24th Annual HIMSS Leadership Survey

March 4, 2013

Panelists

• Steve Lieber – CEO HIMSS

• Willa Fields, DNSc, RN, FHIMSS– Professor in the School of Nursing, San Diego State University– HIMSS Board Chair

• Mitzi Cardenas– Sr. VP Strategy, Business Development/CIO, Truman Medical Center

• Milisa Rizer, MD– CMIO, Ohio State University

• Mike Rozmus– VP & CIO, RMH Healthcare

• Steve Fanning – Vice President, Healthcare Industry Strategy, Infor

• Jennifer Horowitz– Senior Director, Research

Methodology

• Data collected from December 2012 to February 2013– Web-based survey

• 298 respondents – Senior IT executives– Represent nearly 600 hospitals in the United States

Survey Headlines

• Healthcare organizations are making strong progress towards federal mandates– Two-thirds have already qualified for Meaningful Use Stage 1– Three-quarters expect to qualify for Stage 2 in 2014– 87 percent expect to complete ICD-10 conversion on time

• IT staffing is still a concern– 21 percent are concerned they won’t be able to secure IT staff– Need is greatest for clinical applications– 51 percent plan to increase staff in the next year

FEDERAL INITIATIVES

Business Issue with Most Impact on Healthcare

Hospital Infrastructure NeedsStaffing Issues

Privacy/Security IssuesConsumer Considerations

Technology Considerations Shifting Healthcare LandscapeHealth Information Exchange

Policy MandatesFinancial Considerations

Healthcare Reform

0%

2%

3%

3%

5%

3%

8%

23%

14%

40%

1%

2%

4%

4%

4%

7%

8%

14%

16%

37%

20132012

N = 298

Primary Clinical IT Focus

Focus on Nursing SystemsFocus on Consumer Technology

Installing/Upgrading AncillaryInstalling/Upgrading CDR

Certification of EHREstablishing Clinical Protocols

Closed Loop Medication AdministrationCreating Continuity of Care RecordData Warehouse/Clinical Analytics

Installing CPOELinking Clinical Systems to Quality Measures

Focus on Physician SystemsFully Operational EHR in Place

2%

1%2%

4%2%

3%0%

9%16%

15%16%

25%

2%2%

2%2%2%

3%3%

7%10%10%

16%16%

19%

20132012

Not Applicable

N = 298

Area that IT Can Most Impact Patient Care

Ensuring that Data is Secure/PrivateImproving Patient Access to Information

Providing Remote Monitoring of PatientsProviding Competitive Advantage

Enabling Remote Access of DataSharing Information Externally

Supporting Staff ProductivityStandardizing Clinical Care

Reducing Medical ErrorsImproving Quality Outcomes

0%

0%

6%

3%

5%

7%

16%

22%

38%

1%

2%

3%

4%

5%

7%

8%

12%

25%

31%

20132012

Not Applicable

N = 298

Top IT Priority – Next Two Years

Integration of IT and Medical DevicesSecuring Patient Information

Focus on Ambulatory SystemsHealthcare Consumer Issues

Exchange Info with Other EntitiesInteroperability

Completing ICD-10 ConversionFocus On Clinical Systems

Leveraging InformationOptimizing Use of Current Systems

Achieving Meaningful Use

0%

1%

2%

1%

1%

3%

11%

15%

13%

12%

38%

1%

1%

2%

2%

2%

6%

9%

11%

17%

20%

28%

20132012

N = 298

Percent of Organizations that Expect to Qualify for Meaningful Use Stage 1

Don't Know

Not Planning to Attest

Expect to Attest by end of 2012

Will until by 2013 to Attest

Have Already Attested

5%

1%

4%

24%

66%

N = 297

Level of Investment Made by Healthcare Organizations in Meaningful Use Stage 1

Don't KnowNot Applicable

Prefer Not to Disclose$20 Million or More

$10 Million to $19 Million$5 Million to $9 Million$3 Million to $4 Million$1 Million to $2 Million

$500,000 to $999,999$250,000 to $499,999

Under $250,000No Investment Made

8%2%

8%3%

4%10%

13%14%

7%11%

14%5%

7%3%

7%5%

6%6%

11%17%

10%9%

14%5%

20132012

N = 297

Expected Return on Investment From Meaningful Use Stage 1

Don't Know

Prefer Not to Disclose

Not Applicable

$10 Million or More

$8 Million to $9 Million

$6 Million to $7 Million

$4 Million to $5 Million

$2 Million to $3 Million

Less than $2 Million

6%

9%

1%

7%

3%

5%

16%

23%

30%

N = 255

Expected Timeline to Qualify for Meaningful Use Stage 2

Don't Know

No Plans

2016 or Later

2015

2014

6%

4%

1%

15%

75%

N = 297

Expected Timeline to Qualify for Meaningful Use Stage 2

Not ApplicableDon't Know

Prefer Not to Disclose$20 Million or More

$15 to $19 Million$10 to $14 Million

$5 to $9 Million$3 to $4 Million$1 to $2 Million

$500,000 to $999,999$250,000 to $499,999

Under $250,000No Additional Funds

3%17%

6%0%

0%1%

6%6%

12%9%

15%14%

11%

N = 297

Expected Return on Investment From Meaningful Use Stage 2

Don't Know

Not Applicable

Prefer Not to Disclose

$10 Million or More

$8 Million to $9 Million

$6 Million to $7 Million

$4 Million to $5 Million

$2 Million to $3 Million

Less than $2 Million

17%

1%

9%

4%

2%

3%

7%

18%

38%

N = 255

Primary Financial IT Focus

Direct Claims TransactionsUpgrading Encoding System

Web Enabling Patient SchedulingEligibility Transactions with PayersWeb Enabling Registration Process

