The document discusses several key issues facing healthcare systems and how information technology can help address them. It identifies quality, safety, rising costs, and workforce issues as primary concerns. IT is presented as a way to help integrate care delivery, automate records, connect different parts of the system, implement evidence-based practices, and close information loops. However, past IT strategies are criticized for being fragmented and short-sighted. The document calls for developing long-term strategic IT plans that treat healthcare as an adaptive system and focus on priorities like eliminating errors, waste, and delays.

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