2022 symplr Compass Survey and Report
Technology-led transformations that accelerated during the pandemic are likely to continue in healthcare, and health systems are increasingly seeking vendor partners that will deliver solutions capable of efficiencies. However, there is li le tolerance for technological change that places undue strain on an exhausted workforce.
Our data, from 132 decision-makers at top health systems across the U.S., reveals opportunities to streamline and optimize healthcare operations systems to combat financial pressure, burnout, and other challenges in healthcare.
The findings of symplr’s Compass Survey are validated by other industry analyses, including a Bain & Company / KLAS Research report1, which found that 63% of providers seek to streamline the number of third-party software solutions in their technology stacks over the next year. Respondents to the Bain / KLAS survey were similarly motivated by financial pressures and challenges, with nearly 80% citing labor shortages, inflation concerns, or specific organizational situations as the motivation for software investments.
symplr found that future priorities and needs for healthcare organizations will include investment in healthcare operations with an emphasis on automation and interoperability. Improving interoperability (26%) and workforce management (23%) will be the top areas of focus for health system executives. Adoption of technology that is built on standardized, enterprise-level architecture to provide automation and data-driven insights will ultimately drive down costs, avoid risks, and improve the patient experience. Providers and healthcare systems will lean toward a human-centered approach to technology infrastructure that causes the least disruption and produces better outcomes for all.
Global conditions are placing undue pressure on health systems worldwide. In the U.S., the repercussions are felt from the front lines to the back office — from price spikes in resins, cotton, and metals to microchip shortages, and from fractured infrastructures to a fatigued workforce.
Healthcare is no longer “recession proof,” and provider organizations understand the need to prepare for perpetual change. Make-or-break circumstances outside their control — financial market contractions/recessions, pandemics, natural and man-made disasters in their communities — render it necessary to influence tractable factors. Post-COVID-19, there is an accelerated timeline to digitally transform, using technology to predict, connect, complement, and streamline human tasks.
The pandemic greatly increased health systems’ momentum in adopting a multitude of software applications, such as telehealth and medical research tools, that allow patient care beyond the physical walls of health service facilities. The addition of point systems was critical to closing the gap caused by the need to physically distance. In hindsight, however, it underscores the challenge of continually adding scores of siloed tools that physicians, administrators, and clinicians are required to master while still providing patient care.
This ongoing influx of disparate resources complicates the ability to easily locate and report accurate information and presents the potential for costly compliance violations. Most importantly, requiring the healthcare workforce to juggle time consuming, often repetitive administrative tasks wastes resources, negatively affects patient care, and adds to staff fatigue and frustration.
Against this backdrop, symplr surveyed 132 decision-makers at top health systems across the U.S. to obtain insights and sentiment regarding healthcare operations technology at their organizations, including usefulness, effectiveness, common frustrations, and areas of opportunity. All respondents were members of the College of Healthcare Information Management Executives (CHIME), the professional organization dedicated to serving chief information officers (CIOs), chief medical information officers (CMIOs), chief nursing information officers (CNIOs), chief innovation officers (CIOs), chief digital officers (CDOs), and other senior healthcare IT leaders.
An emerging category — healthcare operations — is facilitating clinical operations with the tools to collectively address controllable challenges in healthcare. Within the realm of healthcare operations, health systems must efficiently and effectively manage a multitude of manual and digital operational systems, many of which are fragmented, counterintuitive to the workflows of clinicians and staff, and problematic in that they pose compliance, security, and financial challenges that extend to the C-suite.
The identification of this category is rooted in the principle that a uniform, unified, and human-centered approach to the healthcare infrastructure produces better outcomes for patients, clinicians, staff, the healthcare enterprise — and ultimately, the healthcare industry.
Healthcare operations software, or technology-assisted healthcare operations, is already being used, for example, to identify value in supply chain spending and contracts, comply with changing regulations, prevent unnecessary staff overtime, and create an appealing digital front door for increased patient acquisition. While adoption of a user-centric approach is gaining traction in the healthcare industry, there is abundant opportunity to create dynamic, efficient technology ecosystems within healthcare organizations that automate and empower the workforce to focus on and deliver quality patient care.
The following report elucidates the current state of technology use in the healthcare industry and its impact on financial strategy and workforce management.
It also looks forward into ways health systems are aligning their technology ecosystems with solutions that alleviate undue burdens on clinicians and staff, ease financial pressures where possible, accommodate enterprise infrastructure, and stabilize quality patient care.
For the purpose of this report, healthcare operations are defined as the administrative, non-clinical tasks that help run a hospital/health system, including finance (contracting and spend management); provider data management, workforce management; healthcare governance, risk management, and compliance (GRC); and quality, safety, and supplier management.
The need for health systems to digitally transform their healthcare operations is clear, as they grapple with managing disconnected software systems and solutions.
Negative downstream effects are numerous: when data is stored in multiple software solutions or sources, the risk of security breaches rises in tandem. A lack of data transparency wastes resources and inhibits an enterprise’s ability to maximize its workforce and to identify opportunities for cost containment. Moreover, the inability to easily locate and report on accurate information that exists in multiple or manual systems introduces the potential for costly compliance violations.
