“Nearly two-thirds of all respondents said they were at least somewhat worried about their ability to implement standards-based applications and how that would affect meaningful use determinations for their organizations.” (Survey finds Healthcare CIOs Concerned about Proposed Meaningful Use Standards, December 3, 2009)
The statement above is a result of a recent healthcare CIO survey conducted by CHIME (College of Healthcare Information Management Executives). Primary reasons for the concern about implementing standards-based applications include:
- 21.6 percent of all respondents listed vendor readiness
- 14.8 percent of all respondents listed the need to implement upgraded or new systems
- 15.3 percent mentioned insufficient capital
- 10.2 percent were lacking staff with needed skill sets
- 8.5 percent indicated insufficient staff
In a previous article, the anxiousness over Meaningful Use and its impact on health IT operations and projects has grown. The CHIME survey reflects the concern about how it is all going to come together.
The concerns can be summarized in two primary points:
- Will vendors be ready to support the various healthcare standards?
- There are many systems to implement and tie together. Will there be enough internal budget and people with the right skills to make it happen within the defined milestones?
On the vendor readiness with healthcare standards point, it is important that vendors implement the healthcare standards in a cohesive, manageable manner. Today, the healthcare standards are very flexible, and there are numerous versions. The Health IT Standards Committee is adding to the mix of uncertainty by entertaining discussion on using the Internet as an example for the effective use of data standards. Add to this a recent statement by the HL7 CEO urging that the discussion remain focused on utilizing the existing standards rather than creating new ones.
The readiness concern, consequently, is valid since there isn’t a clear direction on implementing healthcare standards. Essentially, it comes down to this: There are multiple healthcare standards available today which have extreme flexibility in the way they are used and implemented. Combine this with calls for revisiting the existing healthcare standards and adopting a new model or approach to defining healthcare data exchanges. What do you healthcare software application vendors to be ready for?
In the middle of this, literally, are healthcare integration platform vendors. They are ready to support the healthcare standards maze… and options. Hospital CIOs need to take this into account as they approach their software and process implementation initiatives. Software readiness to support standards cannot be viewed in separate application silos, but rather what technology can connect them together no matter what the standard or version of the standard.
Regarding the second point, proper funding may always be a challenge. In the HITECH case, hospitals and other providers must spend money to meet the requirements with the hope that all projects will align and they will be eligible for the incentive funds. In other words, it is taking limited financial resources and placing calculated bets on getting a return on the dollars spent. The return is both financial rewards from the Federal government and higher quality, more efficient patient care. Again, although the current debate is centered on health care reform, healthcare IT reform is already well underway with many risks of its own.
With HITECH passage, ensuring the right people skills are available was addressed through grant programs. There are two grant programs available:
- Community College Consortia to Educate Health Information Technology Professionals in Health Care Program: This program is focused on quickly developing health IT academic programs at community colleges. The program is focused on the following roles: practice workflow and information management redesign specialists, clinician/practitioner consultants,implementation support specialists, implementation managers, technical/software support staff, and trainers.
- Curriculum Development Centers Program: This program offers grants to colleges to develop curriculum healthcare information technology programs. The curriculum will be available to community colleges.
These programs are designed to develop the people through educational programs so there an adequate, qualified talent pool available. Unfortunately, this will take some time to develop and then began enrollment in the programs.
The CHIME survey confirms what is obvious and raises a rightful concern that there are many puzzle pieces which need to fall into place almost flawlessly to ensure the HITECH goals are accomplished. This is not to say it can’t be done; it is saying – understand the current environment, the risks, the opportunities, and the goals, and develop a reasonable, practical, and thoughtful approach to implementing the plans.