By Neil Versel

Feb. 26, 2008 | ORLANDO, FL — Hospitals and health systems are looking at electronic medical records (EMRs) and other clinical systems more than most other components of health-IT as their organizations sharpen their focus on quality of care, according to an analysis of a survey of hospital IT professionals.

Of the 307 people — mostly chief information officers — who participated in the 19th annual survey of health-IT leaders by the Healthcare Information and Management Systems Society (HIMSS), 40 percent named inpatient clinical information systems as a current IT priority. Nearly as many listed reducing medical errors and implementing EMRs as priorities, though the numbers for all three categories fell by 8 to 15 percentage points from last year’s survey.

This, says HIMSS president and chief executive H. Stephen Lieber, might indicate a ripening of the market to the point that clinical and safety-related systems are so ingrained in organizational strategies that they no longer are top priorities in IT departments. “It’s just becoming standard operating procedure now,” Lieber surmises. We’re reaching a level of maturation of technology adoption across the survey population.”

Some 44 percent reported having fully operational EMRs, up from 32 percent a year ago and 24 percent in 2006. “EMR adoption has seen strong progress,” said HIMSS board chairman John Wade. He added, though, “I think we need to pick up the pace even more.”

Twenty-six percent of those surveyed said implementing an EMR was a priority over the next two years, more than any other activity. Another 23 percent had implementing clinical systems on their future to-do lists. HIMSS added some new choices to this category this year: 20 percent indicated a desire to implement a data warehouse, while 19 percent said they would seek to unify communications technologies between now and 2010.

Quality of care topped the list of business issues facing health care, cited by 56 percent of respondents, though that is down from 69 percent a year ago. That was followed by the perpetual looming prospect of Medicare reimbursement cuts, at 43 percent.

For the eighth straight year, more respondents said money was the greatest hurdle they faced, though this time that amounted to just 26 percent of the survey pool. “Lack of financial support continues to be a barrier to IT implementation,” Lieber said.

However, only 5 percent cited lack of clinical leadership and an equal number reported difficulty gaining end-user acceptance as the most significant roadblock — “challenging, perhaps, some perceptions,” said Frances Dare, director of health care business solutions at survey sponsor Cisco Systems.

Nearly one quarter of respondents report that their organizations had at least one security breach last year. (See, “Debate Persists Over What's the Right Safeguard Strategy.”) And the biggest threat appears to be internal; 51 percent said an internal breach was their primary concern.

Of particular interest to HIMSS is the finding that only 64 percent of the survey participants have a seat at their organizations’ executive table, down from 81 percent last year. “This is a trend we will have to watch as we go forward in the future,” Wade said. He suggested that the result may be related to greater CIO turnover within health systems.