LAS VEGAS – For the first time in years, financial constraints have been replaced as the most significant barrier to health IT implementation in the 23rd annual HIMSS Leadership Survey.

Instead, 22% of respondents cited IT staffing as their greatest challenge, up from 17% last year. Inadequate financial support was the top barrier to IT implementation last year for 18% of respondents, falling to 14% this year.

"Meaningful use regulations/incentives are creating an opportunity for health care [providers] to receive funding for IT adoption, and therefore more financial resources are being allocated to health IT in order to attain these financial incentives," HIMSS [Healthcare Information and Management Systems Society] president and chief executive officer H. Stephen Lieber said in an interview.

But the rapid adoption of health IT by so many organizations is placing a strain on staffing. Nearly two-thirds (61%) of respondents said they will hire more IT staff in the next year, with the greatest need in the area of clinical application support (43%).

The HIMSS survey is based on feedback from 302 health IT professionals, largely chief information officers and IT directors, representing more than 600 hospitals throughout the United States.

Achieving meaningful use was identified by 38% of respondents as the top IT priority to be addressed at their organization over the next 2 years. This is a notable decline from last year when 49% of respondents cited the federal meaningful use electronic health record (EHR) incentive program as their top IT priority.

This year’s number two IT priority was a focus on clinical systems such as computerized practitioner order entry, EHRs, or e-prescribing (15%), followed by leveraging information (13%).

Federal Incentives

Implementing International Classification of Diseases, 10th edition diagnosis and procedure codes (ICD-10) continues to be the top financial IT focus for 67% of respondents. The next closest item, upgrading the patient billing system, polled at just 6%.

"Federal initiatives continue to drive the IT decisions made by health care organizations," Mr. Lieber said.

The recent decision by the Health and Human Services department (HHS) to postpone the Oct. 1, 2013, deadline for ICD-10 implementation reverberated throughout the annual HIMSS conference, where the survey was released. Mr. Lieber pointed out that the statement from HHS Secretary Kathleen Sebelius stated that the ICD-10 deadline would be extended for "certain providers."

"I interpret ‘certain’ to mean that it may not be extended for all," he said, adding that no further clarification has been issued by HHS.

Regardless, institutions have spent considerable time and money on the federal initiatives. So far, 26% of respondents said their organization has attested to stage 1 meaningful use and were preparing to meet stage 2 requirements. In addition, 89% of respondents are on track to complete the ICD-10 conversion by the original deadline.

Although 43% of respondents could not say how much their institution had invested in converting to ICD-10, 29% said it was less than $1 million, 15% between $1 million and $4 million, and 4% spent $5 million or more.

Only 5% of respondents indicated that their organization made no additional investment in order to achieve stage 1 meaningful use. One-third reported they will invest less than $1 million, 27% between $1 million and $4 million, and 29% at least $5 million.

Those investments, however, are expected to pay off. A full 23% anticipate they will receive $2 million to $3 million, while 13% expect no less than $10 million in incentives.

IT Security Breaches Continue

The report notes that IT security breaches continue to plague health care organization, although the reduction in violations from 26% last year to 22% this year, suggests efforts to secure patient information are working.

Compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations and Centers for Medicare and Medicaid Services security audits are the top security concerns (34%). This displaces an internal breach of security (32%), which had been the primary security concern for the past several years. One-third of respondents (32%) also expressed concern that their organization’s security systems were inadequate.

"What this shows is that health IT executives continue to hold this as an area of critical importance and diligence," Mr. Lieber said.

Notably, only 6% of respondents expressed concern about the organization’s ability to secure information on mobile devices.

With regard to IT infrastructure priorities, mobile devices were a priority for 18% of organizations, just behind servers/virtual servers at 19%, which was also the top response in 2011. Virtual desktops/laptops and security systems were each identified by 16% of respondents as their primary infrastructure goal. Cloud computing and telemedicine were not on the radar of many organizations, polling at just 3% and 2%, respectively.

When asked to select areas where IT could have the most impact on patient care, the leading answer was once again improving clinical and quality outcomes (38%), followed by reducing medical errors/improving patient safety (22%), and standardization of clinical care using evidence-based medicine (16%).

Staffing Tops Money as Biggest IT Barrier