2013 HIMSS Leadership Survey: Senior IT Executive Results

2013 HIMSS Leadership Survey
Senior IT Executive Results

March 4, 2013
Sponsored by:
www.himss.org
transforming healthcare through IT
24th Annual HIMSS Leadership Survey

Final Report: Healthcare Senior IT Executive Sponsored by Infor The 24th Annual HIMSS Leadership Survey reflects the opinions of information technology (IT) professionals in U.S. healthcare provider organizations regarding the use of IT in their organizations. This study covers a wide array of topics crucial to healthcare IT leaders including IT priorities, issues driving and challenging technology adoption, IT security, as well as IT staffing & budgeting plans. Contents 1. Executive Summary 2. Methodology 3. Profile of Survey Respondents 4. IT Priorities 5. IT Barriers 6. IT and Patient Care 7. IT Security 8. Health Information Exchange (HIE) Participation 9. IT Governance 10. Federal Initiatives 11. IT Budget and Staff 12. About HIMSS 13. About Infor Healthcare 14. About Infor 15. How to Cite This Study 16. For More Information
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2013 Healthcare Information and Management Systems Society
Figures Figure 1. Participant ProfileTitle Figure 2. Participant ProfileFacility Type Figure 3. Participant ProfileType of Hospital Figure 4. Participant ProfileRevenue Figure 5. Participant ProfileRegion Figure 6. Top IT Priority Next Two Years Figure 7. Primary Clinical IT Focus Figure 8. Primary Financial IT Focus Figure 9. Primary IT Infrastructure Focus Figure 10. Key Business Objective Figure 11. Business Issue with Most Impact on Healthcare Figure 12. Most Significant Barriers to Implementing IT Figure 13. Area that IT Can Most Impact Patient Care Figure 14. Role of Clinicians Figure 15. Access to On-line Patient Information from Remote Location Figure 16. Security Breach Figure 17. Top Concerns Security of Computerized Medical Information Figure 18. Health Information Exchange (HIE) Adoption Figure 19. Alignment of Organizational & IT Strategic Plan Figure 20. Member of Organizations Executive Committee Figure 21. Senior IT Executive Responsibilities Figure 22. Organizations Approach to IT Spending Based on Meaningful Use Figure 23. Percent of Organizations that Expect to Qualify for Stage One Meaningful Use Figure 24. Level of Investments Made by Healthcare Organizations in Meaningful Use Stage 1 Figure 25. Percent of Organizations that Expect to Qualify for Stage 2 Meaningful Use Figure 26. Level of Investment Made by Healthcare Organizations in Meaningful Use Stage 2 Figure 27. Anticipated ROI for Meeting Meaningful Use Stage 1 Requirements Figure 28. Anticipated ROI for Meeting Meaningful Use Stage 2 Requirements Figure 29. Preparedness to Meet ICD-10 Conversion Figure 30. Level of Investment Made in ICD-10 Conversion Figure 31. Expected Change in IT Staff in Next 12 Months Figure 32. Number of IT FTEs Budgeted to be Added Figure 33. 2013 IT Staffing Needs (Top Ten) Figure 34. Additional Functions Managed by Senior IT Executives Figure 35. Projected Change in IT Operating Budget Figure 36. Reason for Increase in Budget Figure 37. Reason for Decrease in Budget
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1. Executive Summary The findings from this years Annual HIMSS Leadership Survey, sponsored by Infor, strongly suggest that the federal governments efforts to impact provider investments in information technologies to qualify for Meaningful Use (MU) and ICD-10 conversions, are paying off. To illustrate, two-thirds of survey respondents have already qualified for Stage 1 Meaningful Use while three-quarters indicated they expect to qualify for Stage 2 in 2014. Additionally, 87 percent of respondents indicated they expect to complete their conversion to ICD-10 by October 2014. Now that a majority of IT executives report having achieved Meaningful Use Stage 1, many leaders have turned their attention to MU Stage 2. In fact, findings reveal that more than one-quarter (28 percent) of organizations have identified the implementation of the systems needed to achieve Meaningful Use as their key IT priority. One-quarter (25 percent) of respondents also reported that they will invest a minimum of $1 million to achieve Stage 2. Respondents also continue to express concerns about IT staffing shortages. While half of the respondents (51 percent) indicated they plan to increase their IT staff in the next year, 21 percent are concerned that they wont be able to secure the IT staff needed to successfully achieve their IT objectives. The leading areas in which respondents need staff are in the areas of clinical application support, network/architecture support and clinical informatics professionals. Other key survey results include: Health Information Exchanges (HIEs): Approximately half of respondents (51 percent) reported their organization participates in at least one HIE in their area, a finding that is slightly increased from last years participation level. ICD-10: Approximately half (47 percent) of respondents to this study indicated that implementing CPT-10/ICD-10 continues to be the top focus for financial IT systems. Impact of IT on Patient Care: Respondents were most likely to indicate that IT can impact patient care by improving clinical/quality outcomes, reducing medical errors or helping to standardize care by allowing for the use of evidence-based medicine. Role of Clinicians: Clinicians are active participants in many aspects of IT use at their organizations, including selecting IT systems for use in their department and acting as project champions.
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Security Concerns: Nineteen (19) percent of respondents indicated that their organization has experienced a security breach in the past year. Respondents were most likely to indicate that securing information on mobile devices was the top security concern at their organization. Organizational Infrastructure: Almost one-quarter of respondents (22 percent) indicated that a focus on security systems was their current key infrastructure priority. IT Governance: There continues to be a strong level of integration between an organizations overall strategic plan and their IT strategic plan as half of respondents reported that their IT plan is part of their overall organizational strategic plan. Senior IT Executive Responsibilities: Executives were most likely to report that they play a role in contributing to overall business strategy and driving value from IT investments. External Areas of Responsibilities: Nearly all senior IT executives reported that they were responsible for at least one IT area outside of the traditional IT department, primarily telecommunications. Consumer Attitudes on Health IT: On a scale of one to seven, where one is of no importance and seven is a high degree of importance, IT executives recorded an average score of 4.94 with regard to the importance that patient/consumer attitudes have on adoption of new technology.
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2. Methodology
A total of 298 valid responses were received for this years Web-based survey. Data was collected between December 2012 and February 2013. Survey respondents represent nearly 600 hospitals throughout the United States. The average bed size of the hospitals represented in this survey is 468 (median = 200 beds).
3. Profile of Survey Respondents

