Tuesday, July 2, 2013

The FY14 BIDMC Information Technology Budget

Beth Israel Deaconess Medical Center runs on an October 1 to September 30 fiscal year, so Summer is
always a time of capital and operating budget decision making.

We've finished our FY14 capital budget submission and requested $10.7 million to fund all the needed infrastructure/applications supporting 3000 doctors, 22000 users, and a growing 1.2 billion dollar clinical enterprise.     This breaks down into $7.5 million for general operations, $3 million for security/regulatory initiatives and $210,000 (plus a $1.3 million FY13 carryover) for ICD10.

We've finished our FY14 operating budget submission and requested a base budget which is flat compared to FY13.   However, we have added two special operating budget requests - $2.6 million for security/regulatory initiatives ($1.3 million in new FTEs, $1.3 million in purchased services),  and $4 million in ICD-10 related costs.     Our total IS expense will be about 2 percent of the operating budget of the entire organization.

It is interesting to note that like many CIOs, more and more of my budget is directed to government mandated initiatives.  I've published the graphic above previously which shows what a healthcare CIO must do 2010-2015 -  Meaningful Use, ICD-10, HIPAA 5010, Physicians Quality Reporting Initiative, Value Based Purchasing, and Affordable Care Act/ACO formation all while ensuring appropriate protections are put in place to comply with the new HIPAA Omnibus Rule and increased Office of Civil Rights enforcement.   Also, there is an uptick of audits of all kinds motivated by federal, state, and internal risk reduction mandates.

My modest budgets are not a sign of unwillingness of the organization to allocate resources to IT - they are a function of the budget realities facing all healthcare organizations.

The work that we do is a function of time, scope, and resources.    As I reflect on the external pressures all CIOs face in 2014, change is accelerating, reducing time to complete projects.   Scope is increasing as healthcare moves from fee for service to global captitated risk.    Resources are shrinking with increasing pressure to reduce reimbursement, merge/acquire/affiliate, and overall reduce total medical expense associated with the care we give.

We all need to be very careful that CIOs and their staff do not approach the breaking point as the requirements for time, scope, and resources (FTEs, capital, operating) no longer align supply and demand. As I discussed in a previous blog post, we're moving forward diligently to inform the Board and senior management about the cost of every new project and deal.

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