Mid-Size Hospitals | Hospital EMR and EHR

Many Hospital Executives Expect Big Health IT Investments This Year

Surprise, surprise. A new report from the Premier healthcare alliance finds that many hospital executives will make their largest capital investments in IT this year.

To prepare the report, known as the spring 2013 Economic Outlook, Premier spoke with 530 survey respondents, most of whom were hospital leaders. Survey respondents also included materials and practice area managers, reports iHealthBeat.

Roughly 43 percent of respondents said that their health organization’s biggest capital investment over the next year would be in health IT, a jump of 21 percent from two years ago. Offering a hint on where the money may be going, the report also found that 32 percent of respondents can’t currently share data across the continuum of care.

Other clues as to where the spending is going come from the study’s topline finding, which predicts a big shift from inpatient to outpatient care.

According to Premier, only 35 percent of respondents are expecting to see an increase in inpatient spending this year as compared to 2012, down 30 percent from predictions made last year. Meanwhile, 69 percent of respondents said they expect to see an increase in 2013 outpatient volume compared to last year.

Some additional intelligence from the report:

* 22 percent of respondents are in an ACO, and 55 percent plan to be by the end of next year

* 27 percent don’t have plans to pursue the ACO model, and may look to bundled payment, care management fees or pay for performance options

* 29 percent said overutilization of products and services and 22 percent said lack of clinical coordination were the biggest drivers of healthcare costs

* 48 percent said reimbursement cuts had the biggest impact on their health systems

* 40 percent said capital spending would increase over the next 12 months as compared with the previous year

* Almost 37 percent project a capital spending decrease

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May 8, 2013 I Written By Anne Zieger

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Tags:Health IT Investment iHealthBeat Premier

Survey: Healthcare CIOs Average $200K In Annual Base Salary

While numbers varied widely depending on organizational factors, healthcare CIOs earned an average base salary of $208,417 in 2012, according to a recent survey conducted by CHIME.

The survey, which drew responses from small, medium-sized, large and rural facilities, drew responses from 263 CIOs from late December 2012 and early January 2013.

Some key findings from the survey included the following:

* Multi-hospital, academic medical center execs make more The average base salary reported for multi-hospital system execs was $254,054. and the academic medical center CIOs reported an average $243,229 base salary.

* Smaller-hospital CIOs make much less Top IT execs at the smallest hospitals, CAHs with 25 beds or less, got an average base salary of $125,573. Execs at hospitals with fewer than 200 beds reported an average base salary of $150,956, or about 28 percent than the overall average, notes iHealthBeat.

* Standalone execs make less CIOs with stand-alone community hospitals also responded lower income than the average, at $178,786, roughly 14 percent less than the overall average.

* Titles matter, a lot Hospital leaders with the title of CIO had average base salaries of $199,890, about four percent less than the overall survey average, but when they had additional titles salaries went up starkly. CIOs who were also titled vice president had an average salary of $206,788, while those with CIO and executive vice president had an average salary of $310,326, or almost 49 percent over average. Meanwhile directors of IS or IT averaged $128,193, or about 38 percent less than the survey average.

* Reporting relationships count As iHealthBeat reports, salaries varied depending on who the CIO reports to in the organization. The 44 percent of respondents who report to the CEO earned ann average of $217,170, or about 4 percent more than average. Meanwhile, those reporting to the CFO earned an average base salary of $175,263, or 16 percent less than the average of salaries reported.

* Few and small raises reported Despite the huge amount on health IT execs’ plates, most survey respondents reported minimal pay raises, with almost 75 percent saying that their base salaries increased by less than 5 percent between 2011 and 2012.

So, readers, how do these numbers look to you? Do they reflect the realities of your institutions? And how about those low raises — think hospitals are risking losing critical talent by holding that line?

