Rich Temple, CIO & VP, Deborah Heart and Lung Center
IT professionals working in healthcare know the complicated, ever-spiraling challenges they face on a daily basis. While technology is transforming business landscapes across all industries, few if any industries are being impacted as much as the healthcare space. Over the course of the last several years, many new regulations have been promulgated that have fundamentally altered the healthcare IT landscape, bringing very positive disruption (by and large) to an industry that is perceived to have lagged behind others, in terms of its adoption of technology for day-to-day work processes. This disruption has also taken place in an industry that historically invests a much lower percentage of its revenues in information technology, exacerbating the situation.
Over the last several years, both the American Recovery and Reinvestment Act (ARRA) – also known as the Obama Stimulus Package-and the Affordable Care Act (ACA) have driven healthcare providers to invest in new digital electronic medical record technology and to find ways to electronically share medical histories with other providers, subject to increasingly rigorous security regulations powered in large part by the HIPAA security and privacy legislation. “Meaningful Use” legislation, which was a part of the ARRA, specifically spells out quality and technology adoption items that hospitals and physicians have to document their adherence to, in order to receive financial bonuses and avoid financial penalties. More than just embracing technology, these laws also emphasized quality reporting and clinical process transformation to ensure that best practices were adhered to and appropriately documented so that healthcare providers’ relative levels of quality based on many parameters could be easily compared by consumers using on-line tools. Through financial carrots (bonuses) and sticks (penalties), these laws are making healthcare institutions retool the core of their business model to be rewarded for keeping patients well, as opposed to merely treating patients when they are sick.
"Over the course of the last several years, many new regulations have been promulgated that have fundamentally altered the healthcare IT landscape"
Paradoxically, these mandates to share data (known in the industry as “interoperability”) - and the focus on wellness (known in the industry as population health) - are coming down the road at the same time that providers are being buffeted by new security challenges including major breaches of sensitive patient health information and ongoing ransomware attacks, where a bad actor finds a way to install malware on a provider’s network that encrypts system files and precludes them from being used unless the provider pays a ransom to decrypt the critical files. Both aggressively securing data, and easily sharing data, are thus simultaneously top-of-mind for healthcare IT leaders, an interesting situation to be in.
Deborah Heart and Lung Center in Browns Mills, NJ’s nearly 100-year old hospital operation includes an information system environment with a large number of disconnected systems that don’t communicate with one other as well as they should. The organization historically has simultaneously focused on world-class cardiovascular care while maintaining a charitable mission to serve all patients regardless of their ability to pay (the founding motto is there is no price on life). This charitable mission, and its unique philosophy of never balance-billing patients, translates into a need to be extra-judicious with limited financial resources, adding to the challenge of maintaining the latest technology possible.
In order to tackle this overall challenge and ensure that a nearly century-old hospital like Deborah is efficiently poised to meet its IT needs for decades into the future, there is a multi-pronged strategy plan in place. This plan encompasses a number of different critical initiatives, including: Replacing or upgrading the electronic health record (EHR) system for both the inpatient hospital as well as the outpatient clinic with an eye toward having both inpatient and outpatient on a common platform to ensure seamless information sharing across the full spectrum of caregivers who will be interacting with the patient.
In concert with a new EHR system, upgrading or replacing the current imaging platforms for various specialty areas so that they will seamlessly communicate image, report, and patient demographics with both the EHR and with different specialty areas so any physician, at any workstation, can see any image in any place at any time. This will further increase the efficiency and timeliness of care provided at the hospital.
Deploying a state-of-the-art business/clinical intelligence and analytics platform to allow all users to interact with their data in new ways that makes data truly actionable. This program will push key performance indicators based on the job role of the individual through dashboards and allow users to drill down on values they would like to explore further and receive proactive alerts when certain values broach a certain user-determined threshold.
Continuing to stay compliant with new regulations around meaningful use of health information technology, which will allow monitoring adherence to clinical best practices as well as to electronically exchange key clinical data with other healthcare facilities. Investing heavily in new security measures to prevent unauthorized incursions into information systems that could compromise the integrity of patients’ protected health information as well as finding new ways of monitoring compliance internally with measures taken to ensure patient data security and privacy is rigorously upheld in all parts of the organization
Installing a new unified communications system that will allow for easier communication on many levels between clinicians and other key hospital staff. Central to this initiative is deploying a new VoIP-based voice network along with a robust data network that will allow for centralization and real-time monitoring of such functions as nurse call systems, communication of critical test results, referrals, and consultations between providers, and many other things.
If this sounds like a full plate, rest assured that it is indeed just what it sounds like. It is, however, what makes being a healthcare IT leader these days thoroughly fun and stimulating without ever a dull moment.
Courtney Fisher-Lewis, Associate CIO, Saint Luke’s Health System & Ex-Sr. Director, IS Program Management, Children’s Mercy Hospital David Chou, SVP & CIO, Harris Health System & Ex-Chief Information & Digital Officer, Children’s Mercy Hospital