More than half of respondents (55 percent) identified themselves as a Chief Information Officer (CIO), at either the corporate-level (36 percent) or the facility level (19 percent). Another third (31 percent) of respondents indicated they were a Director of Information Systems/Information Technology (IS/IT) and six percent of the respondents were Chief Medical Information Officers (CMIOs). The remaining respondents include Chief Nursing Information Officer (CNIO) and Manager of ITs. Nearly 90 percent of survey respondents reported working for an acute care hospitalbased environment, either at a stand-alone hospital (48 percent), a healthcare system (27 percent) or hospital as a part of a multi-hospital system (14 percent). Another six percent of respondents work at an outpatient setting. The remaining respondents reported working for other types of healthcare facilities including mental/behavioral health facilities, long-term care facilities and home care agencies. Respondents working for an acute care, hospital-based environment were asked to identify the types of hospitals that were part of their organization. Approximately twothirds of respondents (64 percent) noted that at least one facility in their organization was a community hospital. One-quarter of respondents indicated that their organization contained at least one critical access hospital and 17 percent reported working for an academic medical center. Thirteen (13) percent reported that they work for a general medical/surgical hospital. Annual gross operating revenues for the provider organizations represented in this years survey were: $50 million or less25 percent; $51 million to $200 million23 percent; $201 million to $350 million11 percent; $351 million to $500 million7 percent; $501 million to $1 billion10 percent; More than $1 billion15 percent; and Dont Know/Not Applicable10 percent.
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Respondents were most likely to work in the East North Central 1 region of the United States (17 percent), followed by the Mid Atlantic 2 and South Atlantic 3 regions (16 percent each). New England 4 had the fewest number of respondents (six percent). Figures: Figure 1. Participant ProfileTitle Figure 2. Participant ProfileFacility Type Figure 3. Participant ProfileType of Hospital Figure 4. Participant Profile Revenue Figure 5. Participant Profile Region
4. IT Priorities
Healthcare reform 5 was identified as the key issue that would most impact healthcare delivery in the next two years. In this context, IT executives reported their organizations were focused on achieving Meaningful Use, optimizing currently installed systems and leveraging information housed in existing systems to improve healthcare. IT Priorities When asked to identify the top IT priority to be addressed at their organization in the next two years, respondents were most likely to identify implementing the systems needed to achieve Meaningful Use (28 percent). However, the number of respondents identifying this area as a top IT priority continues to drop from a peak of half of respondents (50 percent) in 2011 and 38 percent in 2012. Another twenty percent of respondents indicated their top IT priority was to optimize the effective use of their currently installed systems. A focus on leveraging information housed in data warehouses and business intelligence systems rounds out the top three for the second consecutive year. This was identified by 17 percent of respondents. Less than one percent of respondents indicated that securing patient information was a top IT priority at their organization at this time. None of the respondents identified a focus on revenue cycle management (RCM) or supply chain systems as a top IT priority in the next two years.
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Illinois, Indiana, Michigan, Ohio, Wisconsin New Jersey, New York, Pennsylvania Delaware, Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia, Washington, DC, West Virginia, 4 Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont 5 Referred to in this study as ACOs, new care models or payment structures
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To more fully understand the areas on which IT executives were focusing their attention, respondents were also asked to identify the primary focus their organization has with regard to clinical IT, financial IT and infrastructure at their organizations. Primary Clinical IT Focus In 2013, respondents indicated that ensuring their organization has a fully functional EHR is their primary clinical IT focus (19 percent). However, the number of respondents indicating this to be the case declined from the 25 percent reported in 2012. A focus on physician systems, such as physician documentation or clinical decision support tools, was identified by 16 percent of respondents as a priority; another 16 percent of respondents indicated a focus on linking clinical systems with quality measures and outcomes. Less than one percent of respondents indicated that creating clinical documentation flow sheets was a primary clinical focus. None of the respondents indicated that installing a PACS system was a top clinical focus at this time. Primary Financial IT Focus Implementing CPT-10/ICD-10 continues to be the top focus for financial IT systems among the respondents to this study. Approximately half of respondents (47 percent) indicated this