursement Increasing Clinical and Rising IT Payer Regulatory
Operating Cuts Cost IT Labor Investment Pressures Compliance
Margin Structure Shortage Costs Costs
Source: Accenture analysis
1
Centers for Medicare & Medicaid Services (CMS) defines meaningful use using three main components: “1. The use of a certified EHR in a meaningful manner; 2. The
use of certified EHR technology for electronic exchange of health information to improve quality of health care (including e-prescribing in outpatient settings); and 3.
The use of certified EHR technology to submit clinical quality and other measures.” For a full definition, please see: https://www.cms.gov/EHRIncentivePrograms/
1

3. HIMSS Stages of EMR Maturity vs. All US Levels of Achievement
Exhibit 2: HIMSS Stages of EMR Maturity vs. All U.S. Hospital Levels of Achievement
Percent of Hospitals at
Each Stage
Stage Cumulative Capabilities 2008 2009
Mature
Complete EMR; CCD transactions to share data;
Meaningful Use Threshold
EMR Stage 7 0.3% 0.7%
data warehousing; data continuity with ED, ambulatory, OP
Physician documentation (structured templates), full CDSS
Stage 6 0.5% 1.6%
(variance & compliance), full R-PACS
Stage 5 Closed-loop medication administration 2.5% 3.8%
Stage 4 CPOE, clinical decision support (clinical protocols) 2.5% 7.4%
Nursing/clinical documentation (flow sheets), CDSS (error
Stage 3 checking); PACS available outside Radiology
35.7% 50.9%
CDR, controlled medical vocabulary, CDS, may have document
Stage 2 31.4% 16.9%
imaging; HIE capable
Stage 1 Ancillaries- lab, rad, pharmacy-all installed 11.5% 7.2%
No
EMR Stage 0 All three ancillaries not installed 15.6% 11.5%
Source: HIMSS
In the short term, mandates Meanwhile, hospitals have come Even as all these pressures intensify, Requirements to upgrade Accenture’s EMR Study 10 percent of the total installed
stemming from healthcare reform under increasing cost pressures hospitals are being asked to make technological infrastructure and hospitals in the health systems we
To help prepare our clients better for
will present varying complications due to the shortage of qualified significant investments in their to comply with new mandates studied. Meditech and Quadramed
the EMR journey ahead, Accenture
for hospitals. Some hospitals may nurses, primary care physicians healthcare IT infrastructures. pose further top-line risks for healthcare solutions were also
conducted interviews with the CIOs
benefit from these mandates, and clinically trained support staff. Regulations set forth by the hospitals. To be sure, the HITECH installed in a small segment of our
of 15 leading US health systems,
since reform will provide improved Labor costs typically account for 40 World Health Organization (WHO) Act provides incentive payments to total hospital population. [Note: We
which range in revenue from $1
healthcare coverage to approximately to 50 percent of hospital operating are prompting a shift to ICD-10 encourage hospitals to adopt new are not recommending or supporting
billion to $15 billion. Each system
25 million Americans by 2015, expenses.iv These costs will continue coding,2 which is expected to cost technology. However, it also contains the implementation or use of one
was advanced in its EMR maturity,
and 32 million by 2019.ii Other to increase as the industry struggles the industry $700 million to $2.7 penalties that will be imposed on specific EMR technology or vendor.]
having achieved at least Healthcare
hospitals may suffer from reduced to hire, train and retain skilled billionvii through 2013 in one-time hospitals that fail to meet strict
Information and Management
public spending or shifting patient resources. The total healthcare labor implementations and upgrades. implementation timelines. The
Systems Society (HIMSS) Stage 4,
mixes that adversely impact their gap may reach up to one million Additionally, ARRA stipulations, severity of these penalties varies
and nearly all expected to achieve
reimbursement rates. Over the longer nurses, physicians and healthcare including financial incentives and based on a hospital’s size and patient
meaningful use before penalties
term, however, reform (as currently IT resources by 2020,v representing penalties, accelerate the pace at mix. Still, Accenture estimates that
begin in 2015. Study participants
proposed) will almost assuredly hurt a shortage of almost 175 full-time which hospitals shift away from an average 500-bed facility would
represented diverse geographies in
margins at all hospitals, owing to equivalents (FTEs) per hospital.vi paper-based medical records. The face annual reductions in Medicare
terms of their hospital footprints
Medicare and Medicaid rate cuts resulting massive transition to reimbursement rates equivalent to a
– Northeast (3), Midwest (5), West
of up to 11 percent per patient.iii EMRs may translate into annual $3 million to $6 million fee annually
(2) and South (5). One-third of our
industry-wide expenditures of up to for failing to meet meaningful use
participants represented academic
$13 billion per yearviii in software, requirements by 2015. These fees
medical centers. As Exhibit 3
hardware, labor and support services. weigh on the minds of hospital
highlights, the EMR vendors used by
executives. As Exhibit 2 highlights,
this group are also diverse; however,
more than 85 percent of hospitals
over half of the hospitals included
are outside of the compliance
in the participating systems were
range for meaningful use today.
