Healthcare Information Technology-The similar and the different around the World

Healthcare Information Technology

The similar and the different around the World

Research conducted by the Healthcare Information and Management Systems Society (HIMSS, and its market research subsidiary HIMSS Analytics, suggests that the benefits of information technology and management systems transcend from local healthcare needs to global settings.

In 2007, HIMSS conducted research with healthcare executives in the US, and EMEA (Europe, Middle East and Africa) region. The US Annual HIMSS Leadership Survey provides insight to the perspectives of American health IT executives.¹ While the first HIMSS EMEA Annual Leadership Survey,² sponsored by CISCO, surveyed senior executives throughout the healthcare organisation, including staff members in IT, finance, clinical areas and executive officers.

Respondents to both of these surveys were most likely to identify improving quality of care / patient safety as a top business issue that will impact healthcare in the next two years.

Following is a review of the similarities and differences in the results of these surveys, including a perspective on how health IT represents a universal equaliser for improving the delivery of patient care.

What’s the same…

A Universal Healthcare Goal - Improving patient care and patient safety

Top healthcare it priorities

Executives who responded to the surveys were asked to identify their organisation’s top five IT priorities today. A comparison of the responses suggests that respondents to both surveys were concerned about reducing medical errors / improving patient safety. Results also indicate these respondents believe that technologies, such as electronic medical records and other clinical applications, advance this objective and should be a priority for their organisation. The chart below shows the five most frequently selected responses from each survey.

Current Healthcare IT Priorities

• 2007 HIMSS US Leadership Survey
• 2007 HIMSS US Leadership Survey
• Implementing technology to reduce medical errors/increase patient safety (54 per cent)
• Integrating systems in a multi-vendor environment (40 per cent)
• Replacing/upgrading inpatient clinical information systems (48 per cent)
• Implementing an electronic medical record or its components (37 per cent)
• Implementing an electronic medical record (48 per cent)
• Replacing/upgrading/implementing inpatient clinical information systems (34 per cent)
• Business continuity/disaster recovery (35 per cent)
• Training personnel to use existing and newly installed systems (33 per cent)
• Integrating systems in a multi-vendor environment (34 per cent)
• Implementing technology to reduce medical errors (27 per cent)

The two surveys identify specific priorities for healthcare IT professionals in each part of the world. Yet, health IT also appears to be the catalyst for improving patient care in both sets of survey results.

Other research confirms the conclusions of the HIMSS and HIMSS EMEA Leadership Surveys. For example, a 2007 survey from Health Affairs, a US policy journal, reviewed the healthcare experiences of adults in seven countries: the United States, the UK, New Zealand, the Netherlands, Germany, Canada and Australia. ³ According to the survey, “ensuring that information flows with patients as they move across sites of care is also critical to integrating care.” Technology is cited as the required impetus for successful and integrated patient care and patient safety.

Thus, focussing on patient needs, integrating care between caregiver and patient and introducing health IT into this patient care equation can provide effective and efficient results for the delivery of care.

Healthcare business issues in the next two years

For senior executives responding to the HIMSS surveys, the top business issues in both the US and the EMEA region are similar. As the chart below illustrates, the “top business issues facing healthcare facilities in the next two years,” are largely focussed on ensuring that their organisations provide quality of care and that their patients are satisfied.

Top business issues facing healthcare facilities in the next two years

• 2007 HIMSS US Leadership Survey
• 2007 HIMSS EMEA Leadership Survey
• Quality of care (69 per cent)
• Patient safety/quality of care (49 per cent)
• Patient (customer) satisfaction (55 per cent)
• Increased need for healthcare services due to issues, such as aging population (46 per cent)
• Medicare cutbacks/managed care fees reduction (52 per cent)
• Patient satisfaction (43 per cent)


• Increased need for healthcare services due to issues, such as aging population 45 per cent)
• Adoption of new technology (37 per cent)

Quality patient care has been, and must remain, a basic tenant for healthcare delivery in any setting where patients and clinicians interact.

