Business Needs Drive Demand for Information Management Systems at Healthcare Provider Organizations

2 Healthcare Informatics Research Informatica

INFORMATICA ■ BusIness needs dRIve demand foR InfoRmatIon management systems

As the mountains of health- and business-related data grow, the challenge facing healthcare organizations is how best to

manage and distribute the information in a way that can support and improve administrative, financial, and clinical decision-making. In a recent survey, Healthcare Informatics Research panelists de-scribed the prevalence of information management systems (IMS) among hospitals with 200 or more beds, how their organizations are currently dealing with information and data management demands, as well as strategic plans, to better take advantage of their data assets and meet expanding decision-making and compliance needs.

Nearly all mid- to large-size hospitals in this survey currently have some type of IMS. For most of those

surveyed (54%), the IMS is a component of one or more vendor’s clinical and/or financial system(s). However, a significant number, nearly one in three (30%) organizations, uses an enterprise-wide, stand-alone IMS that is supported by their IT department. As expected, larger facilities and those that are part of integrated delivery networks with six or more enti-ties are more likely to have such an enterprise system. Among the organizations that do not currently have an IMS, 8% are in the process of evaluating their information management needs; 5% are creating an IMS; and 2% are making plans on how to proceed with an IM strategy. It is noteworthy that not one respondent indicated that their organization neither has nor needs an IMS.

The ImpacT of aRRa-hITech on InfoRmaTIon managemenTFunding and incentives offered under the Health Information Technology for Economic and Clinical Health Act (HITECH) provi-sions of American Recovery and Reinvestment Act of 2009 (ARRA) and targeted to accelerating the adoption of standardized, interoperable electronic health records (EHRs) to improve qual-ity, safety, and efficiency are strong driving forces for many organizations. To qualify, care providers must use certified electronic health record technology and meet a core set of mean-ingful use objectives, which include reporting clinical quality measures.

As care provider orga-nizations strive to meet meaningful use goals, the role of data management and analysis expands to include integrated clinical, as well as financial, data.

Information Management System Status

Standaloneenterprise-wideIMS supported

internally30%

Evaluating needs8%

Building system5%

Planning strategy2%

Need/Can’t afford1%

Evaluating, building, planning,

or can’t afford16%

Component ofone or more vendor’s

clinical and/or�nancial system(s)

54%

n=644

Figure 1

Impact of ARRA-HITECHAdopting an EHR:

No data migration, legacy data access concerns

8%

No plans to changecurrent EHR or IMS

44%

Upgrading/Changing EHR

48%

Migrationstrategy via

vendor-partner(s)23%

Plan to migratedata 12%

No data migration;Need access to legacy data 13%

Figure 2

n=556

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When asked how provisions of ARRA-HITECH af-fect their organization’s clinical data access and management strategies, 56% of those surveyed say their organization is upgrading, changing, or adopting an EHR to qualify. Most of these projects (48%) involve upgrades or changes to the EHR. For these organizations, data migration and access are major issues. (Data migration and legacy data are not concerns to the 8% of organizations that are adopting an EHR.)

Associated with these changes to the EHR are questions of data migration and the role of vendor partners. About half of those currently in the process of upgrading and/or changing their EHR are working with their EHR vendor partner to move the data from the old to the new system. The other half is divided between those who plan to leave data in the legacy system but

want periodic access to the stored data (13%); and those who want to move as much data as possible from the old to the new system (12%).

BusIness InTellIgence RepoRTIngOverall, most of those surveyed, regardless of job roles or functions, think their current systems are meeting the organizations’ decision-making needs with business intelligence (BI) reporting of structured data and business process. One in three (35%) rates their IMS as robust and able to generate excellent business intelligence reports across major areas, including clinical and financial departments. Most are powered by multiple vendors’ products but about one in ten overall (11%) uses an IMS powered by a single vendor. Although urban hospitals and those that are part of large networks are more likely to rate report generation capabilities as excellent, fewer

than half rate their system so highly.

A significant number (43%) rate BI reporting capabilities as good. They report some integra-tion between disparate reporting systems across multiple departments and some capabilities to derive BI reports across some of the departments. Another 20% rates support for BI needs as fair: Integration between disparate report-ing systems across multiple departments is lacking and they are limited to certain types of BI reports at the departmental level. Very few (2%) can derive no BI reports.

