The technology wish lists included in the HIMSS Leadership Survey is
a vendor's wet dream - so many things, and so many
CIOs want to buy them! Of course reality strikes back by figure 12, "barriers
to adoption." Here we learn the biggest barrier is a "lack
of financial support" - insufficient funds.
Reluctance to Close Unprofitable Product Lines: Hospital
bottom lines are being helped by some product lines and hurt by others,
yet there is a tremendous gap between the percentage of CEOs who report
a product line as unprofitable and the percentage willing to close it.
Radiology services, laboratory testing, ambulatory surgery, outpatient
therapy, orthopedics, cardiac care, and rehabilitation were cited by a
majority of CEOs as being profitable. By contrast, some services, such
as emergency room care, pediatrics, and obstetrics, were largely
reported as unprofitable, but the CEOs are reluctant to close
these service lines. For example, while 73 percent of CEOs report that
emergency room (ER) services are unprofitable, only one percent would
be willing to close their ERs. The same is true for pediatrics (78
percent find it unprofitable but only four percent would close) and
obstetrics (64 percent unprofitable, seven percent willing to close).
CEOs feel that they have good reasons for keeping unprofitable lines
open. The most important factor, by far, is community demand for the
Education/Training, Standardization, Technology Seen as Key to Reducing Errors: More than 85 percent of CEOs highlight education/training
and standardization as being in the top five among activities with the
greatest potential to reduce medical errors. Technology clearly has an
important supporting role to play as well, with 75 percent of CEOs
placing it in their top five. Relatively few CEOs believe that medical
errors will be significantly reduced through public reporting of errors
(29 percent) or through increased staffing (25 percent).
Investing Capital to Meet Near-Term Operational Needs: Eighty-six
percent of CEOs highlight purchasing replacement equipment as a major
capital need, while 72 percent cite purchasing new equipment. With the
exception of purchasing IT systems (cited by 68 percent of CEOs), the
majority of hospital CEOs are not planning to make long-term strategic
investments, such as the building and/or renovating of inpatient and
outpatient facilities, or expanding emergency room or operating room
capacity. To the extent that hospitals are investing in IT, most of the
investment to date has focused on security and privacy applications
along with pharmacy systems.
Hospital boards are focused first on financial viability (66%),
information technology infrastructure ranked second (at 22%). Hospital
CEOs are investing in programs to improve quality. Specific programs
are chosen in large part for their ability to generate revenue
enhancements and/or reduce costs.
As a complement to the above, the HFMA just released their third report in the series, Financing the Future II. The report is titled, Essentials of Integrated Strategic Financial Planning and Capital Allocation,
and in it there's lots of good info on aligning capital investment with
strategic planning. Both of these reports are good reading for vendors
who want to make a sale and hospital management that wants to make a