to be their top financial IT focus; this is a decrease from the two-thirds of respondents who reported this to be the case in 2012. Another 15 percent of respondents indicated their organizations key financial IT focus was to upgrade financial analytics systems to support Accountable Care Organizations (ACOs) and a bundled payment system. Rounding out the top three is upgrading the patient billing system, identified by 12 percent of respondents. One percent of respondents or fewer indicated that the following items were a top IT priority with regard to financial systems at their organizations. Implementing claims transactions directly with payers (no clearinghouse); Web-enabling the patient scheduling process to improve patient self-service; Implementing direct eligibility transactions with payers; and Upgrading the encoding system.
None of the respondents indicated their organization had a present focus on webenabling the bill payment process to improve patient self-service functions.
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Primary Infrastructure Focus With regard to their top infrastructure priority, nearly one-quarter of respondents identified a focus on security systems (22 percent), up from 16 percent in 2012. This is followed by last years top response, servers/virtual servers, which was identified by 18 percent of respondents. Rounding out the top three is a focus on mobile devices, which was identified by 16 percent of respondents. Respondents were least likely to identify that either deploying a vendor neutral archive system or telemedicine were key infrastructure priorities at their organizations. Each of these was identified by less than three percent of respondents. Key Business Objective When asked to identify the single key business objective their organization was trying to achieve in the next 12 months, nearly one quarter of respondents (21 percent) indicated sustaining financial viability. This represents an increase from the 15 percent of respondents that selected this response in the 2012 study. Rounding out the top three key business objectives are improving patient care/quality of care and improved outcomes and improved operational efficiencies. These were selected by 19 and 17 percent of respondents, respectively. Last years top response, achieving Meaningful Use dropped to fourth place, identified by only 15 percent of respondents. For the past several years, very few respondents have indicated that attracting qualified staff or improving supply chain dynamics are key business objectives for their organizations. This continues to be the case in 2013, when these items were selected by a combined total of one percent of respondents. Business Issue Driving Healthcare This years survey respondents continue to identify healthcare reform as the top business issues that would have the most impact on healthcare in the next two years. This option, which includes items such as ACOs, new care models and payment structures was selected by 37 percent of respondents. Rounding out the top three responses are financial considerations such as the demand for capital (16 percent) or creating new revenue sources and policy mandates such as ICD-10 and Meaningful Use (14 percent). These items also rounded out the top three responses in 2012. No other option was selected by more than 10 percent of respondents.
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Respondents were least likely to indicate hospital non-IT infrastructure needs, such as facility upgrades and mergers or acquisitions (one percent), would be a business issue impacting healthcare. None of the respondents indicated that external threats or hospital infrastructure needs were drivers that will have a significant impact on healthcare in the next two years. Figures: Figure 6. Top IT Priority Next Two Years Figure 7. Primary Clinical IT Focus Figure 8. Primary Financial IT Focus Figure 9. Primary IT Infrastructure Focus Figure 10. Key Business Objective Figure 11. Business Issue with Most Impact on Healthcare
5. IT Barriers
For the second consecutive year, respondents indicated that the ability to hire the necessary staffing resources was the key barrier to being able to implement IT at their organizations today. Having the appropriate financial resources also continues to be a key barrier to IT implementation. Respondents indicated that being able to hire adequate staffing resources was the top barrier to successfully implementing IT at their organizations for the second year in a row. This was selected by 21 percent of respondents. Rounding out the top three responses are lack of financial support (15 percent) and vendors inability to effectively deliver products or services to respondents satisfaction (13 percent). These responses also rounded out the top three in the 2012 survey. No other response was identified by more than 10 percent of respondents. One percent of respondents indicated that laws and regulations prohibiting technology sharing with referring providers was a barrier to IT implementation at their organizations. The same number of respondents indicated that the ability to secure data was a barrier to IT implementation. Only one respondent noted that his/her organization had no barriers to IT implementation. Figures: Figure 12. Most Significant Barriers to Implementing IT
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6. IT and Patient Care