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April 9, 2013 I Written By Anne Zieger

Filed Under: Community Hospitals Critical Access Hospitals Healthcare CIO Hospital CIO Hospital EHR Hospital Electronic Health Record Hospital Electronic Medical Record Hospital EMR Hospital EMR Jobs Hospital Healthcare IT Mid-Size Hospitals

Tags:Healthcare CIO Healthcare CIO Salary Healthcare IT Executive Hospital CIO Salary

Real-Time Responses To EMR Training

Teaching hospital staffers and clinicians to use your EMR is a hard enough job. Figurng out just what they didn’t learn during training is even harder. But here’s a trick some hospital administrators and IT leaders are using to do just that.

A report in the HealthTechZone blog notes that at St. Joseph Hospital in Chicago, they’ve already seen some success with a technology that allows audiences to respond to quizzes embedded in EMR training materials.

The hospital’s training sessions use a polling software application called TurningPoint which allows audience members to respond to questions in real time, using either their smart phones or “ResponseCard” keypads. The technology also allows presenters to bring in audience members not in the room at presentation time and collect their responses to polls remotely.

At St. Joseph, administrators use this technology to structure their EMR training sessions more effectively and focus in on areas where the audience seems not to have understood what was presented. It’s as simple as sending the training group on a break, reviewing the quiz and reorganizing PowerPoint slides to re-emphasize any points that the audience missed.

But the response technology’s use doesn’t end there, the blog reports. Once the formal training is over, administrators hand audience polling results to the IT team. IT administrators then use the data to address employee concerns as they proceed with the EMR rollout.

I think this is a great approach, not only for training but for gauging employee (and clinician) support for the EMR rollout, gathering input on the effectiveness of the EMR in users’ daily work lives, and generally fostering EMR acceptance by having a finger on the pulse of user sentiment. Readers, have you tried anything like this?

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February 28, 2013 I Written By Anne Zieger

Filed Under: Community Hospitals Healthcare CIO Hospital EHR Hospital Electronic Health Record Hospital Electronic Medical Record Hospital EMR Hospital Healthcare IT Mid-Size Hospitals Mobile Technology

Tags:EHR Training EMR Training Health Tech Zone TurningPoint User Feedback

The Dawn Of “Compliance As A Service”?

A few days ago, I posted a quick report on our EMRandHIPAA.com sister site discussing Verizon’s plans to offer a HIPAA-compliant cloud service.

Verizon, which has beefed up on security services over the past few years, seems to see its role as being compliance vendor rather than just a mere business associate. The carrier notes that not only does it offer super-secure data centers, it has trained staffers on HIPAA-specific data handling issues.

But Verizon obviously isn’t the only cloud vendor out there capable of offering HIPAA-compliant services. Could this be the dawn of CaaS (compliance as a service) for healthcare? (Others industries, like banking, are already well into this approach.)

According to reader Scott Gardner, who commented on the story, this concept has legs. “I’ve been pitching [Compliance As A Service] to cloud-based persistency vendors targeting mobility for some time,” writes Gardner, whose company Inyago focuses on private practice IT services via MacPractice. “Offering this service makes perfect sense, especially in private practice healthcare. And you get interoperability (core #14) right out of the box for all users on the platform.”

The burning question here, I suppose, is whether CIOs feel safe trusting outsiders with clinical data flow. Right now the answer seems to be “no.” As my colleague John noted in a related blog post, at present even those providers who are cloud users are more prone to access it for “commodity” services such as e-mail, file storage, videoconferencing and online learning, according to a CDW survey.

With providers needing interoperability under Meaningful Use Stage 2, the landscape may change, however. Whether or not they’re terribly comfortable with Verizon and its rivals, CIOs might find it easier to delegate compliance than cope with the difficulties of build-your-own-interoperability schemes. So perhaps CaaS really does have a chance at achieving rapid uptake — unless someone invents the insta-install HIE!

Health Management Associates Makes System-Wide Deal With athenahealth

Cloud-based EMR vendor Athenahealth has struck a deal with hospital chain Health Management Associates that its vendor competitors would die for.

HMA has signed an agreement with athena under which the chain’s 1200+ employed physicians — cutting across 15 states and 300 locations — will now use the vendor’s practice management, EMR and patient communication services. HMA’s 10,000-odd independent physicians will also have access to the systems.

