Healthcare Information Management
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  • 1. Healthcare Information Management ISM 520
  • 2. Healthcare Information Management Main Healthcare Concerns: • Quality • Safety Why? Human nature is …. We make mistakes Safety is a primary issue
  • 3. Healthcare Information Management 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
  • 4. Healthcare Information Management How to address these issues: Health care as an integrated system Accepting the change Sustainable for the future Solution (for a greater part) is within IT.
  • 5. Healthcare Information Management 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
  • 6. Healthcare Information Management CAS? (Complex Adaptive Systems)
  • 7. Healthcare Information Management Five negative conditions that need to be eliminated •Preventable errors •Inappropriate Variance •Waste •Delays •Frictions
  • 8. Healthcare Information Management Forces converging Healthcare systems •Demographics •Consumerism •Biological Breakthroughs •Information Technology •Public Mandate
  • 9. Healthcare Information Management Visionary guideline for Healthcare Information Management: 1.Build Healthcare IT architecture around the person 2.Automate the process: eliminate the paper-based record 3.Connect the person – from living room to operating room 4.Structure, store and Study Information: make every event a learnable moment 5.Close the loop: implement evidence-based medicine Goal Regenerate the Trust in a shared care system to eliminate avoidable errors, variance, waste, delays, and friction
  • 10. Healthcare Information Management IT Strategic Planning Process •IT Strategic Planning steps •Constitution of the team •Mission & vision •Operational reality •Strategy for implementation •Quality management •Incentive Alignment
  • 11. Healthcare Information Management 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)
  • 12. Healthcare Information Management IT 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 organization 4.Formulate a strategy 5.Implementation plan
  • 13. Healthcare Information Management IT Strategic Planning Process 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 organization 4. Formulate a strategy 5. 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.
  • 14. Healthcare Information Management IT Strategic Planning Process 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)
  • 15. Healthcare Information Management IT 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
  • 16. Healthcare Information Management IT Strategic Planning Process 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
  • 17. Healthcare Information Management IT Strategic Planning Process Organizational impact assessment: -Work load analysis -Workflow analysis -Affected cross-departmental dependencies -Downstream budget and staff implications -Cultural barriers
  • 18. Healthcare Information Management IT Strategic Planning Process 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
  • 19. Healthcare Information Management IT Strategic Planning Process 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
  • 20. Healthcare Information Management IT Strategic Planning Process 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
  • 21. Healthcare Information Management Managing 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)
  • 22. Healthcare Information Management Role of Ethics in IT Decisions Typical ethical and social issues are: Privacy, confidentiality but Electronic medical records and health information networks poses new issues Such 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
  • 23. Healthcare Information Management Managing the Change Process 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
  • 24. Healthcare Information Management Managing the Change Process 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
  • 25. Q&A