Your grandmother wouldn't have thrown the turkey, sweet potatoes and green bean casserole in the oven at random, hoping they would all end up hot and ready at the same time. Why should your hospital expect the same to work with its IT strategy?
Health care reform has been simmering in the oven for years now, and following last week's election, it's about ready to be served. But experts say it'll be hard for the health care industry to swallow its mandates of population health and value-based reimbursement without a healthy side dish of technology to help coordinate across the continuum of care.
I'm working on a feature story for an upcoming issue of Hospitals & Health Networks that explores hospitals' IT needs under health care reform, and how to develop a technology master plan to meet those needs. I recently discussed the topic with Graham Brown, a vice president with The Camden Group consulting firm, who specializes in clinical integration and health IT strategy.
Brown says it's critical for hospitals to cook up an IT master plan now to prepare for the future of health care. Otherwise, leaders may end up with electronic medical record systems that work fine individually for cardiology, orthopedics, obstetrics and the emergency department, but don't "speak to each other" and help coordinate among all specialties.
"The implication is redundancy, both at a cost from what you're spending on technology itself, but also redundancy in terms of staff effort, duplication of laboratory and radiology and diagnostic procedures, and really a lack of coordination from the patient's perspective on the care that they're receiving," Brown says. "The patient's impact is going to be that they're treated like they're in a silo every time they come in and get care, and the amount of staff effort involved in taking their medical history and understanding their medications and their allergies has to be done every single time."
To achieve the necessary coordination, Brown says hospitals and health systems need to have, among other things, a health information exchange that allows doctors to view clinical results across an entire network, from the ED to the primary care provider. In addition, providers should have a "central data repository" to view a patient's history over years and better understand his or her needs. Risk adjustment and predictive modeling tools are also key ingredients to look at who they're caring for, which patients are the most acute, and which ones are likely to become the most acute down the line.
But how do you know if your IT systems are fine, as is, or whether they're in need of a gut job? Brown recommends taking an inventory of your existing technologies —analyzing the gaps, finding solutions, prioritizing them, picking the most appropriate and strategic, and understanding the costs as well as staff needed to keep the system up and running. And don't just put together your plan and forget about it a year later. Assess and update it annually in terms of capital allocation, staff needs and whether the new IT systems are meeting your original needs.
"Technology costs a lot of money and it takes a long time to implement," he says. "Having a technology master plan is really about laying a course forward to look at what technology you have right now that you can leverage and scale up, and that's useful in a way above and beyond how you're using it now."
For Brown, the key starting point is getting all members of the C-suite on the same page and thinking strategically about the hospital's IT plans.
"The call to action for the CEO — and for the CFO who's going to oversee these investments, the CIO who's going to implement these technologies and the CMO who's going to hopefully guide the quality improvement initiatives across clinical realm — is to be working together," he says. "Organizations that aren't doing that now really should be assessing what actions they need to take to be thinking about preparing themselves for the future."
What about you? Does your hospital have an IT master plan? Did you try to wing it without a strategy and get forced to backtrack? Share your experiences with me at firstname.lastname@example.org, and look out for my story in the February issue of H&HN.