In the announcement, HMA and athena took pains to emphasize that the selection process was a fair and thorough one:

Health Management selected athenahealth after a twelve-month review and due diligence process that involved more than 350 clinical experts, including more than 200 physicians. The evaluation process included detailed questionnaires, onsite and virtual demonstrations, site visits, and clinical template shootouts.

Perhaps those details were included to convince observers that the deal didn’t include some kind of payola. I don’t think doctors are going to be too impressed by the IT talk. (If it were me I’d care about only one demonstration — how it worked for me on Day One.)

HMA may not be the country’s largest hospital chain, but it’s still a heavyweight, operating 66 hospitals spanning 10,330 licensed beds. Its hospitals span Alabama, Arkansas, Florida, Georgia, Kentucky, Mississippi, Missouri, North Carolina, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Washington, and West Virginia.

Particularly given its scale, this deal intrigues me for a few reasons. It raises what seem to me to be important questions:

* Is HMA expecting its independent physicians to dump whatever EMR they may already have in place and switch it out for athena? Or adopt its practice management module instead of what they use now? That seems, uh, a bit unrealistic?

* I don’t know what enterprise EMR system HMA uses (do you, readers?) but whatever it is, I doubt it will plug seamlessly into to the athena cloud. How do the IT types at HMA plan to connect the whole schlemiel?

* If the independent physicians don’t want to adopt the athena package, what will HMA do? Club them like baby seals? Or just accept that a large percentage of its docs aren’t connected?

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September 21, 2012 I Written By Anne Zieger

Filed Under: Cloud EHR Hospital EHR Hospital EHR Company Hospital EHR Vendor Hospital Electronic Health Record Hospital Electronic Medical Record Hospital EMR Hospital EMR Company Hospital EMR Vendor Hospital Healthcare IT Hospital IT Budget Hospital IT Jobs Hospital IT Systems Hospital Security IDN International Hospital EHR Mid-Size Hospitals

Tags:athenahealth Health Management Associates HMA Hospital EHR Hospital EHR Vendor Hospital Electronic Health Records Hospital Electronic Medical Records Hospital EMR Hospital EMR Vendor

What Won’t Happen In #HIT By September 2013

As part of the upcoming National Health IT Week (#NHITWeek), which takes place September 10 through 14th) my august colleague John has written up a list of ways in #HIT is likely to make a difference over the next 12 months. (He makes some great guesses; definitely give the post a look.)

For my part, being the naughty contrarian that I am, I thought It’d turn John’s blog post on its head and answer the question “What Won’t Come Together In Health IT Over the Next 12 Months?” Here’s some of my predictions:

* EMR-to-EMR interoperability: Folks, from what I see we’re definitely more than a year from having a workable form of interoperability between systems or even routine high-volume data sharing. Really, do I even have to debate this one?

* High penetration by HIEs: With funding mechanisms and goals ranging all over the map — and players including health plans, broadband network providers like Verizon, hospital coalitions and more — I just can’t see the HIE picking up a lot more market share over the next 12 months. Too many organizations involved, and too much to figure out.

* Major uptick in open-source HIT use: Time and again, I’m reminded that far too many hospital leaders, government CIOs and medical practice leaders aren’t ready to take open-source tools seriously despite the myriad of good reasons to do so. I don’t think this is poised to change in the near term, sadly.

* Epic controls the hospital EMR world for good: Yes, hospitals are still switching over to Epic. And yes, hospital cutovers to Epic probably haven’t even hit their all-time peak. But the smaller to medium-sized hospitals that just can’t afford Epic are still in play, and there’s a lot of them. Let’s see who comes riding in to put the lock on this niche before we crown Epic world heavyweight champ.

* Major growth in remote monitoring: Mobile technologies are becoming more critical daily to the practice of medicine. But somehow, that doesn’t translate to a hunger for home-monitoring patients using, say, wireless glucose monitors. I’ve been watching this sector for years and it still seems like it could explode, but I’m not seeing critical mass this year.

