Managing a Strategic Approach to Health Care IT Quality

Managing a Strategic Approach to Health Care IT Quality

Susan Peiffer, Chair of ASQ's Healthcare Division

Susan Peiffer, Chair of ASQ's Healthcare Division

Ben Franklin once said “When you're finished changing, you're finished” and that’s certainly applicable in the world of healthcare technology where constant change and innovations have led to significantly improved care for patients and invaluable digital tools for providers. These changes have also spurred an opportunity for enormous growth. Recent data indicates that the healthcare IT market in North American is forecast to reach $31.3 billion by 2017, increasing from $21.9 billion in 2012.

That spending has led to innovative developments that are increasingly playing a role in almost all healthcare processes, from patient registration to data monitoring, from lab tests to patient self-care tools. According to a new survey of more than 170

ASQ Health Care quality experts, some of the technologies that are having the most positive impact on patient experience and care coordination include:

• Incorporation of wearable sensors, remote patient monitoring and other caregiver collaboration tools (71 percent)
• Smart phones, tablets and applications providing a wealth of information for physicians and other clinicians (69 percent)
• Online communications along every step of patient process (e.g., website, registration, payment) (69 percent)

New technologies such as smart phones and tablets enable healthcare staff to remotely access the electronic medical records including laboratory and radiology results as soon as they are available for more timely patient care. Home Health nurses use tele-monitoring technology placed in client homes such as scales, blood pressure cuffs, and devices that measure pulse, oxygen levels and blood sugar. Clients can take their own readings while these devices capture the information and promptthem on key questions. The information is sent to the homecare agency via landline or satellite for monitoring. Daily information then prompts nurses to take action for early client intervention.

Overcoming Technology Challenges

But while major progress has been made in integrating technology into various aspects of patient care, particular hurdles are making implementation prohibitive, according to the study. Some of the biggest challenges include:

• Resistance to change from physicians and staff due to perceived impact on time/workflow and unwillingness to learn new skills (70 percent)
• High cost of implementing IT infrastructure and services and unproven return on investment (64 percent)
• Problems with complex new devices, poor interface between multiple technologies and the haphazard introduction of new devices that could cause patient errors (61 percent)

Healthcare staff still often uses dual paper and electronic processes during technology transitions due to these multiple systems. Chance of error increases as memory aids and safety prompts for electronic systems do not exist for the paper processes. There is also constant change after implementation – upgrades, new technology, and regulatory changes, which requires constant learning by the end users. Finally, quantifying ROI for IT is difficult. Because a nurse gets a prompt, or a physician gets an alert, does that increase patient safety or improve patient outcomes? Although alerts assist in these areas, there is a fine line between necessary alerts and alert fatigue. The problem is how to consider the various contributing factors and translate to cost avoidance or reduction.

To fully realize the benefits of technology, healthcare executives must work closely with IT departments to ensure that technology adoption is done strategically and is properly aligned with the organization’s mission and goals. Implementing a strategic technology selection process and evolving the technology support infrastructure are also necessary to achieve the substantial benefits to patient care and economic sustainability.  Two other key areas pointed out by quality experts in the ASQ study include: 

• Designing workflows that improve efficiency and technology adoption (78 percent)
• Nurturing strong organizational leaders who champion health care technology initiatives (71 percent)

To avoid workflow issues, it is crucial to incorporate end users into decisions regarding design and how to best implement IT functionality so that it matches technology to optimal clinician workflow. The more involvement on the front end, the better IT can match the end users’ needs and increase acceptance. Leaders can also help move technology forward by understanding organizations priorities and how IT can support them as well as continuing to support digital education for themselves and their staff.

Dollars and Technology Sense

Many healthcare organizations are grappling with the growing cost of implementing medical technology. That’s why it’s crucial to examine the value of each technology to determine which ones have the potential for reducing the overall cost of medical treatments as well as improving patient outcomes. Quality experts in the ASQ survey ranked the following aspects of health care technology as having the greatest impact on reducing the overall cost to the organization and maximizing the organization's return on investment.

• Remote patient monitoring reducing the need for office visits and improving patient compliance (69 percent)
• Patient engagement platforms that encourage patients to get more involved in the long-term management of their own health conditions (68 percent)
• Electronic medical record/electronic health records that eliminate time-consuming tasks (68 percent)

Technology can also build in billing capture points to help ensure appropriate patient billing and includes features such as safety alerts that can help ensure accuracy and completeness in patient care. This increases safety and decreases chance of errors which helps avoid the cost of poor outcomes.

Ultimately, effectively implementing technology in any healthcare environment will require innovative thinking and approaches. Some quality improvement solutions offered by survey respondents to strengthen the use of technology within health care organizations include:

• Embed a quality expert into every department in order to learn user needs before determining what type of technology is implemented. If users are involved, they are more likely to have a positive view of the change instead of feeling like it's another problem added to their workload.
• Improve available software with easier navigation, more detailed organization of medical record types, more widespread use of file transfer protocol (FTP) servers and the ability to upload records to requesting facilities as well as a universal notification system indicating the status of a medical record.
• Create healthcare apps for the use of professionals, e.g., a medication calculator, implementing clinical pathways on mobile apps that can be easily used by doctors, and medication reconciliation can also be done via technology.

Use voice of the customer techniques to better fit improvement approaches to the stakeholders who are being asked to change.

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