healthsystemCIO.com SnapSurvey: CIOs Surviving MU Stress Test

Three quarters of CIOs are either feeling great or cautiously optimistic about qualifying for Stage 1 Meaningful Use dollars, according to the November healthsystemCIO.com SnapSurvey.

In line with that sentiment, very few (under 10 percent) have been forced to “turn off” an application or piece of functionality they had taken live, something which can happen when systems are implemented quickly.

On the more sinister side of Meaningful Use — perhaps what could be best classified as unintended consequences of the government’s program — 70 percent said vendors were raising prices to take advantage of the artificial market demand.  Also on that side of the ledger, 38 percent said they have found the skill/service level of vendors and consultancies falling under the MU strain.

When it comes to certification, the majority of CIOs cry foul, with 58 percent saying its main effect is to help vendors increase the bottom line by requiring providers to get their latest software.

In an additional section of the survey on application/desktop virtualization, 75 percent said that technology was part of their upcoming two-year plan, with 38 percent handling the project personally. Regarding the replacement of PCs in the march to virtualize, most either planned to keep them (30 percent), or only replace them as they become obsolete (30 percent). To register for an upcoming healthsystemCIO.com Webinar on the subject, featuring hospital CIO speakers, click here.

(SnapSurveys are answered by the healthsystemCIO.com Advisory Panel. To see a full-size version of all charts, click here. To go directly to a full-size version of any individual chart, click on that chart)

• Still much to do and dependent on vendors delivering on their responsibilities.
• I used to be an uninformed optimist; now I’m an informed pessimist. But we will get it done.
• Too many initiatives are converging. ICD-10 could dwarf meaningful use in terms of lost revenue vs. any partial recovery of investment realized from MU.
• It seems like the Feds are changing the rules and the game is getting harder.
• Although I think we are well organized, have gotten good internal attention, and are still relatively optimistic, I’m starting to see some holes in our process as to some of the assumptions about our readiness from outside of IT that is starting to concern me.
• We have much that is dependent on our vendor/partners. If we have go-lives missed, it could effect us substantially.
• While there is much to do, we’re on plan.
• Our project is on target for Stage 1 with our greatest concerns centering around CPOE and Quality Reporting.
• We’re doing okay, but about to launch the boat – I’ll let you know if it starts taking on water.
• Latest twist with CMS ruling 11-14 that EHR certification needs to include all 24,25 criteria. This means that Hospitals and EPs need to implement all components of EHR not just components that meet core criteria and the 5 menu items. An example would be an EP chooses to not use patient portal since it is a menu selection. CMS says EPs still need to implement patient portal since it is part of the certified EHR. So to be compliant all EPs implement a patient portal for 1 patient. Crazy.

• Yes we have been forced to backtrack, in the sense of certain EHR functional items having been found by the vendor(s) to introduce clinical patient safety concerns and having to a) stop use until a fix is applied or b) introduce a material workflow workaround.

• I say yes but I cannot verify easily. I guess in some cases it just feels that way.
• Basically they are charging for every little thing as an additional module.
• I think vendors have had to try to recoup some of their development dollars as much of the MU criteria/certification was not on their development list and doesn’t help them differentiate their product necessarily.
• I have not seen it yet, but I suspect that will happen soon.
• Are you kidding? It is like Y2K all over again. They know they have us all over a barrel.
• Yes, but we are mostly self developed for these apps.
• Not significant, but we have seen a jump and requests for longer engagements.
• Only have experience with some niche vendors. Nuance Dragon product has increased license by 75% over the last 6 mos.
• It seems we now have less ability to negotiate.

• I have not – the Allscripts team assigned to us is experienced and been most helpful.
• Not with the consultants, but moreso with the vendors.
• Not yet, but I belive it will happen soon.
• There seems to be a limited pool of top-notch individuals.
• Not yet, but I can see the day coming when the more seasoned of the team is reassigned from our account to the longer term and more lucrative projects.
• No experience with the consultancies, but the expertise level of the vendor’s staff is taking a hit.
• I generally do not use consultants and am more leary now.

• I think it adds cost to the adoption of EHRs. Have any been denied certification under the new program?
• The certification criteria were not as throughly reviewed as the Meaningful Use criteria and many of the requirements are plain stupid.
• The honest answer is really that both apply.
• We were going down this path largley on our own without the Fed’s help. We will take the money anyway, but this is not, NOT a good use of tax dollars.
• Nice revenue stream for the software vendors.
• Really neither. I think it’s probably a necessary evil, but the way we’re going about it is making things complicated.

Virtualization

• Using VM for our server farm today but can’t find the ROI for VDI yet.
• I don’t need more technologies to sort out, I need less. I have 30 people that support desktops. I don’t want to create a constraint whereby I deploy a new technology and only 1 or 2 people now become the bottleneck.
• We wish we could move forward, but there is not enough funding… again, this is a trade-off for MU.
• Most HIT vendors aren’t ready for this.
• We are already rolling it out to our clinics. So far, so good.
• This is on our internal plan but not funded for this fiscal year.
• Yes. We have one unit live and plan to roll out system-wide over next 6 mos.

• My tech director handles it.

• PCs can become great thin clients and could last for many years before needing replacement. Why throw them away prematurely? This savings should be factored into any ROI for VDI.
• The $100 Microsoft annual client license for virtual desktop is cost prohibitive.
• Most of the above. The user roles, pc uses, and age all dictate varied methods, not one.
• Actually we have a mix of Thin Client devices and PCs.
• Once we have proven out VirtDesktops, then we will buy less expensive appliances for those areas where they make sense.
• Actually not sure on this one given that I’m not close to the project.
• Virtualization will be a mixture of PCs and traditional thin clients.
• At present, thin clients.
• New devices will be traditional thin clients.
• Some concern with legacy devices (biometrics for login, etc.) working with these devices.