healthcare information management

Healthcare Information Management

ISM 520


Main Healthcare Concerns:• Quality • Safety

Why?Human nature is …. We make mistakes

Safety is a primary issue


Safety vs. Systematic issues: •Fragmentation of care•Escalating cost•Waste of resources •Incoherent incentives•Aging and discontent workforce•Inequalities in access•Lack of investment capital•Lack of preparedness for future


How to address these issues:

Health care as an integrated systemAccepting the change Sustainable for the future

Solution (for a greater part) is within IT.


IT strategies so far:• IT respond to problems• Short sightedness in solutions ill-equipped for the future•Fragmented solution – leading to aggregation rather than mitigating risks.•Lack of sustainability

still IT is the best hope for safety and quality Healthcare systems


CAS? (Complex Adaptive Systems)


Five negative conditions that need to be eliminated

•Preventable errors•Inappropriate Variance•Waste•Delays•Frictions


Forces converging Healthcare systems

•Demographics•Consumerism•Biological Breakthroughs•Information Technology•Public Mandate


Visionary guideline for Healthcare Information Management:1.Build Healthcare IT architecture around the person2.Automate the process: eliminate the paper-based record3.Connect the person – from living room to operating room4.Structure, store and Study Information: make every event a learnable moment5.Close the loop: implement evidence-based medicine

GoalRegenerate the Trust in a shared care system to eliminateavoidable errors, variance, waste, delays, and friction


IT Strategic Planning Process

•IT Strategic Planning steps•Constitution of the team•Mission & vision•Operational reality•Strategy for implementation•Quality management•Incentive Alignment


IT Strategic Planning Process

IT services is an integral part of modern Health Care Organizations

To enhance: Safety and quality

And

To comply with: Legislations (HIIPA)

Healthcare Information ManagementIT Strategic Planning Process

Phases of IT Strategic Planning Process

1.Define the strategic context (IT within the organization)2.Evaluate the current-state (IT)3.Develop a vision (IT) for the organization4.Formulate a strategy5.Implementation plan


1. Define the strategic context (IT within the organization)2. Evaluate the current-state (IT)

At the end of phase 2 : -Clear understanding of business priorities -Current state of effectiveness of IT

3. Develop a vision (IT) for the organization4. Formulate a strategy5. Implementation plan

Last 3 leading to the objective:To develop, through executive consensus, a compelling long-term

vision of a Business Strategy that is IT supporting which can be successfully implemented by (our) Healthcare Organization.


Ingredients for a successful Strategic Planning Team - Representative Microcosm - Multiple levels of Management - External Perspective - Mix of Business leaders and IT champions - Clear charter and executive support

Objective of IT leadership: - maintain trust and interest of the team -strong strategic planning team to validate org. mission and , vision-Define boundaries (guardrails) for the planning process (financial, operational, cultural, executive, technical)

Healthcare Information ManagementIT strategic Planning Process

Evaluating alternatives: holistic approach

- the business value of the alternative (ROI) - potential impact on the organization - technological risk associated with the investment


Main categories of ROI:-Financial ROI-Operational ROI-Clinical quality ROI

Major metrics used in industry to determine the ROI in IT:-Cost saving-Cost avoidance-Improved staff productivity-Clinical quality improvement/medical outcome improvement-Reduced cycle time-Improved process accuracy-Improved customer (patient/physician) satisfaction-Improved employee satisfaction-Improved patient safety


Organizational impact assessment:

-Work load analysis-Workflow analysis-Affected cross-departmental dependencies-Downstream budget and staff implications-Cultural barriers


Technology risk assessment-Infrastructure assessment: availability level of hardware replacement operating systems mgt bandwidth storage and backup disaster readiness and recovery procedures-Application assessment: product life cycle evaluation enterprise application integration strategy user interface design vendor support strategy new systems implementation costs, total cost of ownership-Sourcing assessment: skill-mix analysis development and implementation resources project mgt. capabilities outsourcing analysis


Strategic decision making

Goal: make everyone a winner

Reasons for failure:-Lack of clarity around business strategy-Inability to respect planning guardrails-Overly focused on one IT imitative-Lack of shared understanding as to the role of IT


Roles for the effective change during the stages of planning:

-Health system executives (ELT) -deliver areas of focus, scope, success criteria and nature of IT contribution -Business unit leaders -deliver business value and operational excellence -should own all business initiatives (incl. IT enablers) -deliver detailed project plans

-IT department (CIO + IT department) -delivers reliable technological innovation in support of business performance -support the work of business units (operational & executive) - Own IT reliability and technological performance

Healthcare Information ManagementManaging the Change Process

Traditional change mgt strategies:

• Technical installation model• Systems approach• Gap analysis

More appropriate for today is the five stage model

-Assessment (inform, collect information from participants, focus groups-Feedback options (to make organization learn from the assessment inputs)-Strategy development (develop and effective strategy using the collected inputs)-Implementation-Reassessment (6 months after the new system is installed)

Healthcare Information ManagementRole of Ethics in IT Decisions

Typical ethical and social issues are: Privacy, confidentiality

butElectronic medical records and health information networks poses new issuesSuch as:

-The potential certification and regulation of online healthcare providers across state and national boundaries

-The new developments in bioinformatics, the intersection of clinical informatics and genomics show promise as well as many ethical and social issues


Outline of major ethical issues raised by IT

-E-Healthcare - inaccurate health information - unverified health claims - conflicts of interest - physician-patient relations

-Online health services -virtual house calls -online pharmaceutical products -behavioral health services -Electronic medical records

-Patient safety

-Bioinformatics


Ethical issues to be considered during IT implementation:

-is it ethical to sell or use private patient medical information for commercial purposes such as marketing pharmaceutical products

-how to distinguish between legitimate and illegitimate access to patients’ medical information

-how to safeguard the confidentially of patient data

-when should patients consent required before using medical data for secondary purposes-who would be held accountable for breaches of confidentiality

Bioethics framework (to resolve some of those conflicts)

Medical profession has its own code of ethics that need to be integrated within the IT system

healthcare information management

Technology

healthcare organization

build healthcare

quality healthcare systems

study information

strategic context

planning process financial

quality safety

business strategy