The Challenge to Lead Change

Sept. 24, 2009

Editor’s Note: When this article was published in August, 1985, in Computers in Healthcare, a previous name of Health Management Technology, Mary Elizabeth McIlvane was president of MEM Communications Group, Winter Park, Fla.

Most of the speakers at the Conference of Health Care Business Information Systems, held at the Dallas Infomart in May, focused on a common thread – the need for healthcare information systems vendors to help hospitals and alternate-care facilities executives in clarifying directions and determining information system requirements in a changing environment.

Traditionally, hospital information system vendors have looked to leadership for changes in information-management systems’ requirements to come from hospital executives. Today, the organizational structure of the healthcare delivery system is changing rapidly to reflect the multiple changes being brought about by public and private sector changes in reimbursement methodologies. The result is the healthcare business is becoming “productized,” emphasized the opening speaker from the Mayo Clinic.

He pointed out that hospital information systems vendors need to develop software products and services to reflect the needs of the fast-changing environment. One example he cited was to provide the information-management resources needed to support preadmission requirements of professional review organizations. He emphasized the need for systems to “improve operational productivity and to enable hospital managers to have information needed to gain a competitive edge. Change is the name of the game.”

The challenge was repeatedly thrown out for vendors to better understand their marketplace. One speaker noted that a recent study reported that in 1984 there were 50 laboratory systems vendors; their marketing efforts sold 83 systems.

Another speaker said that information-systems vendors should lead the way to change, which has happened dramatically in other industries. In the midst of fundamental changes to the healthcare industry, she noted that changes are occurring for all of the players.

Consumer choice is being narrowed. Physicians are beginning to market their practices. Hospital and healthcare managers are seeking guidance to ask the right questions and receive answers to enable them to prudently understand and manage change. She suggested that executives are getting too much information. Do they need 112 reports or do they need four reports? What is the key information they require to support decision making?

Another speaker questioned, “What are the variables in hospital and patient care management to be measured? Do we need to develop new measurements for assessing the economics and quality of care?”

He remarked that with vertically integrated healthcare delivery systems, information-management systems’ designers and developers must consider these factors.

Another speaker reinforced these comments when he identified two shortcomings of healthcare information-system products. Current hospital systems do not adequately meet the changing environment’s requirements and the needs of a vertical healthcare marketplace. Vendors need to put more dollars into the “R” of “R & D” and to develop solutions with a return on their investment in three years rather than less than a year.

Two concluding speakers addressed the problem of appropriate information-management systems for alternate care facilities: ambulatory care centers and a specialized group practice. Both speakers addressed the need to network patient information among the various components of the vertical delivery system.

All of this indicates that either hospital information-system vendors are not communicating their capabilities to the industry or needs are not being realistically understood and met.

Healthcare decision makers and managers need to be involved in the design and development process to produce innovative results. In the long run, there will be substantial payoffs for healthcare providers, consumers, insurers and the healthcare information-processing industry. Today, the opportunity for hospital information-system vendors is to question, listen and be proactive rather than reactive to the changing environment.

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