Senior IT executives working in health-care organizations increasingly support the use of information technology to reduce medical errors and promote patient safety, according to a survey released by the Healthcare Information & Management Systems Society. Fifty-two percent of respondents cited this as a current IT priority, compared to 45 percent last year. The 14th Annual HIMSS Leadership Survey, released at the HIMSS 2003 Annual Conference and Exhibition in San Diego, is based on the responses of 287 senior-level IT executives, most of whom work in health-care organizations as CIOs, directors of information systems, or IT department heads.
"For the first time, patient safety is the most important focus area for IT professionals [in health care] - for the last few years it was Y2K and HIPAA," says HIMSS President and CEO Steve Lieber. "Now they are very aligned with clinicians in wanting to improve the quality of health care."
Still factoring heavily into respondents' concerns, however, is compliance with HIPAA (the Health Insurance Portability and Accountability Act of 1996), with 47 percent indicating that upgrading security for HIPAA requirements is a priority (compared to 60 percent last year), while implementing privacy modifications for HIPAA concerns 46 percent of respondents (this question was not included in last year's survey).
In addition to being a current IT priority, reducing medical errors shows up as the number one business issue over the next 24 months (63 percent compared to 53 percent last year). As a business issue, HIPAA compliance dropped to 61 percent from 81 percent last year, when it was the top business issue, suggesting organizations have already begun to deal with it as the April 14 compliance deadline looms. Cost pressures are cited as the third most pressing business issue.
Critical applications and barriers
Sixty-four percent of the survey-takers cited computer-based practitioner order entry (CPOE) as the most critical application their organizations should implement within the next two years. "Drug order entry is where there's the greatest potential for medical error, through misreading handwriting, for example," says Lieber.
Electronic applications should be user-friendly, cautions Lieber. "Clinicians fully embrace certain technologies," he says. "But if a system is installed without the workflow process having been dealt with fully - the human issues as well as technical ones - or if an electronic method is more time-consuming than doing it by hand, clinicians tend to resist it. But in many cases it's the clinicians who are pushing adoption."
Other applications figuring prominently into health IT plans during the next 24 months include implementation of clinical information systems (53 percent), bar-coded medication management (46 percent), point-of-care decision support (43 percent), clinical data repositories (42 percent), and computer-based patient record (CPR) systems (41 percent).
There is already a significant increase in the number of health-care institutions that have adopted centralized electronic health-care records since 2001. Nineteen percent now have a fully operational CPR system, compared to 13 percent in 2001; and 37 percent have begun installing such systems, compared to 29 percent two years ago. Implementing a CPR system "is the most important thing [IT departments] can do to deliver effective, efficient, high-quality health care," says Lieber.
Despite the importance of CPR systems, 20 percent of respondents report that their organization does not yet have a plan for their implementation.
Cost pressures were named by 56 percent of respondents as their third most important business issue - these pressures contributing no doubt to the 23 percent of respondents who identify "lack of financial support" as a barrier to IT implementation. Despite dismal economic conditions, however, this figure is down from 27 percent last year.
Another barrier to IT implementation is the "vendor's inability to effectively deliver product," cited by 19 percent of respondents. The source of this problem is often miscommunication, says Lieber. "The expectations of the institution may not have been communicated clearly, leading to problems with installation of the systems."-- Bio-IT World (online)