Founded in February 2004, initially as a go-it-alone data collection effort of HIMSS, HIMSS Analytics quickly got a boost that June with the asset acquisition of veteran IT market-watcher Sheldon I. Dorenfest & Associates, Chicago, for $5.5 million in cash.
When we bought the (Dorenfest) database, there were about 3,800 healthcare organizations in it; now there are about 5,000, says Garets, who was hired on as chief of the unit in March 2004. The bulk of the increase in reporting organizations came from facilities with fewer than 100 beds, a market niche that remains the last frontier in clinical IT systems adoption, Garets says. HIMSS Analytics also beefed up its annual survey form to 1,200 questions, upgraded it from paper to online, and recently completed a re-engineering of its online survey capabilities to take advantage of the newer, more flexible .NET Web development framework.
We did it so (chief information officers) could do it (the survey, online). And we offered the ability to do delegation, so if you wanted to hand it off to 15 other people, you could do that, Garets says.
The survey also was restructured to promote the acquisition of clean data, replacing fill-in-the-blanks with the names of 1,400 separate healthcare IT applications and products placed on drop-down menus by departments within a healthcare operation.
So if they wanted to put down what system they use for emergency departments, they couldnt enter Microsoft, Garets says. Microsoft Corp. products are among the 1,400 listed in the survey, but they dont have an (emergency department) system. We use the drop-down menus to keep the accuracy rate way high.
For vendors and consultants who buy HIMSS Analytics services and value accurate data, that was a big deal, Garets says.
To give both vendors and providers a measure of broad clinical IT market trends, the HIMSS unit developed what it calls the EMR Adoption Model, which now has eight stages of IT system uptake. But when the model was first created in 2005, the basic assumption was that virtually all hospitals had what were then deemed to be a basic trio of clinical IT systems: for laboratories, pharmacy and radiology. So, the bottom of the model was set initially at Stage 1 with those three systems as a baseline.
As results poured in from the small-hospital hinterlands, however, surveyors quickly learned their initial assumption was invalid. It turns out a whole bunch of people didnt have lab, radiology and pharmacy, so we added Stage Zero, Garets says.
There are about 18% of the hospitals still in Stage Zero because they dont have all three of those systems, Garets says. Another 15.6% are at Stage 1, which means they have the first three, but not a clinical data repository.
Though there is a definite correlation between hospital size and IT adoption, there are a surprising number of hospitals ranking in the upper reaches of the adoption model that are remarkably small in size, Garets says.
There are about 2,300 single-hospital towns in this country and in those places youll find (computerized physician order entry) capable of being implemented and personal health records are being implemented, Garets says. Thats the kind of stuff were trying to get out to the industry and say, Hey, take a look at this place in the middle of Missouri. Thats how they did it. You can do it, too.