InvesTmenT plans and challengesMost organizations (62%) are actively engaged in strategic planning that

Figure 3Support for Business Intelligence Needs

n=620

Multiplevendors

24%

Singlevendor

11%

Poor 2%

Good43%

Excellent Robust IMS

35%

Fair20%

Figure 4 Information Management Strategy

n=576

Within 12months

48%

In 12-24 months13%

Begin more than 24 mos. 2%

Plan to invest inpeople andtechnology

62%

Satis�ed with IMSNo investments

planned24%

Not a priority at this time 1%

Need an IMS/No action 4%

Have a strategy/Evaluating options 9%

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involves investments in people and technol-ogy for IMS needs, and nearly half (47%) plan to begin making investments within the next 12 months. Fewer respondents report that their organizations have identified an IM strategy and are currently evaluating options (9%) or have concluded that they need an IMS but have not proceeded further (4%). Very few (1%) say it is not currently a priority. One in four organizations (24%) is satisfied with its existing IMS and has no plans for major investments,

Data integration continues to be a major challenge for organizations seeking to improve their information management capabilities and provide users with business intelligence. Nearly half (46%) of those surveyed cite integrating data from multiple, disparate systems containing a

wide variety of data for-mats as their single biggest challenge.1 Data quality that varies across systems creating cleansing, de-duplication and validation needs accounts for an addi-tional 17%. Data-related is-sues including integration, quality, and aggregation are of somewhat higher concerns for hospitals with more than 500 beds than for mid-size institutions with between 200 and 499 beds.

Other challenges cited by those surveyed relate to deficiencies in leadership, technology, and staffing. Lack of leadership and management buy-in is a problem for one in ten organizations (10%). Technology-related challenges include the inability to aggregate enterprise information to a single view/portal (9%); the ability to expose the right data to users in a timely manner (6%); and lack of an adequate infrastructure to sup-port an enterprise-wide IMS (6%). For 7% of organizations, the IT staff lacks skills necessary to implement and maintain an IM system.

There are some differences related to hospital

1 Funding, which is typically the number one response to questions related to adoption and implementation challenges, was intentionally omitted from the survey choices.

Main Challenge to Improving IM CapabilitesFigure 5

n=517

Data integration/multiple systems, formats

Variable data quality

Leadership, management support

Unable to aggregate enterprise information toa single view/portal

Staff skills

Time to expose right data to users

Inadequate infrastructure

46%

17%

10%

9%

7%

6%

6%

Most Important Factors in Selecting an IMS Provider*Figure 6

Ease of use of technology

Mid-to Large-sizeHospitals All Hospitals**

Number of Beds200-499

9.29.14

9.048.888.58

8.168.027.43

500+8.918.87

8.758.668.23

7.997.527.6

Urban9.099.02

8.878.838.4

8.117.867.58

SuburbanLocation

99

8.798.78.33

7.997.627.38

Rural9.39.2

9.058.858.57

8.258.247.19

One9.269.05

8.818.78.4

7.97.916.99

2-59.139.09

8.978.828.49

8.267.897.5

6 or More8.919.03

8.888.888.35

8.177.817.87

Number of Facilities in Network

Healthcare expertise and experienceInformation management expertise and experienceTotal Cost of Ownership

Healthcare client base and referencesExpertise in data migration and applicationretirementSingle vendor accountabilityBest-of-breed functionality

* Ranking is based on a scale of 1-10, where one is not at all important’and 10 is ‘very important’. Results are based on responses received.** Includes hospitals with fewer than 200 beds.NOTE: Shading indicates results which are statisticaly higher than other results within the same subgroup

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size. In general, larger hospitals are somewhat more concerned about data-related issues, including integration, quality, and aggregation, whereas smaller hospitals are somewhat more likely to name inadequacies in staff skills and a lack of an adequate infrastructure to support an enterprise IMS.

When making a decision about an IMS provider, most panelists are more interested in the end user experience and the IMS provider’s expertise and experience in healthcare and in information management. Ease of use ranks as extremely important across all types and sizes of hospitals, but is somewhat more important among mid-size hospitals, which typically lack the resources and skilled staff usually found in larger facilities. Ratings for total cost of ownership, which in-cludes hardware, software, implementation costs, are consistent for respondents in all job roles and across all hospital types and sizes.

conclusIonProfessionals across all key leadership sectors, includ-ing information technology, clinical, administrative and financial professionals, recognize the value of information management systems as essential busi-ness intelligence and reporting tools to support the lifecycle of data across the enterprise. With the ex-ception of a very few cash-strapped institutions that say they cannot afford an IMS, all hospitals with 200 or more beds have some type of reporting system(s) to support their organization’s decision-making needs. Most rely upon multiple providers’ systems for reports.

Major concerns and drivers fueling planned invest-ments within the next 12 months include lack of data integration and compliance with the HITECH provi-sions of ARRA. When considering an IMS provider, ease of use and expertise and experience in health-care and in information management trump cost as key decision-making factors.

meThodologyA total of 1,223 interviews were conducted with healthcare provider professionals who are part of the Healthcare Informatics Research Panel. Within this group, 661 represent hospitals with 200 or more beds. The first invitations were sent July 30, 2010, and completed surveys were accepted until the survey was closed on August 12, 2010. The data was then tabulated, analyzed, and objectively reported by Healthcare Informatics Research.