2013 was another year of overcoming challenges, to say the least, in the Health IT space. So much time, money, and energy has been spent in recent years and months implementing net new functionality and components in organizations that I think we are all seeking an opportunity to ‘take a deep breath.’ While I don’t think that ‘breath’ will come in 2014, I do see a glimmer of hope coming. I don’t know that I would call it a light at the end of the tunnel, because I really don’t believe this tunnel has an end. I do believe that the tunnel will begin to pass through areas that produce better results and feel much more like progress toward the latter part of the coming year. So, in this article, I would like to focus attention on what I believe will be five different shifts of focus that we will begin to see in 2014 as it relates to Heath IT.
Our focus will begin to shift from…
- Compliance to Efficiency – While the mad rush to implement certified EHR’s in a “meaningful way” is far from over, I do see that this will be a turning point year where the focus will shift from implementation and adoption to optimizing systems for efficiency and results. Once organizational leadership has confidence the “boxes have been checked” on compliance they will quickly move to a realization that all of this investment must produce a return. That return must come in the form of improved efficiency, improved market share and improved physician and patient satisfaction/health. While these ideas may sound like pipe dreams today, these are the promises that we all seek (sometimes in spite of the regulatory mandates). The good news is, projects of this nature tend to be a much more rewarding work for us all. This will require us to get back to creating and executing solid IT Strategic Plans that have clearly defined goals and metrics for success that are centered around projects that move our business/organizational priorities forward rather than being focused on externally imposed mandates. I don’t know about you, but I can’t wait for those days to return.
- 100% Focus on Clinical Technology to Returned Attention on Financial Technology – In the past 5 years, we have all been nearly 100% focused on implementing clinical automation to a point where improvements in our financial and revenue cycle systems have taken a complete back seat. I believe we will see that balance begin to tilt back toward the center in 2014. With ICD-10 becoming effective in October and the likelihood of a continued increase in the size of most patient’s deductible and max out of pocket we MUST return some efforts to improving these financial systems in order to optimize revenue and collections. Additionally, we are starting to see the effects of clinical automation rear its head as it relates to how we charge for services. The automation of clinical documentation functions sometimes has an unintended consequence. Often in the rapid pace to get a system migration completed, entire sections of the workflow can be missed, including the process of charging or at least accurate charging for services. These oversights can often go months or more without being noticed because the lines of responsibilities for charge capture and oversight can easily be blurred during a migration. The margins won’t allow us to leave these items undiscovered for very long. A proactive review of charges is something you may want to plan for in 2014, particularly if 2013 was a significant clinical automation year for you.
- Unstructured\Unusable Data to Valuable Information – I believe this is the year where we will begin to see the fruits of our labor as we shift from rapid adoption to seeking a return on our investments. One of the significantly under-developed promises of these systems is the ability to improve our organizations through better information extracted from all of this clinical and financial data. ‘Data Analytics’ or ‘Business Intelligence’ tools are increasingly becoming a competitive conversation for the vendors. This is now seen as a critically important component of a complete system, as it should be. This is our opportunity to demonstrate the power of the investments we have been making. Again, specific projects targeting improved business outcomes through better use of our data will be a way of demonstrating a return on the investment.
- Limited Patient Impact to Patient Engagement - For many organizations, this will be the first year the patient really becomes a central part of the information technology conversation. In all honesty, we have given a great deal of lip-service to being patient-centered in our approach to adoption of EHRs, but how many of us have actually engaged patients in the process of choosing or implementing technology? I suspect that number would be very low. With the patient portal becoming more ubiquitous in order to meet Meaningful Use Stage 2, this opens the door for organizations to begin investing in technologies that truly do connect the provider and patient, the patient and family, the patient and other care providers. This really is a critical early step in a truly patient-centered Electronic Health Record. Those facilities that embrace this effort as a way to better connect with their communities for patient health, I believe, will see this as a way to improve their organizational performance in numerous success categories. As is common for many IT projects, those that do the bare minimum to comply will waste significant money on limited returns.
- Reliable Technology to Robust Technology – This is a subtle difference, but it is an important change for us to make as we think about the systems we put in place to create a culture of continuous improvement. The wiki definition of Robustness is “the ability of a system to resist change without adapting its initial stable configuration.” If you look at this definition from a pure computer science standpoint, it is simply this: “The harder it is to create an error of any type or form that the computer cannot handle safely, the more robust the system is.” We need to be SYSTEMS thinkers in the way we deploy technologies going forward. Our datacenters, our network infrastructure, our methods for dealing with multiple input device types (PC’s, thin clients, tablets, phablets) and software enhancements all need to have a systems approach to minimizing negative end-user and patient impacts caused by user error, systems downtime, software upgrades, etc. Some of these systems are technological, but most are people and process based. For example, what have we done to maintain access to a 24-hour rolling patient summary in the event the software is unavailable? What is our system’s approach to upgrading our technology and testing new enhancements so that the value of the software is optimized without disrupting end-user productivity? These are questions that have answers; but it is important to step away from the constant barrage of new implementation for a bit to shift the focus in this direction or our systems will not be reliable or robust.
Overall, I think 2014 will be another year of much hard work just to complete projects already under way. However, I am optimistic that as we look beyond these projects that our planning for the future will entail much of the above and that’s exciting! At ICE we are always working to create new and better ways to assist our clients in achieving their IT Objectives and we will continue that effort in earnest this coming year. It is our wish for 2014 that you and your organization will have great success!