Meaningful Use, IC-10 conversion top CIO challenges

Healthcare chief information officers (CIOs) face unprecedented challenges implementing and managing health IT initiatives in this new regulatory landscape.

To assess what is keeping CIOs up at night as they integrate IT into their healthcare systems and academic medical centers, the Deloitte Center for Health Solutions in Washington, D.C., surveyed 12 CIOs via phone in fall 2012.  

Meeting Meaningful Use (MU) requirements for EHRs as set forth by the HITECH Act, as well as making the conversion from ICD-9 to ICD-10, are the main short-term focuses of CIOs. Of the 12 interviewed, 11 said they are prepared to fulfill MU mandates. But, the report did not indicate what Stage they were prepared for.

The CIOs expressed consistent ideas on foundational work required before focusing on future priorities, including optimization of their existing EMR systems, efficient utilization of new systems, fraud and abuse prevention, patient health information security measures, as well as better management capabilities, policies and procedures.

“These are table stakes for CIOs. They understand each of these well and invest enormous energy and time in making sure these basics are covered,” said report author Harry Greenspun, MD, senior advisor for healthcare transformation and technology at the Deloitte Center for Health Solutions, and his colleagues in the report.

Likewise, CIOs are preparing for payments based on performance and accountable care driven more by competition and less by legislative efforts, the authors stated.

As CIOs work to implement processes for clinical integration, population health management, disease management and care coordination, “their ability to capture, structure, analyze and report results using valid and reliable measures are intense near-term focus points for most,” Greenspun et al reported.

Across the board, CIOs said they must create an information-driven system based on advanced analytics, build an IT platform for expanded scope of services and develop a platform for risk-based contracts with payers.

“While there is ample innovation, the key is determining the way in which an organization pieces it all together in a way that is manageable,” stated Greenspun and his colleagues, who also later noted, “several CIOs expressed frustration that there has yet to be a proven conceptual model for fitting all the pieces together.”

Investing in technology requires backing from an organization’s board and senior management, and seven out of 12 rated themselves as “very prepared” in soliciting their support.

However, “CIOs express challenges in that, while the rest of the organization is held to 3 and 4 percent annual growth, IT departments demand greater rates of investment over 10 percent,” Greenspun and his colleagues wrote. They concluded that organizations need predictable, substantial funding to implement and integrate health IT.

The authors recommended that CIOs integrate their financial team into their health IT investment strategy.

CIOs also reported challenges in finding technology vendors when considering that the risk these firms may go out of business despite their product’s value.

Diversification of programs and revenue streams, growth and innovation, and interactions with consumers, employers and health insurers and in a wide variety of new models and relationships are “the new normal” for CIOs, the report authors concluded. Robust leadership, competent employees across a wide spectrum and a willingness to embrace an information-driven health system are required to meet the challenges ahead.