We’ve all heard the expression, “You never get a second chance to make a good first impression.” Although that’s almost always the case, what’s also true is that first impressions can be deceiving. At first glance, the 2018 HIMSS Leadership and Workforce Study shows that population health is declining as a priority for health systems. However, it also shows that analytics has risen to the top, which indicates that people are beginning to “understand that the foundational work must be done before we can pursue higher goals,” says Lorren Pettit, VP of HIS and Research at HIMSS.
Recently, Pettit spoke with healthsystemCIO.com about the results of the survey, and the implications they have both for vendors/consultants and hospital leaders. We discuss the “disconnect” when it comes to patient safety, why he’s wary when it comes to digital health, and what we’re learning about the gender pay gap. Pettit also provides clarity on the survey process, and how his team is working to ensure it reflects the needs and goals of today’s health IT leaders.
Throughout the development of the survey, we were very purposeful to emphasize information and technology. But this is going to require a cultural shift. We’re trying to understand how the market sees the health IT worker.
Vendors need to do a better job with their messaging around patient safety, because that’s what is most important to hospital personnel. There’s a disconnect in this area, and that presents an opportunity for vendors and consultants to up their game.
Without data analytics, there is no population health. And so I think the market is realizing that we need to get our arms around data analytics and clinical business intelligence, because once you can wrestle that to the ground and manage it to a certain extent, you can really look at population health and value-based care.
I believe health IT is still a market of opportunity, and so the vendor community is bullish. Look at what we’re seeing with companies like Google and Uber — they’re starting to enter our marketplace because they see opportunities here.
How do we motivate women to demand more and ensure that is parity? It’s a challenge, particularly since most women understand that disparities exist, but many don’t believe they fall into that category.
Gamble: Hi Lorren, thank you for taking time during this busy week to speak with us about the results of the 2018 HIMSS Leadership and Workforce Survey. Let’s start by getting some background information. How long have you been involved with this initiative?
Pettit: When I came here six years ago, I started in HIMSS Analytics as the VP of Research, and then a few years ago moved to the HIMSS North America side, still focusing on thought leadership research but expanding into a few other areas, specifically the long-term, post-acute care area, as well as outreach to Canada.
When I moved over, we brought the survey with us. But it was in the last two to three years that I really started to embrace this and radically change the instrument.
Gamble: What were some of the most significant changes?
Pettit: In the past, leadership and workforce were treated separately. To me, it didn’t make didn’t make sense to hit the same audience twice. The goal was to gain insights into the strategic direction leaders are taking; a large part of that is focused on resources, and the most important resources are humans, and so we tied those together.
Gamble: One of the changes in this year’s survey was to tweak the wording tom ‘information technology’ to ‘information and technology.’ Is that a reflection on where the industry is headed?
Pettit: Yes. And that came from the top; it’s the strategic direction in which HIMSS is going. Our CEO, Hal Wolf, has been encouraging us to move away from just information technology, which is focused more on devices, and moving toward information and technology, which is much broader. We’re seeing the entire market shift in that direction. It’s no longer just about the IT department — it’s clinicians, administration, and other areas as well.
Gamble: What type of process do you have in place to determine whether a change should be made to survey?
Pettit: We sit down with leadership, as we did in this case, to make sure we’re in sync with HIMSS’ messaging. It was clear that this is the direction the organization wants to take. And so, throughout the development of the survey, we were very purposeful to emphasize information and technology. But this is going to require a cultural shift. We’re trying to understand how the market sees the health IT worker. And so this is a process.
Gamble: Let’s talk about the findings. There were some notable differences between hospital leaders and vendors/consultants when it comes to what they consider to be top priorities, and how they plan to allocate resources this year. The majority (86 percent) of vendors/consultants said they expect their business to increase, while 63 percent of hospitals believe their operating budget will either stay the same, or decrease. Were you surprised by this?
Pettit: Yes. I wasn’t surprised they had different projections, but I didn’t expect it to be quite so divergent. Over the past two years, we’ve seen a decline in hospital spending, but it seemed to be much more accelerated this year.
If you step back at look at the instrument itself and what it does, it’s essentially looking at a mountain and asking two different people to describe it. The mountain is the priorities that we tether around the HIMSS conference. Last year, we had 18 topics; this year, we had 24. Some of those were split apart. For example, culture of care, care coordination and population health were bundled into one group. This year, we separated population health into its own topic.
