Technology in Healthcare

Key Thoughts:

Each budget cycle, we struggle to produce a reasonable budget by maintaining or reducing total FTEs, reigning in other expenses, (optimistically) projecting market share growth, approving a handful of new business initiatives and, not infrequently, negotiating the negotiating the margin target downward.

Each year it gets more challenging to find new, material expense reduction or revenue generation opportunities.Short of dramatically altering service to the community and, thus, your organization's commitment to the community, what else is available to address the complex business challenges we continually face?

The current revenue and expense environment makes every miss tougher to accommodate, making the organization's ability to fulfill its challenges more difficult.

EMR - if we ask why invest in EMR, you will get a reflexive response citing the imperative to improve safety, enhance quality and lower costs. If we ask what was the decision making process used to allocate significant capital toward an EMR, or ask about its return on investment or specific improvements in patient safety and quality metrics the EMR has produced a couple of years down the road, or what organizational performance dashboard has changed and by how much due to their EMR implementation, the frequent response is an awkward silence - a scary reaction about an investment hat costs tens of millions of dollars and untold millions in consulting expenses and staff time to implement and support.

Traditionally, organizations has sorted technology needs based on cost and perceived priority. They also continued to invest in new technologies without a more comprehensive understanding of their hard and soft yields and their relative ability to accomplish the organization's goals - a key miss when the available resource pool with which to invest in any technology is increasingly challenging to fund.

What we need is an awareness of how to leverage technology to solve our more vexing business problems, a systematic thinking about how a given technology can be creatively and strategically harnessed as a tool to support a process and facilitate fundamental operational or organizational improvement. Which purchase, for example, will help improve market share and by how much? And, why is it superior to the other capital budget requests vying for funding?

Summary - a organized, thoughtful approach in harnessing technology for healthcare delivery:

1. A strategic focus for technology review

What is it that you want technology to accomplish our mission and strategic plan?

2. A framework for assessing a technology's value to the organization

An organized method to evaluate any given technology's potential to solve business issues that extend beyond readily available information about what the technology promises to do.

3. Knowledge of technology trends

4. Tools for finding and staging high-value technologies

Summary - emerging technologies that solves operation problems

Ergonomics - patient mobility devices such as lean-stand assisted lifts, sit-stand wheelchairs, lateral transfer devices, gait belts and repositioning devices, holds great potential to decrease workplace-related injury and disability, reduce costs and help ensure a healthier work force that can remain working

Wireless communication - consolidation of multiple platforms - electronic whiteboards allowing real-time tracking of patients, lab and ancillary results, room status, equipment status and triage state, RFID which tracks and records patient, equipment and staff movement throughout the facility

RTLS (real-time location system) - reduces hunting time for supplies, staff and patients

Point-of-care testing - moves testing to bedside, offering faster test results with fewer transportation-related errors. The ability to obtain quicker test results can increase efficiency and lead to shorter hospital stays and reduced complications

Modeling and simulation - used for training and credentialing, and facilities design

Remote patient management - increase the coverage of scarce specialists clinicians eg telemetry ICU. increasing life expectancy and the rise in chronic disease are driving development of new technologies such as sensors for independent living; remote disease monitoring of asthma, diabetes and congestive heart failure; remote device monitoring for cardiac implants and artificial joints; video-based care for stroke, psychiatric and dermatology patients, cell phone platforms for management, monitoring and testing; and TV, PC and robotic platforms for communication, education and information.

My Comments:

Technology plays a key role in improving healthcare delivery across the board. 'Innovation and care system transformation through technology are inevitable...Making this transition will require a willing ness to replace the standard practice of viewing technology as a capital budgeting decision with a a systematic, comprehensive approach for evaluating technology and its potential to address vexing business challenges and be innovatively leveraged in the service of mission and margin.

Reference: Technology in healthcare: leveraging new innovations by Marc G. Larsen FACHE, Healthcare Executive SEPT/OCT 2008, pg 9-14.