The respondents also recognise that not only are people getting older but will also have increased and / or different healthcare needs. In fact, almost 500 million people are age 65 and over, a figure that accounts for 8 per cent of the world’s population; people aged 85 and over are now the fastest growing portion of many national populations, ⁴ according to the US National Institute on Aging.

The healthcare needs of this ageing population might vary, but integrated care with easy and efficient access to patient health information is imperative. Thus, global implementation of EMR systems becomes even more crucial to maintaining and improving the delivery of patient care now, and in the future.

Health information technology applications

Referencing the business issues and IT priorities that have already been discussed, it is not surprising that the results of the HIMSS US and EMEA Leadership Surveys found that implementation of applications that focus on the care delivery ranked as the most IT application in the next two years for the respondents’ healthcare organisations.

Health it applications important in the next 2 years

• 2007 HIMSS US Leadership Survey
• 2007 HIMSS EMEA Leadership Survey
• Electronic medical records (47 per cent)
• Clinical data repository (37 per cent)
• Computerised practitioner order entry (47 per cent)
• Enterprise-wide clinical informationSharing (33 per cent)
• Ancillary clinical information systems (46 per cent)
• Electronic medical records(32 per cent)

About one-third of the respondents in both surveys indicate they have a fully operational EMR installed in at least part of their organisation (HIMSS – 32 per cent; HIMSS EMEA – 36 per cent).

This represents a continued increase over the 24 per cent of respondents who reported in the US survey having a fully operational EMR in 2006 and the 18 per cent who indicated this to be the case in 2005. This comparison cannot be duplicated for the EMEA survey, which was conducted for the first time in 2007.

Staffing and budget increases

The respondents in both surveys expect to increase staffing and budgets for health IT in the next 12 months. These same respondents expect the growth in staff to be modest with estimated staff expansion at less than 10 per cent. However, staffing needs differ slightly between these two groups. In the US survey, respondents were most likely to identify staffing needs for clinical informaticists (professionals with a clinical background that help work with technology solutions), application support and process / workflow design as top areas with staffing needs. Executives in the EMEA region were more likely to identify that staffing needs exist for systems integration, systems design / implementation and interoperability.

Respondents in both regions predict that their IT budget would increase in the next year. Both groups are most likely to attribute the growth in budget to an overall organisational growth in technology.

Staffing and Budget Increases in the Next 12 Months

• Category
• Expected increase in staffing in the next 12 months
•  
• Expected staffing needs
•  
•  
• Expected budget change In the next 12 months
•  
• Reason for increase in health IT budget

• HIMSS US Leadership Survey
• Respondents expecting Ii increase in staffing levels in the next 12 months (65 per cent)
• Clinical informaticists (32 per cent), application support (29 per cent), and process/workflow design (28 per cent)
• Respondents expecting an increase in budget in the next 12 months (74 per cent)
• Growth in technology (77 per cent)

• HIMSS EMEA Leadership Survey
• Respondents expecting increase in staffing levels in the next 12 months (62 per cent)
• Systems integration (31 per cent), system design and implementation (26 per cent), and Interoperability (26 per cent)
• Respondents expecting an increase in budget in the next 12 months (62 per cent)
• Growth of system technologies (44 per cent)

What’s different…

Barriers to health it implementation

The primary barrier to health IT implementation differs between the US and the EMEA region.

For seven consecutive years, executives responding to the US Annual HIMSS Leadership Survey have identified lack of adequate financial support as the most significant barrier to successful implementation of IT at the respondents’ organisations (20 per cent in the 2007 survey). Respondents in the EMEA region have a different challenge—development of and/or implementation of a strategic health IT plan, the barrier identified by 18 per cent of the respondents.

Conversely, only nine per cent of the EMEA region respondents selected lack of financial support as a barrier. Just six per cent of US respondents indicated the need for a strategic plan to move ahead implementation of the EMR at their organisations.

Bridging the global gap to health it implementation success

A successful transition from paper to digital health records should incorporate tested strategies, steps that can simplify this process. Here are some points to consider.

