With healthcare reform, meaningful use compliance, upcoming changes in medical coding, and a list of other challenges, healthcare providers have a lot on their plates.

A new study, conducted in June and July by IT services and consulting firm CSC uncovers the current pecking order of priorities among healthcare IT leaders and other executives.

The 60 healthcare executives responding to the survey included about half CIOs and other IT leaders, and half operational executives, including CEOs, CFOs and COOs. The executives were from a mix of large multi-hospital health systems, single academic medical centers, and stand alone non-academic hospitals.

Across the board, IT and non-IT executives agreed that achieving meaningful use compliance is their number-one immediate priority. Sixty-seven of all respondents said achieving meaningful use of inpatient e-health record systems was their immediate top priority. Ninety percent said achieving meaningful use was among their two highest priorities.

While meaningful use compliance was the top priority among all healthcare executives, there was some disparity among the IT and non-IT executives. Eighty-four percent of CIOs and other health IT executives named meaningful use compliance as their top priority, while 48% of non-IT executives said that was their number-one concern.

However, 31% of non-IT executives named preparing for new payment models their top priority, while only 3% of IT executives named that as number-one concern.

A big driver in meeting meaningful use compliance is the $20 billion-plus in HITECH Act financial incentives that the Centers for Medicare and Medicaid will begin paying in 2011 for achieving the first wave of 20 core and discretionary objectives set out by the government earlier this month.

Also, starting in 2015, non-compliant healthcare providers will be financially penalized by CMS, another factor driving many healthcare executives' concern about trying to achieve meaningful use earlier rather than later, said David Hampshire, a CSC managing partner for healthcare delivery.

In addition, 42% of all healthcare executives said helping their networks of owned or affiliated physicians meet meaningful use compliance with ambulatory care EHR systems was their second-highest priority, though it was number-one priority for 12% of the healthcare leaders.

Hospital executives are driven to help their network of doctors achieve meaningful use by later HITECH Act requirements for financial incentives that will include the exchange of health data among patients' healthcare providers, and the emergence of accountable care organizations, or ACOs, that in the future will also be paid higher reimbursements for the quality and cost-savings of care delivery.

The comprehensivehealthcare reform act signed into law earlier this year by President Obama includes provisions for payment reforms, and ACOs are among those new models of payment being piloted.

"Interoperability is an enabler of ACOs," said Hampshire. Achieving meaningful use and other transformative improvements in care delivery and cost reductions through health IT will play a role in the success of ACOs, he said.

Among the challenges that fell "surprisingly low" on the list of all healthcare executives' priorities is the conversion from ICD-9 to ICD-10 for diagnoses coding, a regulatory mandate doctors and hospitals must meet by 2013. ICD-10 will impact nearly all major IT systems within healthcare organizations, including billing, payment, patient care, and quality reporting, said Hampshire.

Only 10% of all healthcare executives said ICD-10 code conversion was their number-one priority.

"It's a challenging time to be in this industry, with all the sweeping regulatory changes placed on everyone," said Hampshire. "Organizations need to be planning for all aspects of it -- and at a higher level, need IT to drive out costs," he said.

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