Healthcare IT News - December 2007 - (Page 9)

www.HealthcareITNews.com December 2007 ■ Healthcare IT News o m m n t r y Global interoperability now within reach By MIchael h. NusBauM, HIMSS Fellow S tandards, standards, standards! at every turn we hear about the virtues of healthcare It standards, and how the entire industry is now mobilizing to create (or harmonize!) standards to fit a multitude of clinical use cases, or to support entire domains (such as medication management, public health, etc). We’ve heard this rhetoric before, and having cried out for true interoperability of healthcare systems for the past several decades, why should we believe our prayers will be answered this time? First, let’s understand the basic problem, and why a solution is so important to our health and wellbeing. Suppose I have recurring headaches, and finally get up the courage to consult my family doctor, who conducts a battery of tests and refers me to a specialist for further treatment. the first thing the specialist will want to do is a battery of tests (many of them the same tests), so why can’t a record of my care at the family doctor be automatically made available to the specialist? and, a couple of weeks after my treatment has begun, I find myself visiting my aunt in Vancouver when suddenly my headaches return and I head for the hospital emergency department only to find… yes, they start again from the beginning and order the same battery of tests!! this care model is time-consuming, costly, most frustrating for the patient and absolutely wasteful of precious medical resources. It could be so dramatically improved through the creation and adoption of health- care It standards globally. We clearly have the technology. We’ve solved this problem in the banking industry with globally-accessible atm machines. So why are we spending decades and billions to address healthcare It interoperability at such a snail’s pace? software applications related to diagnostic imaging. the standards de jour, primarily DIcom and HL7, had so much optionality available as to make interoperability next to impossible. IHe, both a process and a specification, undertook to establish a “standard way to implement standards”, resulting in speci- The STandard anSwer In fact, we have a plethora of standards – indeed, so many standards that our attempts to standardize on the standards has been Michael Nusbaum met with less than stellar results. adding to this dilemma is a marketplace of largely multi-national vendors, who are reluctant to commit to the adoption of standards in one jurisdiction when they don’t apply in another. Frustrated healthcare leaders, demanding a world of peace and interoperability, are constantly being advised that standards “out there” are nIH (“not invented here”), and therefore only local interoperability is available, at best. “The train has certainly left the station, but the journey still remains.” fications so precise that vendors were able to build in components that pretty much allowed “plug and play” in a complex, multivendor implementation. So successful was IHe’s venture into imaging that other “domains” took shape (ie. cardiology, patient care coordination, laboratory, patient care devices), each looking to harmonize the array of standards and their implementation guides into a cohesive set of interoperability specifications. at the same time, the movement became global, with national and regional IHe organizations cropping up in all corners of the planet permitting local implementations to benefit from IHe interoperability through an environment of structured national extensions. of the national coordinator and the newly formed american Healthcare Information community, has launched HItSP and ccHIt, panels targeted respectively at building and certifying national standards. Similar initiatives are in place in canada, australia, the UK and in many other countries around the world, where governments are providing much-needed leadership in establishing and managing national systems of standards and interoperability. But what is truly visionary is how the national initiatives are becoming connected, such that interoperability on a global level is now, amazingly, within reach. are we There yeT? the train has certainly left the station, but the journey still remains. tracks must all be harmonized to the same “gauge”, trestles over chasms must still be built and maintained, and fuelling stations need to be constructed and operated along the way. are we there yet? certainly not! are we actually moving along the rails, absolutely! Let’s ensure that we all support this essential initiative, and contribute our varied expertise in a collaborative and positive fashion. all aboard! More at healthcareITNews.com e connect: NusbauM 1207 LighT aT The end of The TunneL over the past decade, there have been a series of initiatives that are encouraging, and may in fact solve the interoperability problem once and for all. the first is the highly successful IHe (Integrating the Healthcare enterprise) movement. ten years ago, IHe was launched by clinicians and vendors frustrated with the difficulties in integrating ● going gLobaL Wonder of wonders, national standards harmonization initiatives are now well under way. the United States, through HHS’ office Michael Nusbaum has been professionally active in the field of health informatics for 30 years. since 1983, he has been providing healthcare management consulting services in a private practice. Time to move project management beyond spreadsheets By JoaNNe Mccool, Primavera Evolve managers and administrators of healthcare organizations must be able to multi-task and understand how to best leverage the It solutions that help them deal with the numerous challenges they face daily. Financial pressures, combined with the ever increasing number of federal, state and local regulations related to patient care and record management necessitate the use of advanced It solutions. However, choosing the correct solutions and maximizing their contribution to the bottom line are tasks that few do well. those organizations that understand which types of tools work best and how to use them to solve different types of problems will have an advantage over their competitors. today’s It organizations are coming under increased scrutiny to cut costs and deliver value to both the healthcare organization and any affiliated practice groups they may support. tighter budgets and scarce resources force managers and administrators to view all new initiatives and projects within the context of the overall business strategy. the hard reality is that new initiatives that cannot be completed within a set deadline and budget will more than likely hurt the organization’s profitability in the long run. many would be surprised to learn that all too often, projects are managed with post-its, whiteboards, spreadsheets and tables in mS Word. Detailed, up-to-date information which could provide valuable intelligence on which initiatives to undertake, both long and short-term, is often buried in spreadsheets or piles of paper and not readily available. overseeing a vast and diverse workforce presents some of the most significant challenges to managers and administrators of healthcare organizations. Workforce managen order to be successful, i ment issues directly impact the cost and quality of care and evant information in one place, easily accessible and quickall employees must be efficiently and effectively managed, ly transferable to those who need to see it. customizable from physicians and nurses to clerks and janitorial staff, dashboards allow managers to see the big picture, and then since they all influence the level of care and directly impact drill down into those details needed to make key decisions. the use of a dedicated project portfolio management, the efficiency with which the organization runs. as difficult as it is to keep labor costs under control dur- or PPm, application instead of generic software or, worse, ing the daily grind, it is even more challenging to ensure that white boards and sticky notes, can help a great deal with the best people are assigned in sufficient numbers to match a implementing workforce management best practices frequently changing patient roster. also, there are contractual because it can provide access to all the information needed and legally mandated staffing requirements to adhere to that about the hospital’s portfolio of projects, and is updated constantly. moreover, the information is all in one add to the pressure to free up or hire the right people for work on everything from JacHo documentation place and can appear in easy-to-use dashboards to disaster preparedness efforts. that make it possible for executives to see the big In order for hospitals and other healthcare picture and then drill down into the details whenorganizations to provide quality care profitably, ever necessary. although workforce management is one of the managers must build their hiring, training and resource assignment plan around clear strategic most critical issues to managers and administragoals. those goals should emerge from an undertors, PPm solutions can also be used for demand standing of industry trends and of the strengths Joanne McCool management. Viewing the entire roster of projects and weaknesses of their own workforce. a portfoat one time and understanding how they impact lio approach to strategic workforce management is critical. day-to-day operations allows for proper prioritization so technology is essential to effective execution of a port- that overarching financial and clinical goals can be met. folio approach to strategic workforce management. a good an advanced PPm solution leverages It systems currently in project portfolio management solution can establish a clear place to allow executives to constantly link long-term strategy window into all aspects of the demand pipeline and resourc- with the planning and delivery of pro http://www.HealthcareITNews.com http://www.HealthcareITNews.com http://www.healthcareitnews.com/story.cms?id=8223 http://www.HealthcareITNews.com http://www.healthcareitnews.com/story.cms?id=8224 http://www.primavera.com/industry/cs/ http://www.primavera.com/industry/cs/

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Healthcare IT News - December 2007

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