IT leaders continued to indicate that IT positively impacts patient care through improved clinical/quality outcomes, reduced medical errors or standardized care by allowing for the use of evidence-based medicine. IT professionals also reported that clinicians continue to be widely engaged in the IT process, including participation in the evaluation and selection of IT systems. Respondents continue to indicate that IT can most impact patient care by improving clinical and quality outcomes. This was selected by 31 percent of respondents and was also the most frequently identified response for the past two years. One-quarter of respondents (25 percent) indicated that IT can impact patient care by reducing medical errors/improving patient safety, while 12 percent indicated that standardization of clinical care using evidence-based medicine would be a benefit. These items also rounded out the top three responses last year. Less than two percent of respondents indicated the greatest impact that IT could have on patient care would be to ensure that patient data is private and secure. This was also the least frequently identified option in the 2012 study. Nearly all of survey respondents noted that clinicians play some role in the IT process as four percent of the respondents indicated that clinicians have no role in the IT process. This is consistent with the data collected in 2012. Respondents were most likely to report that clinicians participate in IT systems evaluation and selection (76 percent). Nearly three-quarters of respondents (74 percent) also reported that clinicians act as project champions to educate and lead other clinicians. These were also the top two responses identified in the 2012 study. Approximately one-third of respondents (32 percent) indicated that their organization employs a Chief Medical Information Officer (CMIO). This is a slight decrease in the number of respondents who reported this to be the case in 2012 (36 percent). The number of respondents reporting that their organizations employ a Chief Nursing Information Officer (CNIO) has also decreased slightly in the past year (seven percent compared to nine percent). When asked which individuals have remote access to secure, on-line clinical patient information, physician mentions are almost universal; 97 percent of respondents reported this to be the case. This is consistent with what was reported in 2012. The percent of respondents indicating that different groups of individuals have access to this type of information is noted below.
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Physicians 97 percent; Physician extenders 81 percent; Non-clinical staff (i.e. transcriptionists) 65 percent; Nurses 57 percent; Other clinical professionals (i.e. occupational therapists) 52 percent; and Patients 28 percent.
While the availability to access data remotely has remained relatively constant for most of the groups identified above, there has been a steady increase in the number of organizations that are making this type of information available to patients. The percent of respondents indicating this to be the case has increased from 19 percent in 2011 to the current 28 percent. Finally, on a scale of one to seven, where one is of no importance and seven is a high degree of importance, IT executives recorded an average score of 4.94 with regard to the importance that patient/consumer attitudes have on adoption of new technology. This question was not asked in 2012. Figures: Figure 13. Area that IT Can Most Impact Patient Care Figure 14. Role of Clinicians Figure 15. Access to On-line Patient Information from Remote Location
7. IT Security
IT Security breaches continue to plague organizations but the reduction in actual violations reported this year suggests efforts to secure patient information may be working. Respondents were most likely to indicate that securing information on mobile devices was the top security concern at their organization. Nineteen (19) percent of respondents noted their organization had experienced some type of security breach in the past 12 months. In 2012, 22 percent of respondents reported this to be the case. Respondents were also asked to identify no more than two concerns that they had regarding the security of electronic medical information at their organizations. Only three percent of respondents indicated that they did not have any concerns at this time. More than one-third of respondents (36 percent) indicated that securing information on mobile devices was the top security concern at their organization; this is a substantial increase from the six percent of respondents who indicated this to be a top security concern in 2012. Compliance with HIPAA security regulations and CMS security audits was identified as a top concern by 28 percent of respondents. Rounding out the top
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three responses was an internal breach of security, identified by 27 percent of respondents. The percent of respondents indicating that funding/financial support for the security process is a barrier continues to decline. This was identified by eight percent of respondents in 2013, compared to 13 percent in 2012 and 17 percent in 2011. Respondents were least likely to indicate concerns about the ability of their business associates to comply with existing business associate agreements; this was selected by three percent of respondents. Figures: Figure 16. Security Breach Figure 17. Top Concerns Security of Computerized Medical Information
8. Health Information Exchange (HIE) Participation

