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As technology continues to play a growing role in health care management, the top concerns of information technology (IT) managers have remained basically unchanged, according to the 13th Annual HIMSS (Chicago-based Healthcare Information and Management Systems Society) Leadership Survey, sponsored by Superior Consultant Company. The majority of survey respondents were chief information officers (CIOs) or directors of information systems (IS); 42% were hospital CIOs or IS directors. Their top three concerns, as reported by the survey, are (for additional survey results, see table.):
|Selected Highlights of 13th Annual HIMSS Survey|
|Most influential health care issues for next five years|
|Health Insurance Portability and Accountability Act compliance||81.07%|
|Reducing medical errors||51.69%|
|Improving operational efficiency||40.11%|
|Obtaining capital for IT||35.31%|
|Improving quality of care||30.23%|
|Technologies facilities currently are using|
|Wireless information appliances||50.28%|
|Hand-held personal digital assistants||50.00%|
|Data security technologies||38.35%|
|Web-enabled business transactions||31.25%|
|Source: Healthcare Information and Management Systems Society, Chicago.|
Of the three, HIPAA "is by far the single largest issue before IT execs right now," says Steve Lieber, CAE, president and CEO of the HIMSS. "It encompasses several different issues, ranging from actual transactions to issues of privacy and security; it’s a multifaceted, all-consuming topic." Recent events have given security an even greater "top of mind" awareness status, Lieber notes. "If you think about the issues before America today, security has taken on a new level of importance. And in data security, we have all become aware of how easy it is to gain information about ourselves."
Providers want to convey a very strong sense of confidence in their patients, he says. "This applies not only to IT managers but to all health care executives." Areas of special concern focus on meeting requirements and timetables established by the government.
When it comes to upgrading security IT systems, HIPAA and patient safety concerns are inextricably linked, Lieber says. "There is a recognition among IT professions as well as clinicians that technology plays a role in the actual delivery of health care," he observes. "There’s a clear recognition that the management of care, the tracking of care, [and] the ability to do diagnostics — all are a major part of a patient’s treatment. We need to recognize what the opportunities are in any number of clinical systems: lab systems, imaging systems, and so on. Technology’s growing role will have a positive impact on patient care."
In the more targeted area of error reduction, the CPOE (computerized physician order entry) system is the most commonly discussed technology today, Lieber says. "Handwritten prescriptions introduce a tremendous opportunity for error," he explains. "With the CPOE, the orders are entered at bedside and transmitted to the pharmacy. You’ve got electronic tracking, and the bar coding of meds and the wristband. All of this helps ensure you have the right patient, and with the patient’s computerized record, that you have taken the right actions."
With the proliferation of drug therapies, keeping track of which drug works best in which situation takes on added importance, he continues. "And in the future, the genomics issue will also have a connection," he predicts. "Perhaps as much as 40% of the prescriptions issued today are relatively ineffective because of the variety in DNA among patients. The ability to map the human genome and to link it to drug therapies are the sorts of things that will impact not only on safety but on quality as well. It should make outcomes that much more effective."
Replacing or upgrading inpatient clinical systems was another key survey concern "because it is closest to the patient," Lieber explains. "We’ve also seen a big increase this year in the importance of enterprise resource planning systems." Such systems consolidate all of a hospital’s business functions and make sure they all "talk" to one another, he explains.
This rise in importance is driven by the need to achieve a very high level of business efficiency. "Clearly, a hospital executive must be concerned with delivery of care, but he also must concern himself with business issues," Lieber asserts. "The hospital has to run smoothly, efficiently, and effectively. One way to do that is through highly effective information systems."
When asked to look into the future, survey respondents saw no change in their priorities over the next two or three years. Lieber agrees. "HIPAA has been on the agenda for two years. Back then, it was not No. 1, but just breaking into prominence. I predict it will hold its top position for several years." Until we start seeing different Joint Commission on Accreditation of Healthcare Organizations survey results on patient safety, it also will remain on top, he adds. "Addressing major issues like these takes time," he explains. "They don’t go away in one budget cycle."
For more information, contact: Steve Lieber, CAE, president and CEO, Health-care Information and Management Systems Society, 230 E. Ohio St., Suite 500, Chicago, IL 60611-3269. Telephone: (312) 915-9225.