2014 HIMSS Analytics Report

Topics: Healthcare IT Management

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The Perfect Storm: Navigating the Health IT Archiving and Data Management Challenge

Background and Purpose

What health information technology (HIT) issues keep you up at night? This is a question HIMSS Analytics researchers often pose to senior HIT executives in research projects. The simplicity of the question resonates with the executives as there is typically a multiplicity of concerns jockeying for the executive s attention: Meaningful Use, ICD-10 implementation and migration to a paperless environment to name a few. As the Affordable Care Act (ACA), Meaningful Use (American Reinvestment and Recovery Act 2009)1 and other regulatory initiatives are influencing the healthcare industry, it is understandable that these are critical initiatives for HIT executives to manage.

  • Achieving Meaningful Use 
  • Optimizing current system use
  • Leveraging information
  • Focus on clinical systems
  • Completing ICD‐10 conversions
  • Interoperability
  • Exchange info with other entities
  • Healthcare consumer issues
  • Focus on ambulatory issues
  • Securing patient information

But like all nightmares, it is usually things you don t expect which can be the most paralyzing when they appear. So what issues are on the horizon now that executives should be considering? It is our opinion that managing the exponential proliferation of data (e.g. storage, data back-ups and archiving) is the next monster hiding underneath the IT leader s bed.

In order to obtain the information needed to meet our research objectives, HIMSS Analytics conducted a web-based survey of IT executives (senior and director level information technology (IT) executives) from randomly-selected U.S. hospitals. Executives were e-mailed invitations to participate in the study and data collection occurred in September and October, 2013. The survey contained 29 questions addressing key topics such as data storage, data archiving and disaster recovery/business continuity.

But like all “nightmares”, it is usually things you don’t expect which can be the most paralyzing when they appear. So what issues are on the horizon now that executives should be considering? It is our opinion that managing the exponential proliferation of data (e.g. storage, data back-ups and archiving) is the next “monster” hiding underneath the IT leader’s bed.

Consider the following;

  • ICD-10 implementation will increase an organization’s data volume as the number of diagnosis codes a hospital manages will more than quadruple from the roughly 14,000 in the ICD-9 system to 68,000 diagnosis codes in the new ICD-10 coding system 3.
  • Stage 1 of the Meaningful Use initiative focused on data capture and data sharing, while Stage 2 of Meaningful Use is focused on advanced clinical processes including patient portals 4. Stage 1 has already impacted the amount of data that a hospital accumulates and this data volume is only expected to increase as organizations satisfy the requirements of successive Meaningful Use stages.
  • Healthcare organizations are trying to improve their EMR capabilities. Partially driven by the Meaningful Use initiative or an organization’s need to improve patient quality, efficiency and safety, U.S. hospitals have made significant progress over the past few years as it relates to migrating from a paper-based environment to a digital, paperless environment. The HIMSS Analytics EMR Adoption Model (EMRAMSM) 5 for example is a resource that quantifiably measures a hospital’s EMR capabilities. According to the 9th edition of the HIMSS Analytics Essentials-Winter 2013 report6, the EMRAM profile of U.S. hospitals suggests the percentage of hospitals with advanced EMR capabilities have steadily increased during the past seven years. As more organizations enhance their EMR capabilities, the amount of electronic clinical data collected and stored will surely increase.
  • The increased use of advanced imaging technologies like the Radiology and Cardiology Picture Archiving and Communication Systems (PACS) have challenged many hospital’s data storage capabilities. Use of PACS systems has grown in the last four years, in particular radiology PACS (R-PACS). For example, at the end of 2012 more than 74 percent of U.S. hospitals have an R-PACS solution in place; up from 66 percent four years earlier 7:

Taken together, the pressures these market trends will have on the management of data in a hospital is very concerning. The healthcare organization’s need to resolve the expected accumulation of clinical, financial and administrative data will directly challenge an organization’s current and future abilities to store, back-up and archive data.

The purpose of this white paper then is to examine the market’s thoughts on the future challenges of data storage, back-up and archiving in U.S. hospitals. It is our hope that the findings of this research study conducted by HIMSS Analytics (and sponsored by Iron Mountain) will encourage U.S. hospital IT leaders to initiate plans for data storage, back-up and archiving.

Study Approach and Demographics

In order to obtain the information needed to meet our research objectives, HIMSS Analytics conducted a web-based survey of IT executives (senior and director level information technology (IT) executives) from randomly-selected U.S. hospitals. Executives were e-mailed invitations to participate in the study and data collection occurred in September and October, 2013. The survey contained 29 questions addressing key topics such as data storage, data archiving and disaster recovery/business continuity.

To be eligible to participate in the survey, respondents were required to play a role in at least one of the following areas: disaster planning, purchasing data systems and responsibility of data management for their organization. Respondents indicating they played no role in these activities were excluded from the study. Almost all of the respondents stated they played a role in at least one of these areas. A total of 150 individuals responded to the e-mail invitation and completed all of the survey questions.

Demographics

More than half of the respondents (59 percent) who participated in this study identified themselves as their organization’s Chief Information Officer (CIO); an additional 37 percent were identified as Director of IT. The remaining respondents included Vice President of Technology and Chief Technology Officers (CTOs).

Most respondents represented single hospital systems (81 percent); with the remaining 19 percent mentioning that they work for an integrated delivery system (IDS). The overall average licensed bed size for all 150 respondents was 2248. The average bed size for single hospital system was 119 licensed beds and the average licensed bed size for the IDS respondents was 653 licensed beds.

For the purpose of this white paper, the bed segmentation has been divided into three categories:

  • Under 150 beds (small bed segment)
  • 150-500 beds (medium bed segment)
  • 500+ beds (large bed segment)

Most respondents (90 percent) from under 150 bed segment, indicated that they support up to 100 applications9 while half of the larger bed segment reported supporting more than 100 applications within their organization

Each respondent was also asked if his/her organization experienced any mergers or acquisitions in the last five years. Most of the smaller hospitals (under 150 beds) reported no activity within the last five years, while more than half of the larger hospitals have reported merger and/or acquisition in the same time period


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