using Epic or Cerner. Eclipsys, GE and
By Accenture’s estimates, roughly
2
ICD-10 is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, McKesson each accounted for about
as classified by WHO. The code set allows more than 14,400 different codes and permits the tracking of many new diagnoses.
half of US hospitals are at risk of
incurring penalties starting in 2015.
2 3

4. Through our 1. EMR planning and
implementation must be a
translated to IT operating expenses
accounting for a larger percentage,
These insights point to the need for
interviews as well strategic initiative, not an IT nearly 200 basis points more, of
the hospital’s overall operating
adroit management of not only financial
initiative – Having the passion,
as quantitative influence, engagement and budget. Evidence also suggests resources but also programs, talent and
that these expense inflections are
benchmarking, attention of a hospital system’s
leadership from the outset was sustained over the long term. stakeholders during each stage of the EMR
we identified six consistently cited by our study
participants as a success driver.
4. The war for health IT talent is on transition—whether it’s formulating an
key insights that 2. It takes longer and costs
– There is a significant shortage of
qualified health IT professionals to
implementation strategy, establishing a
can help health more than most anticipate meet the demand associated with
EMR implementation and support.
blueprint for change, enabling employees
– Most of the health systems
systems successfully in our benchmarking study Nearly every CIO we interviewed and teams to adopt new ways of doing
noted unfilled positions and
navigate the EMR underestimated (by nearly 100
percent) the time and costs expressed concern about how their things or embedding EMR use throughout
journey: associated with implementing
advanced EMR functions, including
health system would source enough
talent from the marketplace,
the entire organization (Exhibit 4).
clinical order entry, nursing
and physician documentation,
including from EMR vendors to
meet longer-term demands.
Let’s now take a closer look at each
clinical decision support and 5. Supporting EMR means thinking of the six insights for successful
bar-coding medication. differently about capability and
operating model needs – Hospital
EMR adoption and use.
3. IT operating costs will spike,
and managing them requires CIOs noted the need to think
leadership alignment and differently about capabilities
patience – Benchmarking shows required to support frontline
that hospitals experience an EMR users as well as to drive
80 percent increase in their optimization of EMR-derived
data through health analytics.
IT operating expenses while Exhibit 4: Capabilities needed at at Each Stagethe the EMR Journey
Exhibit 4: Capabilities Needed each stage of of EMR journey
transitioning to EMR. This In terms of support (training,
service and troubleshooting), the
average hospital had to increase Financial Management
the number of FTEs focused on
healthcare IT support by 45 percent
Exhibit 3: EMR Vendors as it reached mature levels of
Represented by Study Participants
Exhibit 3: EMR Vendors Represented by Study Participants functionality and adoption.
Blueprint
6. Creating a culture for adoption is
5% essential – To achieve meaningful
5%
use, 75 percent of the clinicians
Epic
in a hospital must, among other
10% Cemer things, demonstrate consistent use
Enablement
Strategy
30% of advanced EMR components, Stakeholder Program
Eclipsys
which include computerized Management Management
GE physician order entry (CPOE),
10% physician documentation and
McKesson
closed-loop administration.
