The federal government is offering bonus money to hospitals for meaningful use of healthcare IT, even as it terms 2012 the year of meaningful use. To spur developers to come up with better tools to track patients after discharge, the Office of the National Coordinator for Health IT has launched a challenge to create a Web-based application that could empower patients and caregivers to better navigate and manage a transition from a hospital.
Incentives like this are easy money, but they really shouldn't be necessary. Technology is the only means by which healthcare systems can make it out of their current impasse.
Last week, at one of our Roundtable events—HealthLeaders Media's gatherings of small groups of hospital executives to discuss topics of top concern—Dave Brooks, CEO of Providence Health and Services' Northwest Washington Region in Everett WA, said his system will need to cut costs by 10–15% over the next few years, beyond its already efficient operations.
We hear targets of this magnitude repeatedly from healthcare CEOs and CFOs. That's a huge gap from current practice, in an environment of already-strained balance sheets at many organizations.
Brooks, an experienced executive who has worked at multiple healthcare systems, is experimenting with several ways of controlling costs: improving primary care access, meting out specialty care, and finding a better way to deal with patients who return again and again for expensive ER treatment for chronic conditions.
Case management for such "frequent flyers" offers a remarkable opportunity for savings. Better care for diabetes patients alone can easily cut costs by 4%, according to another of our Roundtable participants, Dr. Edward Jeffries, CMO of Baton Rouge (LA) General Physicians. It's notable that all these moves would improve patient health as well as save money.
Underpinning these necessary changes is technology. Electronic medical records that are accurate, portable, and based on real-time data are a precondition for identifying frequent flyers and improving their care. Clinical informatics, along with nurse informatics and pharmacy informatics, is a key to preventing readmissions. Data analytics offers a way to flag problems before they slam your bottom line.
Like many of their colleagues, Brooks and Jeffries laud the patient-centered medical home model as a means of cutting costs while improving care quality. Although PCMH is much more than an IT project, it requires a substantial IT investment to become reality.
At one of our recent Rounds events, which are executive discussions hosted by a healthcare system and simulcast to a wide audience, C.R. Burke, president and CEO of St. Joseph Heritage Healthcare, listed five elements of the medical home's IT infrastructure: EMR/EHR, patient health records, shared case management, physician utilization, and risk stratification/predictive modeling. All of these must work in concert.
There is, of course, a catch in this happy scenario. Along with technology solutions come technology problems. Although healthcare IT is hardly in its infancy, many other industries are farther along the curve of IT adoption. Executives in financial services, manufacturing, retail, and other IT-intensive industries have learned some hard lessons:
- No IT system ever works as seamlessly as promised. That smooth demo you saw applies to ideal conditions, never to you. Siloed systems that can't communicate with one another, dirty data problems, and stupid user tricks aren't just the stuff of Dilbert cartoons.
- No IT department can do all the work; users have to meet them halfway. Complicating matters is that for healthcare, the users include hospital executives and administrators, physicians and nurses, and patients and their families—parties that have different needs and points of view.
- IT systems cost a lot, but IT consultants often cost more. Yet without consultants who can get into the details of linking disparate data systems in ways that different departments and functions can use, your expensive new system will become shelfware.
In short, IT's role in healthcare will continue to rise, but so will IT's prominence in your role—no matter what your title.
Edward Prewitt is the Editorial Director of HealthLeaders Media.
