Healthcare IT News - November 2007 - (Page 13) www.HealthcareITNews.com November 2007 ■ Healthcare IT News 13 By Barry P. ChaIken, MD, BearingPoint, Inc. aybe Michael Moore o m m n t r y and costs savings did not appear. as frustrating as this period was, companies that continued to invest in It slowly began to experience the jumps in productivity and profit that were long expected. each organization reached a tipping point where processes and workflow evolved to take advantage of the new It tools to deliver unprecedented results. to look at the benefit of It on these companies in isolation is to miss the true lesson to be gained from their experiences. early on, the deployment of It was viewed as the solution. only after companies recognized it to be just a tool, did they formulate the real solutions based upon revised processes and workflow that provided much of the benefits. this is what our healthcare industry must do today. For information technology to play a valuable role in reducing healthcare costs while enhancing quality of care, it must be deployed in a revolutionary way that completely reinvents how care is delivered, professionals provide the care, and technology is leveraged throughout care delivery. Without such a revolution, the billions of dollars currently being spent on healthcare It will sadly be wasted. ■ More at healthcareITnews.com e Connect:e CHaikeN 1107 in his film SicKo overstates the case, but we are receiving rather poor value from the close to 17 percent of GDP we spend on healthcare. Unless we fundamentally change the roles of physicians, nurses and other healthcare professionals in the delivery of care and aggressively embrace health information technology, the United States will continue to rank at the bottom of developed countries on every meaningful metric used to measure access to quality healthcare. revolution is defined as a “drastic and farreaching change in ways of thinking and behaving,” our healthcare system requires a health information technology revolution, a drastic change in the way we deliver care by utilizing It in new and innovative ways. Deploying It, to replicate the processes and workflows that currently deliver our poor results on so many measures, only guarantees continued suboptimal and unacceptable outcomes. Healthcare in desperate need of it revolution M Inherent in revolutionary It is the need for change; change in what professionals do and how they do it. therefore, effective change management techniques must be utilized to facilitate the acceptance of the new processes and workflows, in addition to any new responsibilities and duties. clinical decision support at the point of care plays a significant role in revolutionary healthcare It. through such tools, best practices, those that we know from scientific evidence offer the highest Barry P. Chaiken, MD probability to produce the best healthcare outcome, can be delivered to each patient by healthcare professionals educated, guided, and “double-checked” by the It tool. what physicians, nurses and other healthcare professionals do. Physician activities become more challenging on a cognitive level as other routine tasks such as drug dose recall, use of best practice order sets, and drug-allergy checking become automated. Physician “deploying it, to replicate the processes and workflows that currently deliver our poor results on so many measures, only GuaRantees continued suboptimal and unacceptable outcomes.” expertise is assigned to more important tasks including solving difficult diagnostic problems, devising customized patient treatment plans, and influencing patient adherence to chronic disease care regimens. Work for nurses and other healthcare professionals changes dramatically too. more tasks, formerly done by physicians or healthcare specialists, are completed by these professionals guided by intelligent processes and workflows that include meaningful It. revolutionary healthcare It provides all clinicians with more meaningful and skillappropriate tasks. In addition, patients receive more consistent and higher quality care laced with fewer medical errors. unReliable deliveRy systeM currently patient delivery relies upon an unreliable system formed from poorly integrated and highly variable human parts. revolutionary healthcare It solutions provide needed support tools that increase the reliability of the human components, while integrating these components through effective processes and efficient workflows. In addition, as best practices change, they can efficiently be delivered through the existing workflow by simply changing the knowledge contained in the clinical decision support tool. In the current state without revolutionary It, changing practice patterns requires the inefficient, and often ineffective, method of targeted medical education. revolutionary It fundamentally changes Focus oF RevolutionaRy it revolutionary healthcare It requires a focus on three key areas: 1) information technology tools, 2) processes and workflows, and 3) healthcare provider tasks, duties and responsibilities. Solutions