Having been Scrooge for a bit, I certainly have to join John in saying that yes, this is likely to be a pivotal year for the EMR industry, and for #HIT entrepreneurs. I just think we’re going to remain stuck with some of these legacy issues for some time to come.

Hospitals Adjusting to Meaningful Use Stage 2 Rules

We knew the final draft of Meaningful Use Stage 2 was going to come with as many complaints against it as Stage 1. Given the scope of the new rules, and the importance of following them, hospitals don’t seem to be up at arms to the extent one might have expected.

To start with, it’s worth noting that hospitals are very happy about one change from the draft, the provision that requires Stage 2 compliance to begin in 2014 rather than 2013, though they still have some significant Meaningful Use worries, according to an AHA official quoted in Modern Healthcare. Presumably, the AHA is also psyched that providers will only be required to demonstrate MU for a three month period in 2014, rather than an entire year.

But that doesn’t mean they’re perfectly content. Senior vice president of public policy analysis and development Linda Fishman said in a statement that hospitals are “disappointed” that the rule sets an “unrealistic” date by which hospitals must meet Stage 1 goals in order to avoid being slapped with reimbursement penalties.

Other provider groups are focused on a new provision requiring 5 percent of patients to view, download or transmit health information during a three month period. The College of Healthcare Management Executives’ noted, quite fairly, that providers can’t control what patients do on their own time. If nothing else, making sure patients meet these goals is going to take marketing, workflow changes and some arm-twisting, to say the least, so I feel their pain.

Meanwhile, some non-hospital groups think Stage 2 didn’t go far enough. The requirement that physicians submit an electronic summary of care docs for 10 percent of patients being transferred to a hospital or another provider does far too little to promote data exchange, critics in the HIE world say.

I too am surprised that HIE-type requirements are relatively light (and focused on Direct Project specs). I’m sure that Meaningful Use Stage 3 will address these issues further, but given what our guy Farzad has said about interoperability, it might have been nice to see more progress now.

5 Mistakes Healthcare Vendors Make in Tracking Customer Satisfaction

Chris O’Neal is Managing Partner at KATALUS Advisors. KATALUS Advisors is a strategic consulting firm focused on the healthcare vertical. We serve healthcare technology vendors, hospitals, and private equity groups in North America, Europe, and the Middle East. Our services span growth strategies in new and existing markets, M&A due diligence, market analysis, and advisory services. www.KATALUSadvisors.com

A lot of our work revolves around helping our healthcare vendor clients engage with their customers, specifically to track satisfaction and loyalty. We have seen what passes for customer research in the industry, and while the efforts are commendable, the execution typically leaves a lot to be desired. There are five common mistakes we regularly see healthcare vendors make in their customer loyalty programs:

Survey Fatigue: Most companies use lengthy, complex surveys which just take too much time. Also, providers get hit with a lot of survey requests. These two concerns induce low response rates and poor data quality.
Low Response Rates: Many structured survey programs yield single-digit response rates. If this is the case for your program, you need to rethink the entire process, from how you notify your customers to the tools you are using to gather information. Getting more of your customers engaged is as much about process as it is about product.
Low Frequency: Given the effort required to conduct a wide-ranging customer satisfaction poll, most vendors who do so usually engage once a year, or twice a year tops. Too many things are happening in your customer base in the intervening six or twelve months to stay out of touch.
Lack of Consumability: Typically, it takes weeks and months for a customer research program to turn around the results of the campaign. To be truly effective, the information needs to be as close to real time as possible. That means making the data immediately available and consumable for decision makers as it comes in, not after the fact.
Lack of Closing the Loop: Few customer research programs provide an effective means for applying the results in a way that positively and quickly impacts the customer experience.

Savvy vendors are finding ways to avoid these common mistakes. These companies understand that engaging customers in a consistent, meaningful manner must be a corporate focus, not an afterthought. And customer satisfaction is only becoming more important for hospitals as well, as requirements around patient engagement and similar initiatives will likely be part of the ACO model.