Meditech Every CIO we spoke with talked
about the need for a sharp focus
10% 30% Siemens Optimization
on change management and
Quadramed workforce engagement to ensure
that key stakeholders, particularly
physicians, get behind the effort
and understand the benefits
of using these components. Source: Accenture Talent Management
4 5

5. Make EMR planning and implementation Exhibit 5: The Healthcare Ecosystem
Exhibit 5: The Healthcare EcosystemHEALTHCARE ECOSYSTEM
strategic initiatives, not IT initiatives Patient
Consumer Patient Health Record Telehealth
Patient
Applications (PHR) & Other
Virtually all of the CIOs we Our interviewees recommended The desire of chief executives to
interviewed noted that the key developing an EMR business improve outcomes through health
to scoring early wins with EMR case early for each major system analytics set these organizations
implementation was securing the stakeholder, clarifying the clinical on an accelerated path to EMR
Providers Payer
passion and commitment of the and financial benefits for all. One planning and implementation. One
CEO and the support of the hospital CIO noted, “We were late in engaging of our interviewees, in a system Hospitals Claims
leadership team before embarking on all of the physician stakeholders recognized nationally for its success EMR Care Management
the journey. Senior leaders must view in the ‘collective’ opportunity; it in driving health analytics, said that Rev Cycle PM Health
and frame EMR as a driver of quality was not wise to do it piecemeal.” the organization’s EMR journey
Exchange
care delivery or, as one CIO put it, a (which began almost 30 years ago) Ambulatory Connectivity Ancillary
Our study participants also suggested
chance to deliver high-quality care was about capturing data in a way EMR
that hospitals create a dedicated
as a “system” to the communities that enabled thoughtful analysis Lab
position—the Chief Medical Revenue Cycle/Practice
that their organization serves. One and decisions. Another noted Pharmacy
Informatics Officer (CMIO)—to serve Management
leading hospital noted the passion that the CEO publicly put forth a Radiology
as a bridge between the healthcare
behind leveraging its EMR to test vision for transforming the health Post-Acute Care
IT organization and the hospital’s
if consistent use of new clinical outcomes of the metropolitan area
clinical and business operations.
practices and standards improved that the organization served—and
The structure of this role can vary.
outcomes and reduced medical then identified EMR as the tool for
However, in our observations, CMIOs
errors with a population of lung realizing that vision. This health Quality Outcomes/ Longitudinal Public Health
report directly to the CIO or to the Community Community
cancer patients. Each participating system has stated that its central Analytics Record Access Reporting
Chief Medical Officer (CMO). In either
hospital in our study noted that mission is to improve the health
case, it is an important partnership Source: Accenture
EMR implementation was a strategic of all citizens in a substantial part
for the CIO. A CMIO must possess a
imperative for their health system. of a very large metropolitan city.
blend of deep clinical, technology and
Framing the implementation in this It is investing hundreds of millions
business management skills. He or she
way helped leaders appropriate of dollars to establish a connected Enterprise EMR Strategy In addition, many of our participants Finally, most of the executives
should also be backed by physician
sufficient resources for the program health community with neighboring were subsidizing the costs of EMR we interviewed also had health
engagement teams—groups of Many CIOs we interviewed said
and make critical decisions on ambulatory physician groups. It is implementation for their affiliated information exchange (HIE)3 on their
clinically trained personnel who can that they missed the opportunity
capital investments and trade-offs. also offering significant financial physicians. This subsidization radar screen but noted that it was still
“fight fires” and educate the clinical to think, at the outset, about their
incentives to encourage these ranged from 50 to 100 percent, “early days” in terms of planning and
Our interviewees proposed community about EMR and its usage. enterprise’s EMR journey, which
affiliated physicians to adopt EMR depending on the health system commitment to HIE. Several pointed
three keys to success for the During the EMR implementation, the included inpatient, outpatient and
technology solutions, which is critical and on the independent physicians’ out that HIE was getting more of
EMR strategic planning process: CMIO plays a central role in building ancillary services. Today, more than
to enabling this connected network. willingness to adopt a preferred EMR their attention, owing to overtures
engagement strategy, vision collaboration across the organization 85 percent of the health systems
solution. All of the CIOs we spoke from vendors. However, they wished
and enterprise EMR strategy. and ensuring buy-in from physicians. Indeed, the most frequently cited we studied are proactively engaging
with noted that, regardless of the they had spent more time earlier in
strategic objective by hospital CIOs ambulatory physicians as part of
Engagement Strategy Vision participating in our interviews their current EMR strategy, three
degree of support, getting these the planning phases thinking about
independent physicians on board goals for connectivity with others in
CIOs stressed the importance A subset of the CIOs we spoke was ensuring high-quality patient with significant financial incentives.
was more challenging than they their healthcare ecosystem, outside
of engaging not only hospital with articulated a vision for EMR care and health outcomes. Yet But they noted that doing this after
anticipated, and that they fell far the walls of their own hospital. Many
administrative leaders at the outset implementation early in their these hospitals also recognized the the initial planning stage made it
behind their target acceptance rates. felt that because of this lack of
of the EMR journey but also physician health system’s journey. But importance of realizing the financial more difficult to engage that group. early planning, they were now in a
leaders. Many acknowledged that rather than framing EMR as a incentives for adopting EMR put
position of having to play catch up.