come from an in-depth understanding of tools, and creative thinking around what each healthcare professional can do and how best to deploy the individual skill. Valued solutions offer these professionals healthcare It tools that leverage their unique skills, while organizing the processes and workflows to deliver a consistently high quality, safe and efficient healthcare outcome. ● Roi RequiRes patience For those who are squirming to see return on investment, it is important to be patient. across many other industries that deployed It, a lag period occurred where the quality Barry P. Chaiken, MD, MPh, associate chief medical officer, BearingPoint, Inc. has more than 20 years experience in medical research, patient safety and risk management. Chaiken is board certified in General Preventive Medicine and Public health as well as health Care Quality Management. Chaiken is a board member and a Fellow of the health Information Management and Systems Society (hIMSS). Consumerization key to telemedicine’s full potential By PeTer haIGh, HIMSS Fellow promise for almost a quarter century, but with a few notable exceptions like the arizona telemedicine network and the U.S. military it is still restricted to small scale, grant supported implementation. What’s wrong with this element of the U.S. healthcare system? Is there a novel way to fix it? the answer came to me in an epiphany, as I was listening to yet another speaker describing the rather miniscule scope of their telemedicine program. telemedicine must be “consumerized”. the problem today is that the way telemedicine runs is positively un-american. Let me explain. america stands for free markets where consumers, whether individuals or enterprises, choose the products and services based on a value proposition they understand and control. yes americans understand how to buy “consumer goods”, and corporate america knows how to sell them. So why aren’t healthcare services like telemedicine treated like consumer goods? Perhaps it’s this. current providers of telemedicine services are on the educational, healthcareand military fringes of the american economy. Suppliers of telemedicine technology focus their attention on these customers. their solutions are expensive because volumes are low and the technology is proprietary. no one is targeting them to a mass market, yet there surely is one. eleMedicine has shown enorMous t plans to establish very large numbers of clinics that will compete with conventional healthcare establishments. Is this the answer? I don’t think so. all this will do is create competition for the same kind of healthcare service that’s already available. What’s needed is recognition of the huge potential demand for healthcare services delivered via telemedicine, represented by the huge numbers of the frail elderly and the chronically ill. new deFinition so, what’s the answeR? What’s to be done? Wal-mart and others have announced another important step that will help move telemedicine into the mainstream is to give it a new definition. the american telemedicine association does a wonderful job of showcasing telemedicine, but attendance at their meetings is less than 10 percent of attendance at HImSS. bRilliant application the broader definition I’m proposing would help Peter Haigh they cannot only be reached, they have the capaplace telemedicine front and center at HImSS, bility to take action if and when that’s needed. where it now receives almost no coverage. Here’s the one of m3’s most exciting dimensions is that through a definition I propose. telemedicine is “any healthcare truly brilliantly conceived application called the Patient Health monitor, users actually receive alerts and treatment application that’s enhanced by a “tele” component. What will this really mean? It will emphasize what recommendations. “I have a dream ” that someday every Hc professional will “tele” professionals already know, that all of the products and services involved with a healthcare entity’s network be equipped with a device like this. I certainly want this for are vitally important. It will enable the visibility of new everyone who treats me! remote Physiological monitoring is one of the tele-capabilities like cellular data and the remote and mobile applications that are now possible. most promising solutions to emerge in telemedicine, Let me conclude with two real-life examples that providing an effective means for controlling patients illustrate the potential telemedicine market I visual- suffering from a chronic condition such as diabetes, haIGh see page 44 ize. Healthcare diagnosis and delivery are plagued by huge problems in “coordination of care” because all of the professional and medical services involved may be widely scattered within or outside a provider entity’s facilities. new york Presbyterian has been experimenting for almost three years with a solution dubbed m3, a multinetworked, http://www.HealthcareITNews.com http://www.HealthcareITNews.com http://www.healthcareitnews.com/story.cms?id=8033
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