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August 17, 2012 I Written By John

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Filed Under: Community Hospitals HIE Vendor Hospital EHR Vendor Hospital EMR Vendor Hospital Healthcare IT Mid-Size Hospitals

Tags:Accountable Care Organizations ACO Chris O'Neal Customer Satisfaction Customer Surveys Healthcare Vendor Customer Satisfaction Hospital Customer Satisfaction KATALUS Advisors

For Hospitals, EMRs Increase Costs For Several Years

In theory, the push for EMRs installation is all about money — saving it, that is. Short term, it’s hoped that hospitals improve patient care and reduce the incidence of adverse events, but ultimately public policy types are paying for EMRs because they believe EMRs will squeeze costs out of the healthcare system.

That being said, it seems some recent research from the National Bureau of Economic Research has poked a sharp stick in this thinking. Researchers there have concluded that EMR adoption drives up costs at hospitals, for years, regardless of the resources they have at their disposal (though location matters a lot — more to come).

The NBER study set out to measure the extent to which costs rose at U.S. hospitals between 1996 and 2009, and the relationship between this increase and hospital EMR adoption. They found that across all hospitals, EMR adoption is first associated with a rise in costs.

However, once the dust settles, big differences emerge between urban and rural hospitals. Hospitals situated close to IT organizations, usually those in urban areas, saw a decrease in costs after three years. Meanwhile, hospitals in “unfavorable” conditions, typically those in rural areas, saw a “sharp” increase in costs even after six years of operating their EMRs.

It is worth noting that cost savings from improved outcomes don’t seem to be figured into this analysis. Also, it doesn’t seem to include any offsetting income from the marketing/PR value of a strongly branded EMR — which I believe has been too little studied. Finally, the study’s results might be quite different if they ran from 2006 through 2012, say, as EMRs continue to mature and hopefully cost less to operate.

Still, these are troubling pieces of data. What cost trends have you seen at your hospital? Do you think the NBER study is on target?

An Epic Tale: How Queen Faulkner Controls Her Realm

Once there was a queen in a castle in Wisconsin. She had brave armies of stout young health IT soldiers at her disposal, and for a time, her armies handled all the engagements her health IT fiefdom encountered in with relative ease.

Far and wide, people heard of her Epic deeds, and all wanted to partake in the tools of her empire. But lo, it grew, Queen Faulkner’s armies no longer sufficed, and her servants trained IT mercenaries to handle the constant demands her kingdom faced.

Over time, so many were her supplicants that the Queen’s good men and women scarce could do the work they set out to do. However, the Queen was loath to train more mercenaries for, she reasoned, “at some point they could control my kingdom, and that must not be!”

So the Queen wrought a strategem — a compromise she thought might satisfy the demands outside her realm. She made herself sure that candidates for certification would need to pass nearly through the head of a needle to win the honor of engaging in Epic battles.

And thus, the Queen gave control to her IT mercenaries, but not enough to let them come together and rebel against her realm.

But in her desire for control, Queen Faulkner had left herself open to other discontents. The hospital monarchs who sought her tools and protection began to demand more soldiers and armament, and engagements began to become free-for-alls.

Yet, as per her design, the certified mercenary companies were, alas, far too small to meet the needs of full-scale engagements. And the Queen’s own troops were neck-deep in IT code and infrastructure, unable to come to the aide of their fellow Epic soldiers.

Woe to the Epic Queen. Her engagements, yea, they will continue, but will hospital monarchs continue to seek her aid? Perhaps they need to consider that even great empires have limits…

Many Hospital Executives Expect Big Health IT Investments This Year

Survey: Healthcare CIOs Average $200K In Annual Base Salary

Real-Time Responses To EMR Training

The Dawn Of “Compliance As A Service”?

Health Management Associates Makes System-Wide Deal With athenahealth

What Won’t Happen In #HIT By September 2013

Hospitals Adjusting to Meaningful Use Stage 2 Rules

5 Mistakes Healthcare Vendors Make in Tracking Customer Satisfaction

For Hospitals, EMRs Increase Costs For Several Years

An Epic Tale: How Queen Faulkner Controls Her Realm

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