Healthcare Reform – The Impact on IT

Nov. 25, 2009
The current political focus is targeted on healthcare reform, and the recently passed house bill HR 3962, with its additional 990 pages, has many people concerned about the approach Congress is taking. Is there a positive aspect of this situation that relates to technology? How can the CIO win as the political winds change?

One issue is that, in the stimulus bill, money was allocated for technology to automate medical records. Money was also allocated to study medical outcomes through comparative effectiveness research and the creation of a health board. While these may sound like positive inclusions, these two components match with the NICE system in the United Kingdom, which is used to ration care. Add the public-option insurance plan run by the government, with its mandatory requirements, and the landscape of healthcare changes.

The current political focus is targeted on healthcare reform, and the recently passed house bill HR 3962, with its additional 990 pages, has many people concerned about the approach Congress is taking. Is there a positive aspect of this situation that relates to technology? How can the CIO win as the political winds change?

One issue is that, in the stimulus bill, money was allocated for technology to automate medical records. Money was also allocated to study medical outcomes through comparative effectiveness research and the creation of a health board. While these may sound like positive inclusions, these two components match with the NICE system in the United Kingdom, which is used to ration care. Add the public-option insurance plan run by the government, with its mandatory requirements, and the landscape of healthcare changes.

What does this have to do with technology? On the surface, nothing; but long term, perhaps everything. The stimulus bill allocated $19 billion to automate medical records in physicians’ offices and hospitals. An automated medical record is the engine that drives the management-information system. This is a bonanza for the vendors, but it will put a strain on the human resources for both the vendor and the provider organizations. The technology workforce should be smarter about the use of technology and its impact on the organization. Speeding up the manual system is not going to be a solution in the future.

Increased responsibility will fall to the IT organization to make the use of automation measurable and cost effective. For years, we have automated systems rather than improve processes. The IT staff should work closely with the user departments to simplify processes within each department. The cost of processing has not decreased much over the years, and is at least 25 percent of the cost to provide care.

For medical centers to survive a reduction in future revenue, they should reduce costs accordingly. The IT organization should be the catalyst to make this happen. The use of technology will finally become a true management tool for enhanced business decisions.

As the industry incorporates technology into its strategic plans, there are a number of elements that should be included:

  • link physicians and the community they serve through a regional focus;
  • expand use of telemedicine in rural areas and home health;
  • link the medical center to walk-in clinics and stand-alone facilities;
  • reduce costs in billing and instant insurance verification;
  • commit to process change to reduce cost;
  • improve patient safety (i.e., reduce errors); and

  • integrate outpatient and inpatient records.

The fact that many people do not move far from their home roots makes the use of regional databases more attractive and less costly than a national database. The bigger question becomes: Who pays for them?

The provider community is not alone on this journey. Since the industry is dependent on vendors for software, those vendors should provide software systems that meet the needs of providers and help them achieve their goals.

So where does this leave us? Vice presidents and CIOs need to rethink their strategies and press the CEOs for priority and commitment to the future.

This will not be easy and some laws should be changed to enable the industry to attain its goals for improved patient care and customer satisfaction. This is the moment in time for IT leadership to take charge and advance the agenda to improve the performance of healthcare systems.

Robert Blades serves as an independent consultant focusing exclusively on the healthcare industry. He has experience in management of business operations, strategic planning, contract negotiations and customer-focused information-systems management. He began his executive career as CIO of Georgetown University Medical Center and later joined Shared Medical Services. He most recently served as the VP/CIO of Loma Linda University Adventist Health Science Center. Blades earned a degree in industrial engineering at the University of Maryland and an MBA at Widner University in Philadelphia.

Consultant Robert Blades is author of “HELP!!! Your Health Care Hanging in the Balance” (www.robertblades.com).

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