The 'all or nothing' approach for qualifying as a meaningful user, and the uncertainty over what the final rule will look like, pose a significant concern for CIOs, even at those organizations that have already made significant investments in technology
Ann Arbor, MI (Vocus) February 28, 2010
Upgrading or implementing a certified EHR system will be one of the largest challenges for healthcare CIOs and IT executives in helping their organizations meet the Meaningful Use requirements, according to a survey by the College of Healthcare Information Management Executives (CHIME).
While CIOs continue to express trepidation over the pressures to meet the criteria for HITECH stimulus funding, the need to install new or upgraded systems to meet meaningful use requirements was ranked as the top issue by nearly 30 percent of respondents, with 41 percent listing it among their top three concerns.
Other leading concerns for CIOs regarding EHR implementation include insufficient capital for purchasing systems, doubts about vendor readiness and staffing capabilities.
CIOs continue to believe that the federal support for electronic health records is important to encourage nationwide adoption, and they say the federal EHR program will help improve care quality and efficiency in the nation’s healthcare organizations.
The survey, conducted in early February, found that more than 90 percent of its responding 238 members expressed at least some degree of concern about whether they will qualify for stimulus funding.
More specifically, 27 percent of respondents said they were worried about meeting the requirements for meaningful use specified in the proposed rules, while 34 percent said they were somewhat worried and 27 percent indicated they were only slightly worried.
“The ‘all or nothing’ approach for qualifying as a meaningful user, and the uncertainty over what the final rule will look like, pose a significant concern for CIOs, even at those organizations that have already made significant investments in technology,” said Indranil “Neal” Ganguly, CHCIO, vice president and CIO at CentraState Healthcare System, Freehold, N.J., a member of CHIME’s Policy Steering Committee, which has been analyzing the proposed regulations.
When asked about attaining proposed meaningful use objectives, more than a quarter of CIOs – 28 percent – said their biggest problem will be installing new EHR systems or upgrading existing applications.
But other issues also will make it difficult to achieve meaningful use. For example, capturing and submitting quality data ranked second among top concerns, mentioned by 15 percent of respondents, and more respondents ranked it among their top three concerns – 46 percent – than any other concern.
“Although almost all hospitals are capturing and reporting on some level of quality measures, most of the data gathering is accomplished in a very manual manner,” said Charles Christian, FCHIME, director of information systems and CIO at Good Samaritan Hospital, Vincennes, Ind. “The proposed regulations require quality data to be report from within the certified EMR; I am not aware of any EMRs on the market today that can gather all the necessary data points within their applications. EMR vendors have some development work to do to meet these requirements.”
In rating concerns about implementing a certified EHR system, more than one in five respondents – 20 percent – cited the need to implement a new system or upgrade an existing application. Lack of capital for purchasing EHR systems was listed as a top concern by
18 percent of respondents.
Nearly half of all respondents, 48 percent, expressed concern about vendor readiness, both in terms of vendors’ ability to develop certified products and expected delays in vendor support of EHR system installations.
Current IT staffing levels, and whether existing staff have the requisite skills to implement advanced clinical systems, was rated highest among 11 percent of members surveyed and among the top three concerns of nearly half of all respondents.
“While I am highly confident that my IT team will have us prepared to reach meaningful use and qualify for the incentives, a shortage of experienced implementation specialists is inevitable as many hospitals and physicians begin to gear up,” said William Spooner, FCHIME, senior vice president and CIO at Sharp HealthCare, San Diego, Calif. “The HITECH Act is funding training initiatives around the country, yet the inexperience of these newly trained people will handicap their potential contribution. We will need innovative approaches such as teaming with more seasoned professionals and providing best practices methodologies to ensure success.”
There’s wide divergence of opinion among survey respondents on whether federal initiatives to support HIT will help providers. Just over 36 percent of all respondents said all three federal programs – grants, HIT workforce training and extension centers – will help their organizations, but another 31 percent said federal programs will not be useful. Grants, either by themselves or in combination with one other program, were cited by the highest number of respondents as the most useful assistance.
Despite the uncertainties ahead, CIOs are sold on the potential of EHRs and the federal EHR program to make a difference over the next four years. According to 84 percent of respondents, the program will help their organizations achieve measurable improvements in adoption over the next four years; similarly, 78 percent said they believe the EHR Incentive Program will help their organizations achieve measurable improvements in healthcare quality and efficiency over the next four years.
A full summary report of the survey may be accessed below:
The College of Healthcare Information Management Executives (CHIME) is an executive organization dedicated to serving chief information officers and other senior healthcare IT leaders. With more than 1,400 CIO members and over 70 healthcare IT vendors and professional services firms, CHIME provides a highly interactive, trusted environment enabling senior professional and industry leaders to collaborate; exchange best practices; address professional development needs; and advocate the effective use of information management to improve the health and healthcare in the communities they serve.