Approximately half of respondents reported their organization participates in at least one HIE in their area, a finding that is slightly increased from last years participation level. Respondents were asked to identify their current involvement in an HIE, defined as an organization which brings together healthcare stakeholders to oversee and govern the exchange of health-related information according to nationally recognized standards (which could include a state-designated health information exchange). As would be expected, the vast majority of respondents (ninety-seven percent) had some degree of familiarity with the concept of an HIE. More than half of respondents (51 percent) reported their organization participates in at least one HIE in their area, a finding that is slightly increased from last years participation level. Only six percent claimed their participation was mandated by some level of government. Similar to previous surveys, approximately 21 percent of respondents indicated there was an HIE in their area, but have chosen not to participate in it at this time. Three percent of respondents reported that they participated in an HIE in the past, but that HIE has failed. One-quarter (25 percent) of respondents noted their organization had yet to start planning to participate in an HIE. This is consistent to what was reported in 2012. Figures: Figure 18. Health Information Exchange (HIE) Adoption
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9. IT Governance
There continues to be a strong level of integration between the IT strategic plan at respondents organizations and their organizations overall strategic plans. Senior IT executives also play a key role in contributing to overall business strategy at their organizations. Respondents were asked to characterize the level of integration between their IT plans and their organizations strategic operating, clinical and capital plans. The vast majority of respondents claimed their IT strategies were aligned with the organizations overall strategy with almost half of respondents (46 percent) indicating that the IT plan at their organization is a specific component of the organizations overall strategic plan; and another 37 percent reporting that their organizations IT strategic plans are integrated with overall strategic plan, even though the two plans are separate. These findings are consistent with feedback from previous HIMSS Leadership surveys. Nine percent of respondents indicated that their organization does not have an IT strategic plan. Another eight percent of respondents indicated that while their organization has a strategic plan, the IT strategic plan is not integrated with the organizations overall strategic plan. Sixty (60) percent of respondents claimed they are a member of their organizations executive committee, defined in this study as the leadership team that drives overall organization strategy and direction. This is slightly higher than the 57 percent of respondents that reported this to be the case in 2012. Individuals identifying themselves a senior IT executive were asked to identify which responsibilities they assume on a regular basis as part of their job. Contributing to overall business strategy was most frequently identified (89 percent). Last years most frequently identified response, driving value from IT investments, was identified by 88 percent of respondents. The percent of respondents identifying each option is listed below. Contribute to overall business strategy 89 percent; Drive value from IT investments 88 percent; Enable the CEO/executive team to improve management through IT 86 percent; Support Business and clinical process owners 86 percent; Manage IS department operations 82 percent; and Responsible for process change management to be supported by IT 77 percent.
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Figures: Figure 19. Alignment of Organizational & IT Strategic Plan Figure 20. Member of Organizations Executive Committee Figure 21. Senior IT Executive Responsibilities
10. Federal Initiatives