rework (for example, of order technology solution, they identified forth by ARRA. Nearly all of the CIOs
sets and clinical work flows) was the clinical information and the noted that their organizations had
required later in their health system’s associated health analytics that the incorporated incentive payments into
EMR implementation because implementation would generate their strategic and budgetary plans.
of limited engagement early on. to enable better care delivery and
Turnover of key stakeholders and outcomes. They thus defined EMR
lack of inclusion of physician as the vehicle for achieving a
stakeholders, including community goal that everyone in their health
physicians, worsened the problem. system cared deeply about.
3
Health information exchange is the mobilization of healthcare information electronically across organizations within a region, community or hospital system.
6 7

6. Count on needing more time and money Expect your 3), possibly in an application service
provider or cloud environment. Costs
than you initially expected IT operating can also spike owing to an expansion
Most of our survey respondents Over time, the lion’s share of EMR The hospitals we costs to spike, in the number of staff members
using the EMR software, a rise in the
vastly underestimated (by nearly
100 percent) the time and costs
investment is dedicated to hardware,
software and training, which together
surveyed reported using and manage IT number of FTEs required to support
or considering the more sophisticated EMR systems
associated with implementing
advanced EMR functions, including
constitute roughly 60 percent of
total EMR implementation costs. following practices to
operating expenses and the steady costs of software
clinical order entry, nursing However, these costs shrink over overcome cost- and time- through leadership licenses and upgrades. Interestingly,
after system implementation,
and physician documentation, time, and the amount spent on
clinical decision support and support and maintenance labor
management challenges: alignment and additional functionality (e.g.,
clinical decision support analytics)
bar-coding medication. increases by about four times
over the average implementation
• Establish goals and plans for patience is sought, so the spend continues
total cost of ownership targets to increase to meet greater value
Many health systems time frame. Costs go from roughly
throughout the EMR journey. The increasing level of complexity demand. As EMR systems continue
three percent of total spend to 12
have difficulty taking into • Track performance against
of EMR solutions and the challenges to pervade hospitals and replace or
percent of total spend (Exhibit 6).
account the increasing the stated business case and
that accompany an advanced EMR connect with additional clinical and
implementation often result in a administrative functions, we estimate
cost of securing and ensure and clarify who is
spike in IT operating expenses as that the percentage of hospital staff
employing healthcare IT accountable for realizing each
a percentage of total operating using an EMR could increase from
of the benefits to that case.
FTEs with clinical skills expenses (Exhibit 7). Data from our 40–50 percent to as much as 80–90
and the time required • Design tailored processes and benchmarking study illustrates that percent. In one leading hospital,
clinical workflows to incorporate on average, a hospital’s healthcare IT approximately 75 percent of these
to implement advanced EMR solutions at the start of the operating expenses as a percentage of FTEs were internally managed in the
EMR functions fully. journey, instead of waiting until total operating expenses increased by short term. In the long term, the
after solutions are already in place. roughly 80 percent during an advanced figure increased to approximately
For example, the average time needed EMR implementation. Moreover, our 95 percent at this hospital.
to reach HIMSS Stage 6 (physician • Use real-time feedback loops from
pilot studies to guide management analysis highlighted that the increase
documentation) was seven years,ix in operating expenses, as the hospital Managing through this inflection
roughly double early expectations. throughout the implementation.
reaches EMR maturity, is sustained. in healthcare IT operating costs
However, with the availability of While actual expenditures may vary requires confidence, alignment and
more mature and certified EMRs on across health systems, the increase in patience. This is particularly true
the market, we expect EMR adoption IT operating expenses was a common given the historical role and image
at HIMSS Stage 6 will be reduced Exhibit 6: Breakdown of Total EMR Market Spending theme with our survey participants. of IT organizations in the average
and perhaps achieved during the US hospital. IT spending historically
initial go-live of such a system. Hardware, Software, Training Costs Maintenance and Support Costs
In addition, analysis of available accounted for less than three
Our research suggests that the 60% data for HIMSS Stage 6 and 7 percent of total hospital revenue,
average EMR implementation for hospitals shows that over time, IT and the allotted IT budget typically
a 500-bed hospital might take budgets as a percentage of revenue represented less than four percent of
50% rose approximately 200 basis the overall hospital budget (Exhibit
roughly five to seven years, may
cost approximately $50 million points as hospitals reached more 8). These percentages are much
and could result in $5 million 40% sophisticated stages of EMR use. smaller than in other US industries.
