Setting their priorities

What's hot in healthcare information technology? A lot.

Healthcare leaders are juggling a host of health IT projects, according to our latest Modern Healthcare/Modern Physician Survey of Executive Opinions on Key Information Technology Issues, which asked participants to pick three “hot button” IT priorities for their organizations from a field of 22 possible choices; select four IT priorities over the next 24 months from 20 alternatives; and provide status reports on where their organizations are on each of 13 possible IT projects.

Leading the pack among hot-button IT projects is preparedness for the federally mandated, Oct. 1, 2014 national conversion to the ICD-10 family of diagnostic and procedural codes, selected by nearly 45% of health leaders in our survey.

“I think it could be 100%,” says Bonnie Cassidy, depending on which day the survey was taken, and given the deep impact ICD-10 will have on financial and clinical record-keeping. Cassidy is senior director of health information management innovation at IT developer Nuance Communications and is a past board president of the American Health Information Management Association.

Nearly every hospital she knows is working on some aspect of ICD-10 preparedness, Cassidy says. That work includes planning and training as well as IT systems implementation and testing, she says.

In addition to ICD-10, seven other hot-button issues received a nod from at least 20% of health leaders taking the survey, indicating that healthcare organizations have their hands full, even with their immediate IT concerns. But that's not all the IT they have to worry about.

Looking at longer-term IT projects, those within the 24-month time frame, ICD-10 again was the most popular pick, chosen by 66% of respondents. Upgrading and adopting clinical and financial systems for accountable care and patient-centered medical homes ranked second among 24-month projects, picked by 30% of leaders in this survey. Rounding out the top three 24-month projects was improving clinician decision-support systems, selected by 28%.

Among health IT status reports, for those “planned, but not started,” joining a health information exchange topped the list, chosen by about 25% of survey respondents. Looking at projects for which “implementation starts within 12 months,” adding a patient portal ranked No. 1, chosen by 30% of survey respondents. The status of projects with “implementation in progress,” also was topped by ICD-10, selected by 51% of survey respondents.

Off-the-radar projects, those “not contemplated,” include implementing a personal health record, which was most often picked by survey participants (26%), while cost tracking came in second at 24%.

One unusual ranking was No. 3 spot among projects “not contemplated.” That topic is adding capabilities to send and receive clinical messages via the Continuity of Care Document and Continuity of Care Record exchange standards, or “CCD/CCR capabilities” for short. It was selected by 22% of respondents. That relatively high level of disinterest by some was offset by an even higher level of interest and activity by others. Adding CCD/CCR capabilities ranked No. 4 among projects whose implementation was already under way, chosen by 33% of survey takers, and placed No. 8 among completed projects, at 19%.

CCD/CCR capabilities are a requirement under Stage 2 meaningful-use criteria, which will kick in Oct. 1, 2013, for hospitals and Jan. 1, 2014, for physicians and other professionals, so the muddle might be caused by “too many acronyms,” says Robert Tennant, senior policy adviser for the MGMA-ACMPE, which represents medical group managers.

“If the question is asked, 'Do you want to share patient information with an authorized clinician down the street for patient care?' the answer would be, absolutely,” Tennant says. “If it was, 'Do you want to use CCD next week?' the answer is, no.”