Investments in technologies to help position organizations to qualify for meaningful use and the conversion to ICD-10 are paying off. Sixty percent of respondents reported that they have already qualified for Stage 1 and threequarters indicated that they expect to qualify for Stage 2 in 2014. Nearly all respondents, 87 percent, indicated they expect to complete their conversion to ICD-10 October 2014. Respondents were asked to identify their approach to the investments that will be made to achieve Meaningful Use. The majority of respondents (60 percent) indicated that because they have already achieved Stage 1, they are focusing their investments on achieving Stage 2. Less than one-third of respondents (30 percent) indicated that they are making additional investments to qualify for Meaningful Use incentives, while four percent are identifying the gaps in their environment, but waiting to invest at this time. Only one percent of the respondents indicated that they are not making any investments to qualify for Meaningful Use at this time. Meaningful Use Stage 1 Two-thirds (66 percent) of respondents indicated their organization has already attested to Stage 1 of Meaningful Use. Another four percent of respondents reported they expected to attest by the end of 2012 (and presumably have since the time they completed this survey). Another quarter (24 percent) of respondents reported that they expect to attest by the close of 2013. Less than two percent will not attest at any time. Regarding the amount of money spent (or will spend) to achieve Stage 1, approximately five percent of respondents indicated their organization made no additional investment. One-third (33 percent) reported they will ultimately invest less than $1 million, while 28 percent reported that their organization will invest between $1 million and $4 million to achieve Stage 1 requirements. Eighteen (18) percent will invest $5 million or more on achieving Stage 1 Meaningful Use. The remaining respondents either did not know the answer to this question or chose not to disclose this information. Respondents working for an organization that includes at least one hospital were asked to identify how much money their organization would receive for meeting Stage 1 Meaningful Use requirements. Less than one percent of respondents reported that they
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would not receive incentives in Stage 1. The below list identifies the money that organizations anticipate that they will receive for their investment. Less than $2 million 30 percent; $2 million to $3 million 23 percent; $4 million to $5 million 16 percent; $6 million to $7 million 6 percent; $8 million to $9 million 3 percent; and $10 million or more 7 percent.
The remaining respondents either preferred not to disclose the level of money they expected to receive or did not know the amount. Meaningful Use Stage 2 Respondents were also asked to identify when they expected that their organization would qualify for the Stage 2 Meaningful Use requirements. Three-quarters (75 percent) of respondents indicated that they anticipated that their organization would qualify for the incentives available through Stage 2 in 2014. Another 15 percent noted that they would qualify for these incentives in 2015. One percent indicated that their organization would qualify for Stage 2 in 2016 or later and four percent indicated they had no plans to qualify for Stage 2. Six percent were unsure of their plans at this time. As to how much money spent (or will spend) to achieve Stage 2, 11 percent of respondents indicated that their organization will make no additional investment in IT at this time. More than one third (38 percent) indicated that their organization will invest less than $1 million to achieve Stage 2, while 18 percent will make an investment of $1 to $4 million. Seven percent expect their organization to make an investment of at least $5 million to achieve Stage 2. A large percent of respondents (17 percent) also indicated that they were unsure of the level of investment that would be needed at their organization at this time. When asked to project the amount of money they anticipated their organization will receive as a result of Stage 2, two percent of respondents working for a hospital-based organization did not believe they would receive any incentive. The below list identifies the money that organizations anticipate that they will receive for their investment. Less than $2 million 38 percent; $2 million to $3 million 18 percent; $4 million to $5 million 7 percent; $6 million to $7 million 3 percent; $8 million to $9 million 2 percent; and $10 million or more 4 percent.
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The remaining respondents either preferred not to disclose the level of money they expected to receive or did not know the amount. ICD-10 In the past year, the date by which healthcare organizations needed to convert from ICD-9 to ICD-10 was deferred one year, to October 1, 2014. Respondents were very optimistic they would be able to achieve this objective, as 87 percent of respondents indicated that they expect to complete their conversion by this deadline. Respondents were also asked to identify the level of investment they were making in their ICD-10 conversion efforts. More than one-third (39 percent) of respondents indicated they were investing less than $1 million in this conversion. Another 13 percent indicated they were spending between $1million and $4 million, and three percent spent $5 million or more. While these numbers represent, in general, a lower level of investment than was reported last year, a very large percent of respondents (33 percent) were unsure of the level of investment they made in their ICD-10 conversion. Figures: Figure 22. Organizations Approach to IT Spending based on Meaningful Use Figure 23. Percent of Organizations that Expect to Qualify for Stage 1 Meaningful Use Figure 24. Level of Investments Made by Healthcare Organizations in Meaningful Use Stage 1 Figure 25. Percent of Organizations that Expect to Qualify for Stage 2 Meaningful Use Figure 26. Level of Investments Made by Healthcare Organizations in Meaningful Use Stage 2 Figure 27. Anticipated ROI for Meeting Meaningful Use Stage 1 Requirements Figure 28. Anticipated ROI for Meeting Meaningful Use Stage 2 Requirements Figure 29. Preparedness to Meet ICD-10 Conversion Figure 30. Level of Investment Made in ICD-10 Conversion
11. IT Budget and Staff

