Capitalize on ARRA/HITECH by implementing a fully integrated healthcare-technology system.
There is no shortage of skepticism for how the industry will eventually spend its time and resources in response to ARRA/HITECH and related initiatives; however, without significant change from historical approaches to IT change in all areas of healthcare, this new world of healthcare IT may be painful. Healthcare IT professionals, who view ARRA/HITECH as a golden opportunity to maximize the virtues of HIT within their organizations, should consider the following:
- Seek to understand ARRA and HITECH and the specific opportunities from new technology, not just pick the parts that seem most attractive or only the ones that have dollars attached. Living up to the intent of the two acts will mean lasting change and investment for your organization.
- Take the time to fully assess your organization and identify the level of automation and technology that is right for your entire organization – clinical goals, business objectives and financial requirements. Successful HIT change will necessitate a coming together of clinicians and business operations in order to devise the best and most-lasting solutions.
- Gain a keen understanding of the healthcare IT market. Seek outside assistance to provide expertise and guidance. This is an important step to ensure that the most appropriate technology solution is implemented, as opposed to the most expensive, most highly reviewed or most feature rich.
- Develop a plan and stick to it.
- Get started now – this will not be accomplished overnight. Real-life experience demonstrates time and time again that 24 to 48 months are necessary for a mid-sized hospital to go from concept to live operation with any enterprise technology implementation.
One of the top gripes among clinicians regarding healthcare IT is that it is difficult or time consuming to use. Healthcare is playing catch up to technology that already exists in other markets whose IT implementations are mature and fully integrated, meaning that information entered once is immediately electronically available to other respective areas within the enterprise. This is the goal of the next generation of healthcare technology.
Until recently, most healthcare IT systems were purchased a la carte and not as a complete system. In fact, department-level decisions often determined how much technology would be implemented, if at all. For the next generation of healthcare technology, organizations will have to evaluate the legacy systems in their environment and make a choice: Either continue living with stand-alone systems that can never live up to the intention of meaningful use of an electronic medical record (EMR), or choose to implement a fully integrated healthcare-technology system.
Such systems may deliver on the promise of secure EMRs that feed critical patient information to physicians when they need it, and assure accurate and timely billing by deriving charges through the episode of care, instead of piecing it together afterwards. These systems, however, will also require significant adaptation of internal processes and procedures.
This is a critical point, since many have tried to implement EMR solutions without changing much else within their enterprise – work flow, systems or operations. Simply automating old processes is not a strategy for success; without fully integrating an EMR into the enterprise and developing corresponding work flows and operational support, the goal of increased productivity and true ROI from such systems will be difficult to attain.
One of the most significant areas to consider is who will need to be involved and how to staff such an endeavor. One of the biggest project risks that exist within healthcare today is the overuse of internal staff in key project roles without making other adjustments for expertise and/or time-commitment gaps.
An example might be assigning a healthcare information manager to be project leader for 50 percent of the time. In such cases, what ends up happening is that the internal resource either ends up spending 100 percent of the time as a project leader and allows his regular duties to suffer, or decides that the project is not nearly as important as his regular duties and allocates minimal time to the project. The other factor is that internal resources are more likely to seek solutions based on what they know, which is the current operation – not the possibility of what the operation could be.
Staff should be honest in planning and realize that enterprise technology cuts across the entire organization, and that dedicated project staff is required. This is not to say that internal staff cannot be used; however, realize that they will likely need to be dedicated to the project and not forced to arbitrate between the project and their regular duties. Another option is to partner with a vendor or consultant who has no other responsibility but to see through the successful implementation of your project.
Simply automating an existing process does not deliver the intended results of well-integrated technology, where all key operational work flows within an organization are tightly and newly mapped to the system work flows of an implemented technology.
For this reason, organizations should determine how they want to do tasks today and how the new technology allows them to do tasks tomorrow. Focus on operational objectives and understand how technology can deliver within the context of the operational framework without radically altering the technology. Making operational adjustments one time is easier than customizing the technology on an ongoing basis without any operational changes.
About the authors
Derek Woo and Michael Sullivan are managing directors of revenue-cycle services at Sinaiko Healthcare Consulting. For more information on Sinaiko Healthcare Consulting solutions: http://www.sinaikohc.com/