Medical Necessity Checking SolutionsImplementing Enterprise Scheduling

Upgrading Patient Access SystemUpgrading Patient Billing System

Upgrading Financial Analytics SystemsImplementing ICD-10

0%

0%

1%

1%

2%

1%

1%

2%

6%

67%

0%

0%

1%

1%

2%

2%

4%

4%

12%

15%

47%

20132012

Not Applicable

N = 298

Preparedness to Meet ICD-10 Deadline in 2014

Don't Know

No

Yes

9%

4%

87%

N = 298

Level of Investment in ICD-10 Conversion

Don't KnowPrefer Not to Disclose

Not Applicable$15 Million or More

$10 Million to $14 Million$5 Million to $9 Million$3 Million to $4 Million$1 Million to $2 Million

$500,000 to $999,999$250,000 to $499,999

Under $250,000No Additional Funds

33%6%

1%0%1%2%

4%9%

10%8%

21%4%

N = 296

IT STAFFING

Most Significant Barrier to Implementing IT

Constraints at a Regional LevelDifficulty Proving ROI

Lack of Clinical LeadershipLack of Interoperable Systems

Lack of Strategic IT PlanLack of Time Commitment from Clinicians

Difficulty in End User AcceptanceVendor Inability to Deliver Product

Lack of Adequate Financial SupportLack of Staffing Resources

4%

4%

6%

4%

3%

7%

9%

12%

14%

21%

3%

4%

4%

4%

4%

6%

7%

13%

15%

21%

20132012

N = 298

IT Staffing Change – Next 12 Months

Decrease

No Change

Increase

5%

32%

61%

7%

38%

51%

20132012

N = 296

Top Ten IT Staffing Needs

User TrainingHelp Desk

Database AdministrationClinical Transformation

PC/Server SupportProcess/Workflow

System IntegrationIT Security

Clinical InformaticsNetwork/Architecture Support

Clinical Application Support

10%10%10%

12%12%12%

14%18%18%

21%34%

N = 298

IT BUDGETS

Key Business Objective

Attract Qualified Staff

Grow Through Acquisition

Improve Patient Satisfaction

Increase Market Share

Accountable Care Organization

Achieve Meaningful Use

Improve Operational Efficiency

Improve Patient Care

Sustain Financial Viability

1%

4%

12%

8%

24%

13%

21%

15%

1%

4%

4%

9%

9%

15%

17%

19%

21%

20132012

Not Applicable

N = 298

Change In IT Budget

Definitely Decrease

Probably Decrease

No Change

Probably Increase

Definitely Increase

2%

5%

12%

19%

56%

2%

6%

15%

29%

47%

20132012

N = 298

Reason for Budget Increase

Business Requirements to Invest in E-BusinessAbility to Prove ROI

Competitive Market ThreatsPartnership with another organization

Merger/PartnershipAddition of Facility

Increase in Long-Term IT PlanNeed to Upgrade IT Infrastructure

Need to Comply with Regulatory ChangesOverall Budget Increases

Additional Staffing NeededOverall Growth in Systems

5%8%9%9%

10%18%

23%40%42%42%

52%58%

N = 298

OTHER HEADLINES

Primary Infrastructure IT Focus

Other Deploying Vendor Neutral Archive

TelemedicineWired/Wireless Networking

Cloud ComputingDesktops/Virtual Desktops

Storage and BackupMobile Devices

Servers/Virtual ServersSecurity Systems

9%

2%

7%

3%

16%

8%

18%

19%

16%

6%

3%

3%

3%

5%

10%

12%

16%

18%

22%

20132012

Not Applicable

N = 298

Security Breach

In Last 12 Months

In Last Six Months

22%

13%

19%

10%

20132012

N = 298

Top Security Concerns

No ConcernsLack of Compliance with BAA

Inadequate Security Systems in PlaceConnecting IT at Remote LocationsUnauthorized Use by Third Parties

Patients' Lack of Confidence in Security SystemsInadquate Funding for Security Systems

Limits of Existing TechnologyExternal Breach of Security

Data LeakageInternal Breach of Security

Compliance with HIPAA and CMS RegulationsSecuring Information on Mobile Devices

4%0%

32%5%

7%4%

13%10%

13%12%

32%34%

6%

3%3%4%4%

5%6%

8%8%

10%16%

27%28%

36%

20132012

N = 298

HIE Adoption

Don't Know

Participated in Failed HIE

Participate in HIE

Required to Participate

HIE in our Area/Don't Participate

No Plans to Participate

Don't Know What an HIE Is

2%

4%

49%

6%

22%

26%

2%

2%

3%

51%

6%

21%

25%

3%

20132012

N = 298