Serving as CIO of Good Samaritan Hospital in Vincennes, Indiana, Chuck Christian says he's blessed with a great team. But there's far more to life these days than running an I.T. department. "Some days I feel like a crow," says the down-to-earth Christian, whose staff comprises 29 workers. "I keep looking to that next shiny thing. It feels like adult ADD. It's difficult to know where to focus."

What is the source of all this distraction? In a nutshell, it's Washington, D.C. Christian's lament is widespread these days. Ask hospital CIOs about their holiday wish list, and you pretty quickly catch on to that theme.

CIOs are overwhelmed by the sheer volume of federal programs coming their way. They're finishing the year with their transition to HIPAA 5010, the new claims transaction standard that requires system upgrades and testing with payers. At the same time, they are mired in meaningful use, installing and deploying EHR systems and modules such as e-prescribing, computerized order entry and patient portals. They're hustling to qualify for federal incentives (and avoid eventual federal penalties).

Beyond that, CIOs are facing an October 2013 deadline for the conversion to ICD-10. That alone requires a massive overhaul of clinical, financial and administrative systems in order to keep the cash coming. Layer in other federal programs spawned by health reform-such as accountable care organizations and the shift in risk-sharing and payment methodology they represent-and you have the underpinnings of a bad dream. Factor in the push for health information exchange, and the nightmare can turn into waking delirium.

What's significant about CIO frustration with the regulatory environment is that it's coming from leaders who solidly champion clinical I.T. They are not resisting government programs because they want to live with paper charts. In fact, many CIOs are clamoring for federal involvement in areas where they perceive a need-such as a national patient identifier and a broadened I.T. labor pool to help pull off the projects the government is asking them to do.

A feature story in the December issue of Health Data Management further explores CIO holiday wish lists.


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