“IT is not a strategy!” Now, with nearly three decades of diverse healthcare technology work under my belt, I had to pause for a moment to reflect on my personal sentiments regarding this statement. Hadn’t I guided providers and vendors alike for years that they needed to focus on information technology strategies? Isn’t IT strategy a primary focus of our federal government with committees, regulations, and publications centered on creating an interoperable healthcare IT roadmap? Didn’t we just fund upwards of $30 billion in incentive payments to encourage the use and adoption of IT through commercially available and government-certified healthcare, tech, technology, HIT, IT Thought Leaderelectronic health records? So, how all of a sudden is IT not a strategy?
One speaker after another at a recently attended accountable care organization (ACO) meeting relegated IT to the proverbial basement that it has historically (and literally) occupied. There was a common theme underlying the emotions expressed by these presenters as they referred to those of us who work in IT as “those IT People.” These presenters echo what we read daily regarding the failed promises of IT and IT People (i.e., technologists, analysts, and consultants) who can’t, won’t, or simply don’t deliver.
Yes, healthcare IT is complex and can’t be easily reduced to full understanding by non-IT persons without some baseline understanding of programming conventions, system architectures, integration standards, software vendor motivations in a competitive marketplace, commercial viability and access, implementation strategies, and long-term support. Yet, it is common in these progressive digital times for everyone to believe they know exactly what a particular IT solution should do for them. And most of the time they are angry and disparaging in their proclamations that if they can order on Amazon, why can’t they do X with their healthcare software? That is a slippery-slope question. My first desire is to be empathetic as I attempt to explain the multiple layers of complexity (that bore even me) present in the current state of our industry and the software products available to us at this time in our history. My second (and more overwhelming) desire is to simply say get over it and focus on what we can do in the moment with what is available.
Quammen Health Care Consultants
Whether your focus is on becoming an ACO, replacing previously implemented EHRs that physicians believe are impeding workflow and patient engagement, competing in your local marketplace, reducing cost, or a myriad of other reasons, mistakes will be made if your next move does not include a well-thought-out strategy with defined and measureable outcomes. Much is written extolling the emerging notion that IT decisions and ownership need to get out of the IT basement and become more integral to departmental functions. It is becoming less and less acceptable for business owners (i.e., department directors, practice managers, clinical leaders) to simply task IT with an initiative and expect it to be delivered. Rather, these business owners must engage, own the outcomes of their requested IT investments, and drive them to strategic value that can be measured.
IT is a unique multifaceted skill set with a unique language and cadence. By definition, everyone in a business can’t be an IT expert, but everyone can become an expert in how IT advances the strategies in their specific domain. True partnerships between business and IT ensure the best thinking of both can be applied to a given situation to produce strategic results.
I think of IT strategy as I would any major strategic infrastructure initiative, from building highways and public transportation, to urban development and community health initiatives (i.e., population health or accountable care). Without the requisite strategic investment of time, money, and planning, these initiatives inevitably face delays, cost overruns, diversion from desired strategy, and oftentimes failure. In my work with multiple EHR deployments across the nation, all driven by the requirement to meet Meaningful Use (MU), I can cite example after example where simply approaching this IT initiative as an organizational strategy had the potential to deliver significantly more benefit than is currently being realized. We had the strategic opportunity to change behavior, drive better clinical outcomes, increase patient safety, provide access to incredible data for regulatory reporting, and yes, even enhance physician workflow and efficiency.
As controversial as it may be in today’s press, I believe that even with the carrot-and-stick mandates of MU, healthcare organizations could have focused on this requirement as an IT strategy capable of changing the way care is delivered. Instead, we have been and continue to be irrationally focused on abolishing MU and replacing EHRs that are believed to be the source of our trouble with hopes that the next one will be better and physicians and clinicians will embrace them in ways they have not done today. If we don’t change our thinking, simply changing our technology will not make things better – but it will, quite likely, contribute to more strategic failures as history repeats itself.
From my perspective, IT is a strategy! There is not a single discussion that can be had in a healthcare setting today that does not include technology. I am a firm believer that administrative leaders, physicians, nurses, and departmental managers are compelled to employ technology as a strategy to navigate the challenging times ahead. There is no other more effective tool available to us as our 17-percent-of-GDP healthcare industry continues to absorb rapid and transformative changes in payment structures, heightened scrutiny on quality outcomes, increased patient engagement, decreased physician satisfaction, security threats, and government involvement. If there was ever a time for IT to be a strategy, I believe it is NOW!
