Hospital CIOs confused over e-health records rollout standards

Lack of clarity about government rules slowing efforts, survey says

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"The first draft went a long way in setting out the principles and the expectations and the intent of the regulations. I think what they need to finish is to add clarity, to add some level of detail around security and privacy -- there was a lot of ambiguity there -- and then the industry will, to the best of its ability, move in that direction," Henderson said.

The CIOs interviewed by PwC also said the promise of federal reimbursements has sped up EHR adoption, but the existing IT infrastructure isn't capable of supporting their meaningful use over a nationwide health information network.

"Health care organizations are building high-performance race cars to travel back-country roads," said Daniel Garrett, leader of the health information technology practice at PwC. "Furthermore, we found many health care providers are mired in the complexity of incentive-rule criteria and may not be working toward longer-term goals for meaningful EHR usage."

Garrett said government leaders and health organizations need to consider the ultimate goal of better care and patient safety -- delivered more efficiently -- as they work to finalize and meet guidelines for meaningful use.

Hospital CIOs also indicated that they are behind the curve because there has yet to be a final ruling on meaningful use implementation guidelines.

The survey also found that 63% of the CIOs surveyed believe their organizations are either already working with physicians around meaningful use issues or plan to do so within six months. Eighty-eight percent of the respondents indicated that meaningful use is somewhat or very likely to increase the involvement of non-administrative physicians in quality initiatives.

The CIOs also said there is a shortage of IT staff with the appropriate mix of skills to help integrate the use of IT into clinical, operational and administrative practices. The government predicts a shortfall of about 50,000 qualified health IT workers over the next five years. According to the report, hospitals are scrambling to hire additional staffers, including clinicians with IT expertise and business skills.

In order to address that shortfall, the government has set aside a portion of $2 billion in discretionary spending under Office of the National Coordinator (ONC) to train workers to implement EHRs.

The survey also found that more than one-third of CIOs are concerned or very concerned about IT vendor readiness. In particular, 44% of the respondents said that they worry that the external vendors they rely on in health information exchanges are not prepared for meaningful use implementation.

Complex networking capabilities and increased bandwidth are needed to reliably handle the massive influx of data that needs to flow within and between hospitals, and hospital CIOs are concerned about the unknown cost of maintaining paper records as backups in case a computerized system goes down. While some regional health information networks have been successful, the majority have failed to work over the long term, Henderson said.

Lucas Mearian covers storage, disaster recovery and business continuity, financial services infrastructure and health care IT for Computerworld. Follow Lucas on Twitter at  @lucasmearian, or subscribe to Lucas's RSS feed . His e-mail address is

Copyright © 2010 IDG Communications, Inc.

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