Many chief information officers at healthcare organizations plan to heavily invest in optimizing their electronic health record systems during the next three years, but most will be trying to do that within the constraints of their existing budgets.

That’s because these executives say they will not see expansion of current IT budgets, according to research and consulting firm KPMG.

KPMG in January surveyed 112 CIO members of the College of Healthcare Information Management Executives, finding that the IT professionals are looking for solutions to physician dissatisfaction with the EHRs they have in place, says Ralph Fargnoli, managing director at KPMG.

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With the Trump Administration in place, it still is not clear what will happen with the Affordable Care Act. That makes it even more imperative for CIOs “to continue down the path to get the best efficiencies in IT spend and use data to support accountable care and payment changes,” according to Fargnoli.

Ralph Fargnoli

Survey respondents indicated technology investments would target EHR optimization (38 percent), cloud computing (25 percent), accountable care/population health (21 percent), consumer/clinical/operational analytics (16 percent), virtual/telehealth enhancements (13 percent), revenue cycle optimization/replacement (7 percent) and enterprise resource planning system optimization/replacement (6 percent).

Some 36 percent of responding CIOs expect an increase in operating budgets during the next two years.

In general, CIOs are hoping to achieve savings from optimization efforts and then reinvest those funds, particularly in telehealth and analytics, because executive leadership is telling them, “We can’t give you any more money,” Fargnoli says.

Areas being considered to control or reduce IT operating expense include centralization and standardization of IT services and systems, eliminating redundant apps and their infrastructures, terminating or turning around underperforming IT projects, adopting cloud services, lowering labor spend or eliminating contractors, outsourcing low value services, and renegotiating outsourcing contracts or insourcing.

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The need for greater interoperability, however, could take a bite out of some of the savings, Fargnoli adds. “Interoperability has an impact on costs; if you need more integration steps and are building code, that impacts the budget. Interoperability plays heavily on IT budgets if you want analytics but don’t have free flow access to data.”

In the end, Fargnoli says, optimization should focus not just on technology but on change management, with one key question to consider: “How does an information system impact patients and clinicians and support quality outcomes and patient care?”

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