Research purists might say, ‘it’s not apples to apples,’ and they’re right. But it’s Granny Smith to Macintosh apples. It’s what we refer to as directionally correct. And so if we see a divergence, that’s solid information. The vendors and the hospitals seem to be looking at the mountain very differently this year.
Gamble: Right. Another finding that stood out to me was that hospitals ranked patient safety significantly higher as a priority than vendors and consultants. What are your thoughts on this?
Pettit: It’s really interesting, because if you speak with a vendor or consultant, they would never diminish the importance of patient safety. But there’s no doubt that hospitals are more acutely aware of its significance. That tells me vendors need to do a better job with their messaging around patient safety, because that’s what is most important to hospital personnel. There’s a disconnect in this area, and that presents an opportunity for vendors and consultants to up their game.
Gamble: Sure. We know vendors and consultants understand the importance of safety, but perhaps that needs to be made more clearly.
Pettit: I think so. For those who are on the front line, it’s very real. They live it day in, and day out. For those of us that are peripheral to this industry, we support it, but there are also so many other things on our radar. And so I believe this is a very significant learning.
Gamble: One area that wasn’t quite as surprising is that the two groups both included data analytics/clinical and business intelligence, and privacy/security as top-five priorities. That certainly reflects what we’ve been hearing from CIOs.
Pettit: It was no surprise to see privacy and security identified as a top priority. Everyone understands that. There’s a sense of urgency and fear that drives it, and rightfully so.
In terms of data analytics, I think it’s important to provide some background. This year, we separated care coordination and population health into their own categories, and both plummeted on the list of priorities. If these two areas dropped, and everything else remained fairly stable, what changed?
One thing I can surmise — and this is a theory — is we’ve been talking about population health for years. It’s a buzzword. People get it, but did we really understand what population health was all about?
What we know now is that without data analytics, there is no population health. And so I think the market is realizing that we need to get our arms around data analytics and clinical business intelligence, because once you can wrestle that to the ground and manage it to a certain extent, you can really look at population health and value-based care. I was encouraged by this finding, because it shows that we need to do the foundational work before we can pursue some of these higher goals.
Gamble: On the workforce side, one interesting finding was that vendors and consultants expect their operating budgets to increase, while hospital budgets continued to shift downward. What do you believe this can be attributed to?
Pettit: That’s a very good question. There are different theories, but we don’t know for sure. One thing I will say is that I believe health IT is still a market of opportunity, and so the vendor community is bullish. Look at what we’re seeing with companies like Google and Uber — they’re starting to enter our marketplace because they see opportunities here.
Gamble: That’s a good point. What are you finding in terms of digital health? There’s a lot of talk about it, but is it really a top priority at this point?
Pettit: I think we need to be careful in this area, because of the ‘shiny object’ factor. The EHR, for example, isn’t as sexy as it was a few years ago. A lot of hospitals are still trying to wrestle with some of the basics, like workflow and usability. For the vendors, there’s almost an EHR fatigue because they’ve been dealing with it for so long, but the clients are still dealing with it. And so there’s a need for vendors to be sensitive to where hospitals are, and to make sure we’re not pursuing shiny objects.
Gamble: Right. Was there anything else in the findings that stuck out to you?
Pettit: Actually, yes. I wanted to touch on the results of HIMSS Compensation Survey. On the positive side, we saw that health IT is still a very attractive market. Workers on both the vendor/consultant side and the provider side are paid very well, particularly in comparison to other fields, which works in our favor.
However, the survey also highlighted disparities in certain populations that we, as an industry, need to address. It found that women earn about 80 percent of what their male counterparts do. We always seem to find gender disparities, and the higher the position, the greater the wage gap. We’ve heard this before. But what was unique this year is we then asked, ‘How satisfied are you with your compensation?’ When we broke it down by gender, there was no differentiation between women and men.
And so, while there are opportunities for women in leadership roles, how do we motivate women to demand more and ensure that is parity? It’s a challenge, particularly since most women understand that disparities exist, but many don’t believe they fall into that category.
Gamble: I’m glad you brought that up. It speaks to the need for greater transparency so that women are made aware of the gaps that exist.
Pettit: Exactly. Knowledge is power.
Gamble: Definitely. Well, I want to thank you so much for taking the time to discuss the findings of the surveys and provide insights. It should be very interesting to see what changes the industry makes in the coming years.
Pettit: Certainly. Thank you for the opportunity.