The cost of a breach in the healthcare industry increased 42% since 2020. For the 12th year in a row, healthcare had the highest average data breach cost of any industry at $10.1 million.
Importantly, administrators and clinicians must learn and master an array of siloed tools, taking time away from patient care and adding to their fatigue and frustration with administrative burdens.
As indicated in the symplr Compass Survey results, approximately 60% of health systems and hospitals use 50–500 software solutions for healthcare operations. This includes 35% health systems who use 51-150 point solutions and over 24% who use between 151-500 solutions. The lack of a unified healthcare operations system has also created a rather complicated web of protocols to complete tasks that range from updating provider directories and confirming physician credentials to managing medical supplies and monitoring facility access.
There is one area in which the vast majority (88%) of CIOs agree: “Working with these disparate IT systems and applications complicates [their] job.”
The pandemic touched every corner of the globe. In its wake, rising inflation, changing patient preferences, and the transition to value-based payment models by government and private payers collectively mark a critical shift in the healthcare industry and in how healthcare organizations are proceeding with operational budgets as they plan for the years ahead.
Financial pressure is a top concern, as indicated by more than 40% of symplr Compass Survey respondents.
However, the COVID-19 pandemic is not fully to blame for this shift‑. As noted in the New England Journal of Medicine2 in September 2020: “Though the [COVID-19 crisis was] unprecedented in terms of its scale and cause, the underlying economic issues would have surfaced with any substantial perturbation of the economy.”
In addition, the costs of compliance weigh heavily as an external pressure in post[1]pandemic healthcare. A report3 from the American Hospital Association (AHA) found that health systems, hospitals, and post-acute-care providers must comply with 629 discrete regulatory requirements across nine domains, which translates to nearly $39 billion spent annually in administrative tasks related to regulatory compliance. The amount an average-sized community hospital (161 beds) spends annually on administrative activities to support compliance is $7.6 million.
The cost of compliance goes well beyond the bottom line. As noted in the AHA report: “As a result of this extraordinary burden, providers are struggling to balance the administrative activities necessary to comply with regulatory requirements against the clinical, operational, and financial activities necessary to fulfill their clinical missions.” As revealed in the symplr Compass Survey, more than 30% of survey respondents said clinician burnout is a top concern at their healthcare organization.
While some of the biggest hospital systems are seeing patient volumes rebound4 to pre-pandemic levels, they are still grappling with labor and supply cost issues. According to Kaufman Hall’s Fall 2022 Outlook5, labor costs account for approximately half of a hospital’s total expenses. In addition, shifting patient behaviors are prompting delayed or deferred treatments and surgeries6, causing CFOs and CIOs to reconsider budgets.
According to a new Bain & Company/KLAS Research report7 on the state of healthcare provider IT spending, organizations that adopted multiple systems are revisiting and refocusing their cost strategy to “streamline their existing tech stacks.” As health systems seek cost optimization, they’re also expressing a strong continued commitment to maintain spending, fulfilling their moral imperative to provide care in their communities. The caveat: the introduction of new technology and software must not be disruptive to their workforce.
Financial assets are critical to any business. But not every business is in the business of saving lives. Patients impose a life-or-death reliance on the skills and experience of the healthcare workforce — the human facet of a health system’s working capital.
Myriad pressures stemming from the pandemic have accelerated an unprecedented level of workforce burnout.
As noted in the U.S. Department of Health and Human Services’ Advisory8 on Health Worker Burnout, “there are a range of societal, cultural, structural, and organizational factors that contribute to burnout among health workers…[including] excessive workloads, administrative burdens, limited voice in scheduling, and lack of organizational support.”
Some nursing areas continue to experience a mass exodus of skilled labor, with the national hospital turnover rate at 25.9%, as noted in a recent NSI staffing report9.
As revealed in the symplr Compass Survey, 44.7% of respondents invested in additional workforce/talent management solutions; while 38.6% invested in additional compliance, quality, and safety solutions; and 24.2% invested in additional clinician scheduling solutions. While these investments were considered key to meeting strategic objectives, increasing the volume of siloed systems has resulted in increased disparity among systems and among staff, who must spend more time learning new tools and less time on patient care.
Within these challenges, however, are opportunities to elevate, streamline, and automate staffing and scheduling processes that optimize effectiveness, reduce burnout, and increase retention. For example, revisiting and reframing a healthcare organization’s infrastructure with a clinician-centered technology design enables health systems to help mitigate staffing shortages due to burnout. In addition, clinicians are empowered to practice at the top of their license to deliver high-quality care to patients.
CIOs, CMIOs, and CNIOs are tasked with managing the technology that enables their hospitals’ or health systems’ clinicians to effectively treat patients. Their role and the technology they manage became even more important during the COVID-19 pandemic and subsequent workforce shortage, as technology was and continues to be leveraged to fill critical care gaps.
As a result, healthcare entities adopted many IT solutions in response to the pandemic. More than half (52%) of symplr Compass Survey respondents said their organization has 151-500 IT systems and/or services for both clinical and operational needs across the healthcare enterprise. Another 31% said they use 51-150 systems and services.
