Archive for Essentials

Creativity Required

During the 14 September, 2010 HIT Policy Committee meeting, members raised the issue of quality reporting for different purposes. Much of this focused on the difference between quality measures that are reported to health agencies for purposes of meaningful use or public health, vs. the kind of measures that might be used to analyze the individual organization. While the Committee recognizes that the two can be very different, its work will likely remain tailored, at least in the shorter term, to making recommendations that directly address “meaningful use” of EHR systems as specified in the legislation that created the Committee. » Continue reading “Creativity Required”

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Pay Yourself First

Financial advisors will often tell you to “pay yourself first.” That is, if all of your paycheck goes to pay the bills, you’ll never have any savings or build any long term equity. Set something aside for yourself right off the top; then pay everyone else. The same concept works with data. In the US, the new rules for ‘meaningful use’ of EHRs require physicians and hospitals to report quality data in order to qualify for incentives through Medicare and Medicaid. In a paper-based environment, pulling quality metrics for reporting purposes can be time consuming. In an electronic environment, there will be all kinds of data collected during the course of providing care, and some of it will be used for quality reporting. The bottom line is that in theory at least, technology will make it much easier to collect the kind of data that agencies currently require. If you look at the meaningful requirements as nothing more than a checklist, you may miss a great opportunity to learn something about your organization and the community you serve.

Remember that it is first and foremost, your data. Certain elements must be reported of course, but here is the chance to “pay yourself” by thoughtfully planning how to analyze the data you will be collecting by asking:

  • What are the missing pieces of information about your practice or hospital that would really help improve efficiency, safety, patient satisfaction, etc.? (This is not a question you ask the IT department.)
  • Does the information exist?
  • If it does, who has it? If not, can it be captured?
  • Can the EHR capture the data? Is reprogramming required? (Now you’re talking to the IT department.)
  • How can the data be accessed?
  • How will the data be validated and analyzed?
  • Who should do this?
  • What will be done with what is learned?
  • How have you prepared everyone in the organization to accept the analysis as 1) valid and 2) contributing to the overall success of the mission?
  • What else can be discovered?

Welcome the flood of data; use it to your advantage. While the requirements for meaningful use will be met through federal reporting requirements, your organization will see the immediate benefits of this “self reflection” because you had the foresight to pay yourself first.

-Rod Piechowski

Copyright © 2010, Rod Piechowski, Inc., Consulting

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HIT Essentials for Hospital Boards (and Other Leadership) Part 3

Over the past couple of days I’ve suggested a few essentials that hospital and other healthcare leadership should keep in mind when doing strategic plans that involve technology. The first six again are:

  1. Information technology is a tool, not an end unto itself;
  2. Paper is tangible, electronic records are not;
  3. Information technology is a long-term commitment;
  4. Converting to EHR systems is a baby-step;
  5. Calculating return on investment is hard;
  6. Technology will enable individualized medicine;

Here are two more:

1. Don’t treat HIT as a competitive advantage. It used to be that a hospital that invested in HIT could say it was more advanced, and had access to the latest technologies. Now that every hospital must make the investment, competitive advantage must come from somewhere else. How is the data used? What long-term vision and strategy does the hospital have that HIT can enable? If every hospital has HIT, how will yours differentiate itself in the marketplace? Start planning now.

2. HIT will be the new standard of care. Again, there is no going back. A hospital without HIT will be considered a technological laggard and by extension, a safety and security risk to both patients and to the community. Hospitals that do not employ HIT will be easy targets for lawsuits claiming that they offer a substandard quality of care, which will lead to a downward spiral.

Conclusion

First create a great vision for your hospital. Then ask how IT enables that vision. Secure financing and support senior leadership through the challenging but rewarding times ahead. Most importantly, take ownership of the process, and you will in turn enable your executive leadership to accomplish the mission. Use the eight health information technology essentials to keep you are on the right path. (Link to full article as published here.)

-Rod Piechowski

Copyright © 2010, Rod Piechowski, Inc., Consulting

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HIT Essentials for Hospital Boards (and Other Leadership), Part 2

Information technology should support the healthcare mission, not become the mission, so it is important, especially for the board, to not get dragged into the minutiae. Here are three more essential concepts about information technology in healthcare that should be integral to every hospital board’s leadership toolbox. Understanding these will help position a hospital for successful implementations, and to reap long-term benefits.

1) Converting to EHR systems is a baby-step. This is just an early phase in a much longer process of weaning the healthcare system away from paper and into a world in which the efficiencies of technology can truly enable a reformed healthcare system. Quality reporting, the reduction of administrative burden, the application of standards, more accurate billing, lower prices for coverage and services, computerized decision support, improved home care, and access to better care for all are just some of the goals that depend upon the thoughtful application of information technology. The day each hospital and every physician in the country starts using EHR systems will mark an early milestone in a transformative process that will continue for years. Remember, there is no going back…

2) Calculating Return on Investment (ROI) is hard. Implementing an EHR system is not the same as investing in a new drill press for a machine shop, where the price per widget can be calculated using known formulas and each widget sold contributes to net profit or loss. Furthermore, classic ROI calculations assume a monetary payback for a given investment within a specified number of years. The kind of savings EHR systems bring to a hospital may not be apparent for a while. They may involve improvements in safety and efficiency that are more difficult to measure, or that may pay off in intangible ways such as greater patient satisfaction. From a safety standpoint, the return must be measured in terms of “mistakes not made.” Just to complicate this a bit, consider the drive away from task-based pricing and it gets harder still.

3) Technology will enable individualized medicine. Thanks to what we will learn from research done on anonymized data from populations and their subsets, physicians will be able to target care plans specific to the way an individual reacts to certain classes of drugs or other treatments. Information about what works and what doesn’t work will be more readily available to physicians, providing huge value to both individuals and communities. Hospitals will have first access to this information, and the best ones will use it to assess their performance and perform research with an immediate benefit to both the business and the community. (Link to Part 3 here.)

-Rod Piechowski

Copyright © 2010, Rod Piechowski, Inc., Consulting

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