Improving Health IT

The healthcare industry has been slow in adapting to IT trends that have worked so well for other industries. Take, for example, the computerization of record management, which has been integral for reducing errors and costs in many sectors. The US healthcare system remains almost wholly paper-based, with nine out of 10 doctors and more than two-thirds of hospitals still using paper for patient records. To help address these concerns, 12 cities are set to participate in a $150 million Medicare pilot project offering incentives to those that adopt new practices.

This kind of move is promising for the industry and shows awareness by government agencies and the healthcare institutions about the importance of health IT. Although Nelson is understandably in favor of the use of IT to improve practices, he does not think it should be seen as a silver bullet answer to all healthcare woes. “I would agree in general but as most people in this industry know, IT cannot solve the challenges of quality and efficiency improvement alone,” he says. “It takes the usual three components of people, process and technology to make a material improvement in our industry. There is now more awareness of the potential for technology to contribute to improvements, but there are also large challenges to completing successful projects.”

“If you look out west or overseas to the United Kingdom to some of the publicized major projects, lengthy delays and financial overruns continue to occur, and without clear successes, some organizations hesitate to make further IT investments to provide an electronic medical record, medication administration or computerized physician order entry system. Beyond normal project management, it takes significant resources and focus to demonstrate returns from investments in IT. Regardless if the desired returns are financial or clinical quality improvement, if you cannot provide specific information in a timely manner it may reduce executive buy-in and support for further IT investments.”

“The industry has recognized the potential of IT but translating that into daily delivery of effective IT solutions has been problematic.”

Going without

Wireless local area networks have had a significant impact in hospitals covered by UHS. Such networks have been used in virtually all of their acute care facilities and have enabled clinical staff to document on mobile carts and provide some improvements in clinical care. Despite the benefits of this, there are a few universal challenges. “Ensuring long battery life, minimal downtime for cart repairs, consistently good performance and coverage of the wireless networks are the same at most organizations and we have had to work through those issues as well,” highlights Nelson.

“We have been disappointed in one of our cart vendors and are working to migrate from their product to a different vendor and product. That represents time, effort and money that could have been utilized on other IT improvement activities. We are always looking at technology solutions beyond carts to provide wireless access to clinicians. Some of the tablets and handheld devices are maturing and we will likely want to pilot that technology and see if our adoption and clinical system utilization improves.”

Continuous investment in IT is a priority for the organization, with one of the most recent additions being a physician mobility product from its core clinical system vendor, OPUS Healthcare. Nelson is very pleased with the results so far. “Initially the system would only run on a Windows Mobile device, but we have just received a system update which will enable access from BlackBerry and iPhone devices via a web browser interface. As we test and deploy this capability, physicians will not only be able to view standard orders, results, transcription and vitals, but we will also have the capability to deploy radiology images and EKG strip images. This type of physician orientation to technology will serve the physicians and UHS well over the long run.”

“UHS has also made investments in deploying a one-vendor solution for operating room management, materials management, accounts payable and general ledger. The business/clinical data integration in this area is a must to help manage supply expenses, and we are expecting returns from this investment.”

Looking to adopt

In the future, Nelson advises that those organizations that have not been early adopters of an EMR, Medication Administration or CPOE type system must establish a coherent clinical IS strategy and begin execution over the next couple of years. “These systems will be required to effectively meet the increasing regulatory and quality reporting requirements and physician/patient expectations. There are challenges to being successful in this space and organizations will need to plan for and address major risk points to avoid the pitfalls that even the largest organizations have encountered.”