Healthcare IT Priorities: No Breathing Room

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Healthcare has always been a highly regulated industry, but in the last few years requirements for implementing and documenting digital healthcare systems have been piling up so fast that IT organizations have little time for anything else -- including making sure the systems they already have in place are being used effectively. The InformationWeek Healthcare IT Priorities Survey of 322 technology pros at healthcare providers shows "meeting regulatory requirements" is the No. 1 initiative on participants' minds. Most of the other items at the top of the list, such as implementing or upgrading electronic health records (EHR) systems, are also largely driven by federal government requirements.

 "The priorities we're trying to deal with right now are those being mandated," says Randy McCleese, CIO of St. Claire Regional Medical Center. "We can't do anything else. We have put everything else on the back burner except for those things that absolutely have to be done."

Against the crushing wave of requirements, what's most neglected by IT organizations is optimizing how healthcare providers use all the technology they've bought of late -- "and we've been provided with a lot of functionality in the last three to four years," says McCleese, who's also chairman of CHIME, the College of Healthcare Information Management Executives. "We've put all this technology in place quickly to meet the requirements, but we have not had a chance to make sure it's working effectively."

On a scale of 1 to 5, with 5 a top priority, survey participants give regulatory requirements a mean rating of 4.5, and 65% rate it a top priority. Managing electronic medical records systems gets a mean rating of 4.2 and is a top priority for 53% of health IT pros.

The EHR vendors most frequently used, Epic and Cerner, appear to be cementing their market dominance. Thirty-seven percent of providers cite Epic as the EHR their organizations are implementing or planning to implement, up from 27% last year. Cerner is the choice of 22%, up from 16% last year. Yet the percentage of participants saying their EHR strategy is to rely on a "comprehensive system from a single vendor" is down slightly to 56%, compared with 62% last year.

The federal government encouraged EHR adoption with incentive payments, funded as part of President Obama's stimulus plan approved in 2010, as well as the threat of reduced Medicare reimbursement for organizations that fail to digitize. Incentives are tied to standards measuring "Meaningful Use" of EHRs, and that Meaningful Use program has progressed from requiring initial adoption of EHR in Stage 1 to a more ambitious set of requirements in Stage 2. Stage 2 went into effect this year, requiring capabilities to exchange electronic records with other institutions and to make records available to patients online. About nine of 10 providers say they're very or somewhat confident they'll hit the Stage 2 end-of-2014 deadline.

The Meaningful Use program also encourages the use of health information exchange technology, starting with the ability to exchange Direct Protocol messages, a type of secure email that can include structured attachments such as medical documentation to ensure continuity of care. However, grander plans to build state and regional HIE data hubs have stalled

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