Driven by an overall increase in the number of systems they need to manage, IT leaders expect both their operating budgets and the number of individuals employed in the IT department to increase in the next year. Staffing needs are greatest in the area of clinical application support. IT Staffing According to the 2012 HIMSS Analytics Database, U.S. hospital IT departments employed an average of 35 IT FTEs (median six IT FTEs). Half of respondents (51 percent) in this years survey indicated they anticipated to increase the number of IT staff at their organization in the next 12 months. This represents a reduction from the 61 percent who reported this to be the case in 2012.
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More specifically, seven percent of respondents indicated their staff would increase by more than 20 percent this coming year, 17 percent are targeting a 10 to 20 percent increase while 28 percent believe the increase will be less than 10 percent. More than one-third (38 percent) of respondents indicated that staffing levels would remain the same over the next 12 months, while seven percent of respondents indicated they expected a staffing decrease in the next 12 months. Of those respondents expecting staffing increases in 2012, approximately nine percent reported plans to add more than ten IT FTEs, 13 percent planned to add six to ten IT FTEs, 20 percent have budgeted to add three to five IT FTEs, and over one-third (34 percent) indicated their organization had budgeted to add one to two IT FTEs. Fifteen (15) percent reported that the IT FTEs they plan to add to their organization were not budgeted. All respondents were asked to identify the areas in which they have the most critical IT staffing needs. Six percent of respondents reported that their organization did not have any IT staffing needs at this time. Clinical application support continues to be the area in which respondents were most likely to indicate a staffing need, identified by 34 percent of respondents. This is followed by network/architecture support professionals (21 percent) and clinical informatics professionals (18 percent). These areas have been the top three areas of need for the past three years. Five percent or fewer respondents reported having critical staffing needs in the below areas: IT management (five percent); and IT planning (four percent).
Among senior IT executives, 92 percent indicated they were responsible for at least one area outside of the IT department. Senior IT executives were most likely to report that they were also responsible for the telecommunications functions at their organizations (75 percent). Respondents had responsibilities in other areas such as medical/clinical informatics (51 percent), health information management (26 percent), and biomedical/clinical engineering (18 percent). IT Budgets According to the HIMSS Analytics Database, the average IS operating expense as a total expense for U.S. hospitals in 2012, was 2.73 percent. Slightly more than threequarters of survey respondents (76 percent) noted their organizations operating budgets for 2013 would increase over 2012 levels. These findings are consistent with what was
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reported in the 2012 study. Approximately half (47 percent) of the respondents noted their budget would definitely increase in the next year while 29 percent identified a probable increase. Fifteen (15) percent of respondents reported their IT budget would remain unchanged and eight percent of respondents indicated their budget would decrease in the next year. These findings are similar to what was reported in 2012. Respondents continue to report an increase in their organizations IT operating budget is due to the overall growth in the number of systems and technologies in their organization (58 percent of respondents). Half of respondents (52 percent) indicated the increase would be due to additional staffing or consulting services needed to comply with governmental regulations. These were also the top items reported in the 2012 survey. Overall budget increases and a need to comply with regulatory changes were each identified by 42 percent of respondents respectively as a reason for driving an increased IT operating budget. Respondents were least likely to identify business requirements needed to invest in ebusiness as an item to create an increase in IT operating budget; only five percent of respondents indicated this to be the case. This area was also least likely to drive an expected increase in 2012. Among the handful of respondents noting their budget would decrease, approximately half (46 percent) indicated that the decrease was tied to a reduction in the organizations revenues. More than one-third (36 percent) indicated that an IT budget decrease was a result of a reduction in hospital revenues. None of the respondents indicated that a decrease in revenue was the result of outsourcing IT services to a low cost provider. Figures: Figure 31. Expected Change in IT Staff in Next 12 Months Figure 32. Number of IT FTEs Budgeted To Be Added Figure 33. 2013 IT Staffing Needs (Top Ten) Figure 34. Additional Functions Managed by Senior IT Executives Figure 35. Projected Change in IT Operating Budget Figure 36. Reason for Increase in Budget Figure 37. Reason for Decrease in Budget
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12. About HIMSS

