Leading the Way to Improved Healthcare IT Quality

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The digital future is coming. Are you ready?

Getting healthcare technology “right” is challenging but crucial. We’ve come a long way in the past several decades in incorporating new technologies that have significantly improved care for patients and become invaluable tools for providers. The fields of biomedical and health informatics have been created to support these efforts and, without doubt, it’s a growing market. Recent data indicates that the healthcare information technology (IT) market in North America is forecasted to reach $31.3 billion by 2017, increasing from $21.9 billion in 2012.

That spending has led to innovative developments that are increasingly playing a role in almost all healthcare processes, from patient registration to data monitoring, from lab tests to patient self-care tools. According to a new American Society of Quality (ASQ) survey1 of more than 170 healthcare quality experts, some of the technologies that are having the most positive impact on patient experience and care coordination include:

  • Incorporation of wearable sensors, remote patient monitoring and other caregiver collaboration tools (71%)
  • Smart phones, tablets and applications providing a wealth of information for physicians and other clinicians (69%)
  • Online communications along every step of patient process (e.g., website, registration, payment) (69%)

These technologies are impacting healthcare organizations in a variety of ways. Providers are now able to use smart phones and tablets to remotely access electronic medical records including laboratory and radiology results as soon as they are available for more timely patient care. Emergency medical service personnel are also transmitting EKG information on chest pain patients en route to the hospital so emergency medicine providers can view and make care decisions for these patients prior to arrival. This speeds up processes for immediate care, such as time to cardiac catherization.

Because of their impact on patient care, the deployment of any new healthcare technology can easily impact a wide variety of clinical, support and business operations. And while major progress has been made in integrating technology into all of these areas, particular hurdles are making implementation prohibitive, according to the ASQ study. 1 One of the biggest issues is resistance to change from physicians and staff due to perceived impact on time/workflow, and unwillingness to learn new skills (70%); followed closely by the high cost of implementing IT infrastructure and services, and unproven return on investment (64%); and problems with complex new devices, poor interface between multiple technologies, and the haphazard introduction of new devices that could cause patient errors (61%).

Because of all of the systems and interfaces, often healthcare personnel use dual processes during IT transitions: paper and electronic. Memory aids and safety prompts for electronic systems do not exist for the paper processes, increasing chance of error. And after implementation, there is constant change — upgrades, new technology and regulatory changes — that requires constant learning by the end users. Finally, quantifying return on investment for IT is difficult. If a nurse gets a prompt or a physician gets an alert, does that increase patient safety or improve patient outcomes? Although alerts assist in these areas, there is a fine line between necessary alerts and alert fatigue. The problem is how to consider the various contributing factors and translate them to cost avoidance or reduction.

To fully realize the benefits of technology, healthcare administrators must work closely with their IT departments to ensure that technology adoption is done strategically and is properly aligned with the organization’s mission and goals. Implementing a strategic technology selection process and evolving the technology support infrastructure are also necessary to achieve the substantial benefits to patient care and economic sustainability. Two other key areas pointed out by quality experts in the ASQ study include:

  • Designing workflows that improve efficiency and technology adoption (78%)
  • Nurturing strong organizational leaders who champion healthcare technology initiatives (71%)

Managing Workflow

Introduction of health IT can be very disruptive to existing workflows in an organization. Health IT systems often implicitly assume a workflow structure in the way their screens and steps are organized. Important information can be lost when communication and coordination is impeded by poor workflow that allows unnecessary repetition, delays, workarounds or gaps where key steps might be omitted.

To avoid these issues, it is crucial to incorporate end users into decisions regarding design and how to best implement IT functionality so that it matches technology to optimal clinician workflow. The more involvement on the front end, the better IT can match the end users’ needs and increase acceptance. If solutions are put in place without end user buy-in, they may not meet user needs, and add the potential risk that users will create work-arounds, decreasing process efficiency.

21st Century Leadership

The old ways of doing business simply won’t work in the future of healthcare, and boards and leaders need to be prepared to find people with cross-functional skills and who have digital experience or the mindset to learn these new skills. Leaders can move healthcare technology forward by:

Understanding priorities and staying organized — Overseeing use of information data systems, computer programs and high-tech equipment requires extensive organizational habits and ruthless prioritization.

Continuing their education — Professionals never stop learning, and a voracious appetite for information and research on current healthcare technology options will keep an administrator relevant to the industry.

Improving themselves and their staff consistently — Leaders should continuously push for improved use of technologies on all fronts, and strive to use technology when it’s been proven to provide higher-quality patient care. Implementing and working to accomplish set goals can increase team collaboration and build relationships.

Examining Technology Return on Investment

In a financially stretched healthcare market, medical technology might be seen as a luxury by some, and certainly, many organizations are grappling with the growing cost of implementation. However, one must carefully examine the value of each technology, because using the right one has the potential for reducing the overall cost of medical treatments as well as improving patient outcomes. Quality experts in the ASQ survey1 ranked the following aspects of healthcare technology as having the greatest impact on reducing the overall cost to the organization and maximizing the organization’s return on investment:

  • Remote patient monitoring, reducing the need for office visits and improving patient compliance (69%)
  • Patient engagement platforms that encourage patients to get more involved in the long-term management of their own health conditions (68%)
  • Electronic medical record/electronic health records that eliminate time-consuming tasks (68%)

IT features such as safety alerts and best practice advisories can also help ensure accuracy and completeness in patient care — increasing safety and decreasing chance of errors helps avoid costs of poor outcomes. Technology can also build in billing capture points to help ensure appropriate patient billing.

In the end, effectively implementing technology in any healthcare environment will require innovative thinking and approaches. Some quality improvement solutions offered by survey respondents to strengthen the use of technology within healthcare organizations to consider:

  • Embed a quality expert into every department to learn user needs before determining what type of technology to implement. If users are involved, they are more likely to have a positive view of the change instead of feeling like it’s another problem added to their workload.
  • Improve available software with easier navigation, more detailed organization of medical record types, more widespread use of file transfer protocol servers, and the ability to upload records to requesting facilities, as well as a universal notification system indicating the status of a medical record.
  • Create healthcare apps for the use of professionals, e.g., a medication calculator, implementing clinical pathways on mobile apps that can be easily used by doctors, and medication reconciliation that can also be done via technology.
  • Use “voice of the customer” techniques to better fit improvement approaches to the stakeholders who are being asked to change.
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About Author

Susan Peiffer

Peiffer is chair of ASQ’s Healthcare Division and performance improvement specialist at Hospital Sisters Health System Western Wisconsin Division.

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