% of Total EMR Costs
to $6 million in government
incentive payments if successful.x 30% This increase is driven by a number of
forces, including the need to create
interfaces with other hospital systems,
20% to design and manage middleware,
to support incremental servers and to
10% shift the level of data-center support
from higher tiers (many of our study
0% participants noted the need for Tier
Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7
Source: Accenture Analysis
8 9

7. Exhibit 7: Hospital IT operating expenses asas Percent of Total Operating Expenses
Exhibit 7: IT Operating Expenses Percent of total Operating Expenses Exhibit 8: US provider IT Investment Relative to to Other US Industries
Exhibit 8: US Provider IT Investment Relative Other U.S. Industries
Sample US Provider Cost Waterfall Analysis
Hospital Benchmarking Data Hospital Expectations (n = 163 hospitals)
Relative to other major industries, providers have
4.5% been slow to adapt IT as a means of strategic
differentiation, as highlighted by the relatively
small IT spend as a percentage of revenue:
43%
4.0%
- Financial Services: 5.7%
- Information Technology: 5.5%
3.5% - Professional Services: 4.7%
- Media: 4.6%
- Telecommunications: 4.3%
3.0% 17% - Education: 4.3%
- Insurance: 3.3%
- Pharmaceuticals: 3.2%
8%
2.5% - Hospitality: 3.2%
3%
- Travel: 3.1%
- Healthcare Providers: 2.7%
18%
2.0% - Electronics: 2.7%
11%
- Consumer Products: 2.5%
- Retail: 1.8%
1.5%
Revenue Labor Supplies Bad IT Other EBITDA
Low EMR Maturity High EMR Maturity Costs Debt Expense OPEX Margin
Source: Accenture’s 2010 EMR Survey & Benchmarking Survey Source: THC Financials, Caris & Company Analysis, Accenture Survey Information; Gartner IT Key Metrics Data 2010
To manage through the operating
costs increases, many of our
now placed through this simplified,
standard set—a noted key to success.
Win the war for additional 51,000 healthcare IT
workers will be needed over the next
But healthcare IT workers are not
the only talent that hospitals need
Most clinicians leave because of
understaffing and the assignment
interviewees recommended Standardizing order sets not only health IT talent five years to meet these challenges. to be concerned about. Clinicians
constitute another crucial category
of administrative responsibilities to
them by hospitals seeking to provide
standardizing order sets.4 Our strengthens a health system’s ability Hospitals, EMR vendors and systems
research shows wide variation in to analyze data, it also makes it easier There is a significant shortage of integrators are all competing with of talent. And many hospitals view more service using fewer resources.
the number of order sets across the for the system to use the clinical qualified health IT professionals to one another for these scarce workers. implementing an EMR system as a While there is no simple solution for
study participants—from just 100 to decision support system (CDSS) and support EMR implementation demand way to retain and attract their clinical solving clinician staffing shortages
in the next three to five years. Nearly “The skills shortage is real,” said the
upwards of 2,500. Many participants to predict maintenance costs. workforce. Employee dissatisfaction in the short term, EMR may improve
every CIO we interviewed noted CIO of a $3 billion health system
conducted analyses revealing that and turnover are widespread problems engagement among these and other
unfilled positions and expressed that participated in our study. “At
numerous order sets were simply for hospitals and can significantly employees by increasing work flow
concerns about how to source any given time, I have 50 unfilled
not being used in their health increase annual operating expenses. efficiency. Take a large Midwestern
enough talent from the marketplace IT roles. Like my peers, I need to
system. They were able to rationalize For example, the average turnover health system as an example. The
(and even from their EMR vendors) be focused on finding the right
at least 50 percent of them; for rate for nurses across the US is 13.9 organization incorporated clinical
and how to prevent attrition. skills (first) and at the right price
example, by omitting those that percent per year. It is not uncommon treatment protocols into its EMR
Accenture’s research shows that (second).” Another interviewee noted,
were not being consistently utilized for hospitals to pay signing and system, expediting the ordering of
reaching EMR maturity requires 0.2 “We could have 25 percent more
across the system. This dramatically retention bonuses as large as $25,000 radiological tests, chemotherapy and
healthcare IT FTEs per hospital bed. people in our IT department, but
reduced the complexity of managing, to secure qualified nurses. Add to that medications.xi These changes reduced
That translates into a requisite supply that would still not be enough to
supporting and utilizing their EMR the costs of internal recruiting and strain on clinical staff—which in turn
of approximately 155,000 FTEs in the properly support our EMR system.”