Integrating the healthcare enterprise – Known as IHE, this initiative began in 1998 as a collaborative effort between HIMSS and the Radiological Society of North America. IHE is now a global enterprise with more than 20 professional societies sponsoring, and 200 vendors using, the IHE framework to implement health IT standards throughout the world.

In April 2006, the International Organization of Standardization granted IHE liaison D status to make standards-based IHE integration profiles a formal part of the ISO balloting process and ISO deliverables. This status will make global standards more accessible for the EMR.

HIMSS Nicholas E. Davies Awards of Excellence – Established in 1995, these annual awards recognise healthcare provider organisations that successfully use electronic health records to improve healthcare delivery. Each year, the recipients of these awards present their own individual success story, documentation of technology implementation in an organisational, ambulatory, public health and community health setting (new in 2008). The applications indicate that organisations’ senior management teams supported EHR implementation as a strategic goal of the organisation—and of everyone in that healthcare setting.

The final step

Research conducted by HIMSS Analytics in 2006 (http://www.himssanalytics.org/docs/UHC25.pdf.) and 2007 (http://www.himssanalytics.org/general/pr_08212007.asp) found that patient care improved as hospitals adopted a more integrated and extensive EMR. According to a 2006 report from the US Department of Health and Human Services, “evidence that use of secure, standards-based electronic health records can improve patient care and increase administrative efficiency is overwhelming.” ⁵

In 2004, the world spent US $4.1 trillion on health, which is equivalent to 4.9 trillion international dollars, according to a 2007 World Health Statistics report from the World Health Organization. ⁶ Those health expenditures become even more relevant by noting that the 30 member countries of the Organisation for Economic Co-operation and Development (OECD) make up less than 20 per cent of the world’s population but spend 90 per cent of the world’s resources on health.

Health IT represents a proven and necessary solution to meet the current and future health expenditures of the world population. The Annual HIMSS and HIMSS EMEA Leadership Surveys will continue to present a consistent perspective on how health IT can expedite efficiency and improve the delivery of patient care. Look for an update on these findings later in 2008.

Background on HIMSS and HIMSS Analytics

HIMSS is the healthcare industry's membership organisation exclusively focussed on providing global leadership for the optimal use of healthcare information technology (IT) and management systems for the betterment of healthcare. With offices in Chicago, Washington, D.C., and other US location, the organisation opened its HIMSS EMEA office in Brussels in 2006.

HIMSS Analytics is HIMSS Analytics is a wholly owned not-for-profit subsidiary of HIMSS. The company collects and analyses healthcare information related to IT processes and environments, products, IS department composition and costs, IS department management metrics, healthcare trends and purchase-related decisions.

The Research Tools

Now in its 19th year, the HIMSS Leadership Survey garners opinions from hospital chief information officers about their use of and opinions on EMR implementation in the US. In 2007, results are based on 360 responses from 306 unique healthcare organisations and almost 700 hospitals throughout the US.

Released at the 2007 World of Health IT conference in Vienna, Austria, the results of the first HIMSS EMEA Leadership Survey include 192 responses from senior healthcare executives. The survey tool was offered in six languages—English, Finnish, French, German, Italian and Spanish—to facilitate data collection from respondents in the EMEA region. Individuals from 40 different countries responded to this first survey.

Both surveys are web-based with invitations extended via e-mail to potential respondents.

References:

1 18th Annual HIMSS Leadership Survey, April 2007, Healthcare Information and Management Systems Society, www.himss.org/research

2 1st Annual HIMSS EMEA Leadership Survey, October 2007, HIMSS EMEA, www.emea.himss.org

3 Health Affairs, 26, no. 6 (2007): w717-2734 doi: 10.1377/hlthaff.26.6.w717

4 National Institute on Aging, National Institutes of Health, “Why Population Aging Matters – A Global Perspective,” Publication No. 07-6134, March 2007

5 Walker, Pan, Johnston, Adler-Milstein, Bates, and Middleton: Health Affairs Online: January, 2005

6 World Health Organization, World Health Statistics: “Part 1, Ten statistical highlights in global public health.” http://www.who.int/whosis/whostat2007_10highlights.pdf.