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Healthcare's new smart technology model

With healthcare reform efforts, budget and revenue pressures, and spending on IT typically stalled, mid-sized hospitals in today's economy face significant challenges in implementing the intelligent and integrated solutions that can enhance business efficiencies, professional insight and effectiveness, and patient care. Often, they still rely on paper medical records, x-rays on film, and other procedural and technical processes that can slow responses, inhibit collaboration and drive up costs. In response to this acute condition, mid-sized providers are searching for new ways to manage an uncertain field.

A new IBM study, "Improving Care and the Bottom Line: A Health ICT Strategy to Improve Clinical and Business Performance," is slated to be released in Fall 2010 and suggests a number of smart ways for exploiting information and communication technologies (ICT) to better serve the needs of healthcare organizations by reducing expenses, boosting efficiencies and enhancing quality of care.

"A majority of United States hospitals are in the red, for example," notes the study’s author, Edgar Mounib, Healthcare Industry Champion with the group IBM Market Insights. "More and more, CEOs are pushing to cut back on IT spend and not make these kinds of investments. So CIOs are pressed to make the case for healthcare IT, more than ever before."

The IBM study helps make that case. It projects, for example, that a mid-sized private community hospital with 370 beds can accrue benefits of nearly US$43 million over five years with more holistic IT capabilities. Most important, the study notes that those financial benefits as well as improved business processes and patient benefits come from more than one area.

While there has been a general movement to promote the adoption and use of electronic medical records (EMRs), the IBM study recommends a combination of interconnected, intelligent and instrumented approaches. It's a strategy that not only captures, stores, analyzes and appropriately shares clinical and patient information but also leverages analytics to trigger new business and clinical opportunities, provides patients with actionable information and knowledge, and enables new visibility, insights and decision support capabilities.

And it's a strategy that can show tangible results. Employing electronic medical records, for example, can improve coding for more successful insurance claims. Portals can enhance communication between staff and patients to reduce the time for delivering medications. A health information exchange can cut the number of unnecessary lab tests. Health analytics systems can identify alternative drugs and remind physicians of their availability.

"Our point," explains Mounib, "is that you can make higher value-add IT investments beyond the EMR. We're expanding the vision of and making the case for the IT foundation needed to help thrive—not just survive—and to enable you to deliver comprehensive, coordinated, integrated and personalized care. And we're supporting this with evidence from organizations that are doing this today."

Given the financial constraints on mid-sized hospitals, Mounib recommends the efficient approach that cloud computing provides. "That's a smart solution for a smaller hospital that might not have the staff and other resources needed to begin this transformation."

Real solutions produce real benefits

Instituting a smart technology model and a long-term data strategy amid an industry-wide sea change isn't always easy, and there are many roadblocks on the path to success. Consider legacy IT systems and their lack of interoperability. Notes Mounib, "Hospital departments tend to have their own systems. Oftentimes these systems have been in place for years if not decades, and oftentimes they are proprietary systems that don't talk to other systems."

Hospitals also encounter roadblocks due to cultural resistance to change and a perception among management that new IT solutions will be of limited demonstrable value. Yet the IBM study found quantifiable value to IT solutions—especially to those solutions that build on a medical records program. Providers who implement new IT capabilities are achieving tangible business and clinical benefits. For example:

Electronic medical records help decrease the amount of unnecessary medication and number of tests, accelerate the care process cycle, reduce administrative costs, and improve physician productivity.

Clinician and patient portals can provide greater visibility into patient records, improve collaboration among providers, accommodate increased patient volumes, and reduce coding errors for fewer denied claims.

Health information exchange solutions help reduce duplicate tests and preventable adverse events, enhance referrals and access to records from other institutions, support effective time management, and enable more efficient billing.

Health analytics can support early detection and improved diagnoses, help reduce the cost of patient care, save money on drug costs, and provide greater insight into business performance.

Advanced clinical decision support helps reduce preventable adverse effects and duplicate lab or radiology orders, frees physicians' time for more personalized care, and enables more effective time management with proactive alerts, guidelines and communications.

"Look at this as a real investment that you can measure and quantify to your stakeholders"

Engage all stakeholders, then proceed methodically

How does all this happen? The first step may be to change the organization's view of technology. "Even for the large healthcare providers, IT investments are viewed as a cost of doing business," says Mounib. "But don't look at it like that. Look at this as a real investment that you can measure and communicate to your stakeholders."

Each stakeholder group will have its own needs and each will require specific solutions. But a careful approach to change can put the hospital on track to meeting different business and clinical requirements. "Build a business case for the various stakeholders, particularly clinicians," says Mounib. "Engage your clinicians and other key leaders and stakeholders to determine what your competencies are today and what you need to build or refine as you strive toward this vision."

And ultimately, Mounib cautions against trying to do too much too fast. "Make sure you have the right governance structure in place," he says, "then develop and strengthen your capabilities with a methodical approach. Slow is usually very good. Start with a pilot phase, and use those results to improve the continued rollout—and to share those results with the rest of the organization to get them on board.

* For more information on the study, "Improving Care and the Bottom Line: A Health ICT Strategy to Improve Clinical and Business Performance," contact

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