solution. One leading hospital noted training for new hires, and turnover improved provider satisfaction (as
going from several thousand to a US. Gartner estimates that there are Another challenge facing hospitals becomes alarmingly expensive. measured through formal surveys).
few hundred order sets and cites about 110,000 skilled IT FTEs in today’s is how to keep their current IT
that 60–65 percent of its orders are workforce, creating a deficit of nearly staff up to date on training. As
50,000. The Office of the National eHealth solutions become more
4
Coordinator for Health Information sophisticated, hospitals must identify
An order set is a standardized list of orders for a specific diagnosis. These orders have been developed
by a team of physicians who consult medical literature for evidence-based standards.
Technology also estimates that an ways to ensure that their current IT
employees have the skills needed to
manage and use these solutions.
10 11

8. To address the intensifying war for healthcare talent, our Think differently Hospital CIOs in our study noted
the need to think differently about
In addition, our interviewees noted
that they expected to encounter
survey participants recommended the following practices:
• Consider creating a separate
about your the capabilities required to support challenges in supporting huge
• Focus on being an “employer frontline EMR users and to optimize volumes of electronic data (whether
of choice” for the brightest IT organization to house specialized capability needs EMR-derived data through analytics. for electronic medical records or
healthcare IT talent. Within
professionals who are evaluating
potential health systems as well this organization, offer a more for tomorrow’s In terms of support (training, service
and troubleshooting), the number
electronic health records, EHRs),
securing data integrity and
as jobs in other industries. attractive benefits package
and a different career model;
information- of FTEs hired by the average hospital
increased by 45 percent as it reached
supporting health analytics needs.
One CIO noted concerns he and
• Create talent development
programs specifically for
for instance, opportunities to powered mature levels of EMR functionality his peers had with analyzing and
progress rapidly in the job and to and adoption. In addition, our data managing huge amounts of data.
healthcare IT specialists.
earn more competitive salaries environment showed that mature EMR users Most CIOs noted the importance
• Take advantage of third-party than what would typically be rely on more clinically trained of the CMIO in surmounting these
sourcing pools for IT workers, provided through health systems’ resources, such as registered nurses challenges. But they also lamented
either onshore or offshore. traditional modest pay increases. and pharmacists, for EMR support that deep data warehousing,
You may be able to source those and optimization. On average, statistical and informatics skills
• Establish in-house education
skills to different hospitals in approximately 30 percent of the do not reside in the average US
departments to provide the
your health system during your mature EMR IT organizations in our hospital. Indeed, HIMSS estimates
latest training for IT staff.
organization’s EMR journey. study consisted of clinically trained that only 25 percent of US hospitals
• Forge partnerships with local resources—dramatic increases from have any data warehouse or mining
• Establish a vendor-sponsored
colleges; for example, by setting their early stages (Exhibit 9). capabilities. One leading practice
“boot camp”—a local training
up internship programs for IT work. that Accenture has helped implement
camp to retool IT professionals
for clients is the VIP Helpdesk for
in the area. You can draw on the
resulting talent pool to support physicians. (See sidebar “Spotlight
your health system’s needs. on Accenture’s Service Desk”).
“Training is key, retention is key,” said one Spotlight on Accenture is working with Accenture’s Service Desk is
a large academic health a single point of contact
CIO of a large academic medical center. Accenture’s system on a connected for all application and
“Candidates come not only from existing Service Desk health technology initiative infrastructure and support
IT staff, but also from physicians, nurses to improve patient needs. The solution lets
care while maximizing users call the same number
and technicians always looking for operational efficiency they use today; however,
aptitude. This is a good time to identify and effectiveness. Earlier the calls are rerouted to
this year, the organization Tier 1 specialists based
people who are looking for career change received the highest level upon routing criteria
or development,” added this CIO. designation (Stage 7) and user demographic
for its EMR from HIMSS information. The solution
Analytics, the industry also includes other multiple
organization focused on contact channels, including
the use of information email, chat and voicemail,
technology in healthcare. to reach the service desk,
as well as providing the
self-service portal.
12 13