HIMSS is a cause-based, not-for-profit organization exclusively focused on providing global leadership for the optimal use of information technology (IT) and management systems for the betterment of healthcare. Founded 51 years ago, HIMSS and its related organizations are headquartered in Chicago with additional offices in the United States, Europe and Asia. HIMSS represents more than 44,000 individual members, of which more than two thirds work in healthcare provider, governmental and not-for-profit organizations. HIMSS also includes over 570 corporate members and more than 170 not-for-profit organizations that share our mission of transforming healthcare through the effective use of information technology and management systems. HIMSS frames and leads healthcare practices and public policy through its content expertise, professional development, research initiatives, and media vehicles designed to promote information and management systems contributions to improving the quality, safety, access, and cost-effectiveness of patient care. To learn more about HIMSS and to find out how to join us and our members in advancing our cause, please visit our website at www.himss.org.
13. About Infor Healthcare

Infor is an industry-leading provider of healthcare IT solutions that help to standardize, centralize, and automate business processes across an entire organization. Infors solutions for healthcare business applications and healthcare integration platforms are recognized as market leaders by the most recent HIMSS Analytics Vendor Market Share report. To learn more about Infor Healthcare, please visit www.infor.com/healthcare.
14. About Infor

Infor is the third-largest provider of enterprise applications and services, helping 70,000 customers in 194 countries improve operations, drive growth, and quickly adapt to changes in business demands. Infor offers deep industry-specific applications and suites, engineered for speed, using ground-breaking technology that delivers a rich user experience, and flexible deployment options that give customers a choice to run their businesses in the cloud, on-premises, or both. To learn more about Infor, please visit www.infor.com.
15. How to Cite This Study

Individuals are encouraged to cite this report and any accompanying graphics in printed matter, publications, or any other medium, as long as the information is attributed to the 24th Annual HIMSS Leadership Survey, sponsored by Infor.
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16. For More Information, Contact:

Joyce Lofstrom Director, Corporate Communications HIMSS 312/915-9237 jlofstrom@himss.org
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2013 HIMSS Leadership Survey: Senior IT Executive Results

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2013 HIMSS Leadership Survey: Senior IT Executive Results

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2013 HIMSS Leadership Survey

Senior IT Executive Results

24th Annual HIMSS Leadership Survey

3. Profile of Survey Respondents

6. IT and Patient Care

8. Health Information Exchange (HIE) Participation

10. Federal Initiatives

11. IT Budget and Staff

12. About HIMSS

13. About Infor Healthcare

14. About Infor

15. How to Cite This Study

16. For More Information, Contact:

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