Hospital IT underfunded, CIOs say

Canadian hospital IT managers say an expected 20 per cent increase in computerized business and clinical solutions spending still leaves them shortchanged, according to a study on Canadian hospital IT released Monday.

But the study’s author said money is not a cure-all for the IT problems

in Canadian hospitals.

“”Funding is clearly an issue, but it’s not just funding,”” said Richard Irving, a management science professor at York University’s Schulich School of Business. “”There are large volumes of research that indicate if you invest in IT without a strategic direction, you’re not going to reap rewards from it.

“”Given the resource-poor system already, if you invest in resources that nobody uses, you make a bad situation even worse.””

According to The 2002 Report on Information Technology in Canadian Hospitals, hospitals in this country will increase their IT spending by 20 per cent this year, rising from 1.88 per cent of total operating budgets in 2001 to 2.27 per cent in 2002. Nearly half of all hospitals will employ picture archiving and communication systems in 2002, where 15 per cent of hospitals did so in last year. Forty-four per cent of hospitals will use community health software in 2002, compared with 24 per cent in 2001.

But the 104 CIOs and senior IT managers who responded to Irving’s survey in late 2001 said IT should account for between three and five per cent of operating budgets.

“”The findings are not surprising,”” said Fausto Saponara, vice president of corporate management and business development for the Ontario Hospital Association, which published its own hospital IT survey, “”Building a Foundation for e-Health in Ontario,”” in May 2001. “”We more or less established that a reasonable target would be in the four-to-five per cent range.””

Irving said his Canada-wide survey reveals some significant holes that cash could at least help to plug. For instance, more than a third of the respondents said their hospitals do not have a disaster-recovery plan or continuity program set up. A full 13 per cent do not have any plans for disaster recovery while 17 per cent do not plan on implementing a continuity program.

“”Just because they don’t have a plan doesn’t mean they don’t have protection,”” Irving said, noting that some hospitals do have backup systems. “”But it does give one pause.””

Another surprising finding of the survey, which Irving said is the first cross-Canada study of hospital IT, is that 15 per cent of hospitals admitted to a serious security breach in 2001, a figure Irving thinks understates the severity of the problem.

“”My guess is people probably underreport it,”” he said, noting that hospitals, like corporations, are not always eager to admit to a breach. “”I think you’ve got a gaping security hole.””

According to the survey, 57 per cent of hospitals said their employees bypass security systems because the systems are too complex. Irving, who has studied technology use in organizations for 30 years and authored a 1998-99 study of IT use in long-term care in Ontario, said the more complex the security, the more likely employees will bypass it. He suggested hospitals should spend more on training and less on complicated software.

“”The way the security systems are being implemented is that they so interfere with day to day work that people can’t do their jobs properly,”” he said.

Thirty-percent of survey respondents listed a lack of strategic vision and a lack of understanding of IT by senior management as the two major barriers to the effective use of IT in hospitals. Irving said there needs to be an understanding of how IT fits into a hospital’s strategic plans. He also said it is imperative for CIOs and senior IT executives to consult with all of key stakeholders, especially clinical staff, on an implementation.

“”Even if the CIO thinks its valuable, if the clinical staff don’t think it’s valuable, it’s going to be tough to pull off,”” he said.

Along with funding and human resource issues, the OHA’s May report cited consensus building as a barrier to hospitals maximizing the benefits of IT. The report’s findings inspired the creation of the Ontario Hospital e-health council, which has since established a standards-setting body for health informatics and aided the primary implementation of Ontario’s Smart Systems for Health Network, allowing for the sharing of information by health-care providers by connected hospitals.

Saponara said $1.2 billion to $1.5 billion is required to set up the necessary IT health infrastructure for Ontario. Ontario’s total hospital sector budget is $10 billion per year.

“”Once that infrastructure is put in place, (spending) could perhaps normalize,”” he said. “”But in this field, keeping up with technology is a never-ending process.””

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