You Can’t Have One Without the Other: Patient Experience and Health Information Technology

HealthLeader’s Media Intelligence last month released its annual hospital survey, Forging Healthcare’s New Financial Foundation. (www.healthleadersmedia.com/intellligence). Overwhelmingly, improving patient experience topped the list where hospitals expect to be increasing their investments within the next three years.

Before I get back on my health IT horse, I’ll list the hospitals’ top three:

1. Patient experience improvements – 62%

2. Data analytics – 54%

3. Electronic health records – 52%

It is noteworthy that health information technology initiatives take the #2 and #3 slots. Makes sense to me. Electronic patient record systems collect and store patient data that provide the stuff of which data analytics is made. What happens to all that analyzed data? When we have good information about the patient in front of us, we can better identify best practices and clinical protocols that deliver the best patient outcomes.

Patients come to the hospital to get better. When the data we collect about the patient  in front of us leads us to treatments proven over time that support that end, patients will have a better experience. Guaranteed.

Next up: We’ll look more closely at the 4th item on the hospitals’ wish list: continuous improvement programs like Lean.

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Change Now or Wait for Natural Evolution?

People are not usually anxious to embrace change, that is, unless the existing situation has become so uncomfortable that they imagine things can only get better.

Healthcare providers who want to adopt electronic health records into paper-based practices are finding themselves in that predicament. Unless things are terribly unworkable right now, staff and physicians might not think that another way of doing business will measurably improve the status quo. Add to that resistance the fact that the change is virtually mandated by the government, will cost money and disrupt workflow, and you can end up with a lot of unhappy campers during an IT implementation. Unless, somehow, the providers and staff believe that electronic patient records will improve the current situation.

Electronic patient records could make patient care better, and done well, will certainly address lots of problems with accuracy, availability and useability of patient information. We all know that is possible.

We also know that in their current form, some electronic patient record systems implementations are falling short of the goals of ease of use, workflow improvement, faster claims submission and fulfillment, more accurate patient data resulting in higher quality care, etc. Studies have even shown that, when fully functional, electronic patient records will save money for the individual providers and the entire system, meaning there should be a trickle-down effect in price containment.

No, we aren’t even close to there yet. But we are getting closer everyday.

The government has implemented mandates, incentives, deadlines and processes to advance the pace of the uptake and interoperability of health IT. The official effort pushed down from the top is a catalyst to advance the process ahead of its natural pace. And that assumes there would be a natural pace of the eventual adoption of electronic patient record systems resulting in a national database of patient information for care and research.

Because information technology and the Internet, in particular, dominate our world, it is more than likely – almost certain – that over time we will achieve full uptake, integration and interoperability of electronic patient records, and all the efficiencies that other industries have already realized. And this would probably happen even without government influence.

Knowing the inevitability of information technology for healthcare, the only question left is whether we push through the change now – at the massive cost and effort involved in the push – or we wait for the natural evolutionary pull to occur. For those who advocate pushing through the change now, we’ll need to prepare the way for a whole group of healthcare workers who might not – yet – be convinced that the current state of affairs is undesirable.

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If Health IT Education and Training is the Answer, What is the Question?

The federal government first firmly insinuated itself into the payment and regulation of modern healthcare in 1965 when it passed the Medicare and Medicaid acts as part of the Great Society programs of the Lyndon B. Johnson administration. From there, people have looked more frequently to Uncle Sam for guidance and reimbursement on healthcare decisions.

In the last year, health reform and electronic medical record requirements for meaningful use have changed the face of healthcare forever. Expect care to be more tightly regulated, more closely scrutinized and probably less generously reimbursed. Of all the changes coming out of DC, providers are most concerned about health care reform. Some want to play the new ball game, some are just confused, some are concerned, and others are angry. With some exceptions, very few are pleased as punch.

In the meantime, analysts from all types of organizations and across the political spectrum are scrutinizing what health reform is going to mean to doctors, patients, hospitals, drug companies, medical device manufacturers, researchers, insurance companies, small employers, large industry, unions, retirees – or, put more succinctly, just about anybody taking a breath. And after all the analysis is in, there still are naysayers on both sides of the political aisle talking about “de-funding” the whole shebang and starting over.

We hear that it is pretty hard to rip up a huge piece of legislation after it has passed through the serpentine legislative process. It is far more than likely that some pieces of health reform, at the very least, are going to be put in place permanently.

I want to be a spoiler in this discussion. Yes, it matters which pieces are adopted, when and to what degree. But because we don’t know, and because it is out of the hands of the average healthcare provider, my fallback position is to control what you can. And the one sure thing that will occur over the next decade, health reform notwithstanding, is that healthcare organizations will adopt information technology with or without encouragement from the feds.

In the long run, technology marches on. Newly minted medical school grads, nursing school grads and people swarming out of medical coding technical schools are living in the age of technology. When they get to work, they will expect to use all the great technology that makes their lives easier everywhere else.

The federal government is just making it easier by putting a mandate on it, setting standards and guidelines for meaningful use, and providing funding to get it moving. Realistically, even with lots of help and money from the government, the process of integrating health IT into the workflow of many environments will present challenges.

A little education and training can go a long way toward helping the integration of health IT move more smoothly, quickly and toward a common goal. Of course, first we need technology that is easy to use for providers, secure for patients and easy to integrate for the IT staff that has to implement it. Education and training are only part of the answer, but they are an important part of the answer.

If education and training are the answer, we need to frame the question.

The question is: how are we going to get tens of millions of healthcare providers all on the same page by 2014?

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Technology for Healthcare Education: Build it and They Will Come, and Keep Coming!

Elearning makes sense economically more than ever today. It is the cheapest way to get a clear, consistent message to the most people in the least amount of time. In healthcare, even moreso. What better way to educate healthcare workers on the use of IT than to use technology to deliver the message?  We’ve been using elearning to train workers across all industries in some skills, particularly manufacturing line workers in processes or transactional workers in soft skills. But just lately this trend is accelerating and spreading beyond the workforce and reaching to the upper echelons of the corporate hierarchy.  

Today, we are using elearning modalities to educate, inform and transform at all levels of the organization – webinars, online courses, videos, e-modules, pdfs, list servs – the list goes on and on and on.  Any type of computer-based learning from your laptop or your smart phone, anything you can grab from the web, download, participate in virtually, log onto or phone into, is elearning. Healthcare workers are being asked to change their work processes to seamlessly incorporate the use of information technology to provide better patient care. It only makes sense that one of the ways to migrate these workers to the effective use of technology is to also educate them using those same modalities.

I wrote an article last year for eLearning Guild’s emagazine Learning Solutions called  “Leveraging the eLearning Advantage in Healthcare.”  At the time, I felt like a voice in the wilderness. Now, I am beginning to see the training market tap into this efficient way to meet an acute need for knowledge transfer and culture change as the healthcare system moves from mom-and-pop doctor offices and prescriptions scribbled on paper pads to fully integrated health systems with patient information online and computer  physician order entry mandatory.

Let the medium be the message.

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