The use of many siloed or individual point solutions increases risks to cyber security, resulting in a decrease in management’s confidence in the integrity of their operational infrastructure. When it comes to their healthcare operations systems, CIOs are extremely divided on their highest priorities.
Approximately 26% identified improving interoperability as their top priority, edging out enabling the clinician workforce (24%) for the top spot. Ensuring privacy and security (21%), improving customer experience (18%), and automation (12%) were also priorities.
23.5% of CIO respondents said enabling their clinician workforce is their top priority when it comes to managing hospital/health system operations
As noted in a Fortune article10 on efficient healthcare systems: “Covid-19 has exposed the need to consolidate and integrate processes and systems that manage governance, risk management, and compliance. These areas touch virtually every part of a health care system, including staff scheduling and credentialing of health care providers and vendors.”
The data clearly show that most health systems surveyed have an excess of disparate point solutions and systems that are adversely affecting their technology ROI and burdening their clinical and administrative staff.
According to the 2022 Bain/KLAS report11, a quarter of all providers state that their existing tech stacks keep them too busy to stay current on new offerings in the market. They also cite a lack of cross-solution interoperability and poor EHR integration with existing tech stacks as some of their more prominent pain points, further illustrating the unique challenge of the current environment.
Almost 80% of providers say labor shortages, inflation concerns, or specific organizational situations (like M&A or leadership changes) are top catalysts sparking new investments, and 95% of provider organizations expect to make new software investments in the next year despite economic uncertainty.
As revealed in the symplr Compass Survey results, nearly 60% of health systems and hospitals use between 50 to 500 software solutions for healthcare operations, the administrative, non-clinical tasks that help run a hospital/health system. Of these, 44.7% of respondents invested in additional workforce/talent management solutions; 38.6% in additional compliance, quality, and safety solutions; and 24.2% in additional clinician scheduling solutions.
In the symplr Compass Survey and as numerous industry resources reveal, another prominent pain point reaches beyond the technology infrastructure, to the human network that spans from the front lines to the back office — the doctors, nurses, clinicians, administrative staff, and everyone on staff working toward and dedicated to providing quality care to patients.
Healthcare executives and industry analysts often cite the immense administrative burdens healthcare organizations face — especially the requirement to document visits in EHRs — as a key driver of burnout and waste. Change fatigue, coupled with a discounting of end users’ nuanced needs, is a recipe for a failed technology transformation.
More CIOs realize the importance of tuning into the user experience and using workforce automation to empower clinicians and staff. Thus, CIOs seek technology providers who can address the challenges of burnout and waste with a holistic, user-centric solution that is not disruptive to their staff and does not pile on yet more technology, tools, or processes that result in change12 fatigue.
Such solutions and services address the healthcare operations of an enterprise to unify siloed systems and streamline administrative tasks, providing marked efficiencies in the following areas:
Consolidating and integrating business-critical software and systems not only reduces the number of vendors healthcare CIOs manage, it also ensures operational efficiency, consistency, revenue optimization, and security — and refocuses the emphasis on providing high-quality patient care.
How our research was conducted symplr conducted an online survey of 132 hospital/health system employees, all CHIME members. The survey was conducted in August 2022. Eighty-seven percent of respondents who provided their job titles work in senior management roles such as vice president, CIO, or director.
CHIME is an executive organization dedicated to serving chief information officers (CIOs), chief medical information officers (CMIOs), chief nursing information officers (CNIOs), chief innovation officers (CIOs), chief digital officers (CDOs) and other senior healthcare IT leaders. With more than 5,000 members in 56 countries plus two U.S. territories and over 150 healthcare IT business partners and professional services firms, CHIME and its three associations provide a highly interactive, trusted environment enabling senior professionals and industry leaders to collaborate, exchange best practices, address professional development needs, and advocate the effective use of information management to improve the health and care in the communities they serve.
1, 7, 11 “2022 Healthcare Provider IT Report: Post-Pandemic Investment
Priorities.” Bain & Company/KLAS Research. October 17, 2022.
2 “Are U.S. Hospitals Still “Recession-proof”?” New England
Journal of Medicine. September 24, 2020.
3 “Regulatory Overload – Assessing the Regulatory Burden on Health Systems, Hospitals
and Post-acute Care Providers.” American Hospital Association. October 2017.
4 “Hospitals rebounding from pandemic press for more
federal help.” Axios.com. August 25, 2022.
5 “The Current State of Hospital Finances: Fall 2022 Update.”
Kaufman, Hall & Associates, LLC. September 15, 2022.
6 “Surgeries fail to return to pre-pandemic levels.” The Harvard Gaze e. August 23, 2022.
8 “Health Worker Burnout.” U.S. Department of Health & Human Services Advisory. 2022.
9 “2022 NSI National Health Care Retention & RN Staffing
Report.” NSI Nursing Solutions, Inc. March 2022.
10 “One year later, we owe our COVID medical heroes a more
efficient health care system.” Fortune.com. March 16, 2021.
12 “Why Transformations Fail And What You Can Do About It.” Forbes.com. March 2, 2021.
