Week 7

Health IT strategy is something that seems standard regardless of the organization discussed in our MHA program.  However, IT strategy is very different across organizations and varies much even within an organization.  For instance, the radiology department's work and platforms used is much different and influences the workflow of other departments within an organization.  With a 3-5 year strategy plan to implement new systems, many assume technology is a magical tool that resolves even the culture of an organization.  It may definitely influence a culture of an organization, but likely in a negative way when not properly balanced with meaningful change management.

A challenge I foresee for many organizations with the growth of health IT is variation.  One of the issues from variation that comes up is the lack of interoperability.  Even though many organizations are contracted with the same vendors such as EPIC and Cerner, each organization customizes everything even down to how the data is being collected.  This poses an enormous obstacle in streamlining what is necessary and valuable data and what is considered junk down the line.  This leads to another challenge with variation, the difficulty in addressing population health.  With data being collected so differently between organizations, it's hard for those who do want to address population health to even get the definition aligned as everyone has very different definitions to what to address.

I honestly take these challenges as a good thing in terms of my career in health care.  I don't think I'll ever be out of a job and because the obstacles health faces not only on the delivery side, but other aspects such as the payer, vendors, etc. I am encouraged that I will always find something that is of interest.

Week 7

Week 7- 

This week the subject of data sharing was discussed.  Data sharing can offer new ways of delivering care by allowing patient's information to follow them from one organization to another.  It allows care providers to see a full view of a patient's history without the patient having to request their chart. Perceptions must be challenged that patient data is proprietary.  Organizations should change their view regarding sharing patient data to how the data and data sharing can best benefit their patients. According to an article from The Network for Public Health Law, patient data sharing adds many benefits to patients, health care workers and public health officials, including: Earlier detection of infectious disease outbreaks, improved tracking of patients’ chronic disease management, improved coordination of care across public and private providers, reduction of adverse health care events and more accurate assessments of the amount of disease in the community and of the impact of community-wide prevention initiatives.

Week 7

By: Connor Ledbetter

 The topic for health informatics this week pertained to information exchanges and the need for the seamless flow of data from one provider or location to another, especially amongst those within the same health system.  I am not a techy (I've never even had a twitter account) nor do I claim to be, and for that reason I cannot speak to the specifics of data exchanges, or the technical difficulties that may arise. It is with that in mind, that I will reflect upon the conversation this week from a non-technical approach and some of my views as to why the need for data exchange has arisen.

First of all, I believe that the need for the smooth sharing of information from one organization to another has arisen the shift to a more consumer focus in the healthcare industry. As healthcare increasingly focuses on patients as consumers, we continue to identify pain points (no pun intended) for patients in the process of healthcare delivery and alleviate those pains. Patients being required to fill out the same paper work at every visit, or every time that they walk into a healthcare facility is one of those pain points. To make matters worse, patients often compare the healthcare industry to other industries that are far more advanced in capturing information and relaying throughout their organization to the point of completely understanding customers preferences and expectations.
Additionally, I believe the issue has arisen internally within the healthcare industry as of late due to the meaningful use funds that many healthcare organizations received through the American Recovery and Reinvestment Act. Up to that point some organizations had EMRs but many still operated with paper forms. However, through meaningful use funds, many organizations made the shift to electronics health records and for the first time, it became possible to share information from one organization to the next electronically.

I believe the need for increased retention and sharing of data through exchanges in the healthcare sector is not going away. This is something that consumers will increasingly call for and organizations will move to address.

Week 7

Strategy was our topic for the week.  Dave kept stressing to us that health IT strategy is probably the most complicated chapter in the textbook we are using.  I found this an interesting comment to make, but can certainly appreciate it.  IT strategy for a healthcare organization must be aligned with the strategic plan and the overarching goals of the organization.  In today's healthcare environment, successfully setting and implementing IT strategy is complicated because IT must support the human resources and clinical/non-clinical workflows, IT/IS investments are expensive, IT requires significant ongoing labor costs, technology continues to change year after year, and the business and technology models of the organization must be aligned.  In many situations, adding technology to a broken or bad process will only highlight and exacerbate the problems that exist, so it is important to define the function before one attempts to define or add on to the form.

I enjoyed the class activity, in which Larry and Sarah must make a decision about dealing with the requests from Placebo Domingo and Anne Nemia about replacing the old IV pumps with smart IV pumps.  Our groups talked about how senior leadership must stress the importance of thinking about strategy holistically from a higher level.  Strategic development is about setting the true north of the organization and the strategic goals to bring the organization closer to its vision.  It is important for us to think about the need for senior leadership to balance between different needs and priorities with a set budget.  Unfortunately, I'm not sure there's always a right answer?

Finally, I just want to add that I really appreciate the quote Dave shared with us on the Canvas module.  It definitely captures the essence of what strategy is at its core.  Additionally, the quote also helps us understand why having good strategy is important for an organization.

"Tactics is knowing what to do when there is something to do.
Strategy is knowing what to do when there is nothing to do."- Ksawery Tartakower

Week 7

     Working this summer on all of the clinical data registries throughout UW Medical Center gave me an appreciation for just how much data is out there and gets sent around to a variety of organizations.  However, I'd like to start with addressing the information at the beginning of the case study pertaining to filling out forms.  Before my current position I worked the front desk at an Urgent Care clinic and was responsible for collecting paperwork from individuals.  Over the course of the time I worked there we shifted from a "need to have a form filled out once a year" to "need to have a form filled out once period".  This shift prevented me from having a lot of extra stress in my job.  The argument that we need to ensure that none of your information has changed is valid but extremely frustrating for someone who has lived in the same house with the same phone number for 20 years.  The biggest problem for most of these situations is legal compliance.  Sometimes people would go to the Emergency Room and follow up with us 3 days later and have to fill out a new form because our physicians work under a different medical group and therefore need a different signature for liability protection.  It is incredible frustrating for patients to have separate billing and separate registration systems for different locations within the same organization.  Luckily, we at least had the information from visits in both places which saves trouble.
     In terms of the need for data in various locations there are less complications but still several.  The biggest problem is the lack of centralized oversight.  It might be that one department is collecting certain types of information for one registry while another is collecting the same information to send off to the DOH and neither has any idea the other one is doing it.  At least with demographic information filling out forms the patient is aware and complaints can be heard and addressed.  When it comes to things like registry data the only way to find out about the overlap is to have the two people abstracting the data to happen to talk to each other which is very unlikely.  These kinds of hidden wastes are rampant in larger systems.  We finally formed a sub-committee to look at registry participation and figure out who is collecting what data and sending it where to cut out a lot of dead weight.

Week 7

By Lili Hozakowska:

Because of last week’s detour we’ve gotten a bit behind in our class, meaning we were only able to discuss HIT strategic planning today. While I related HIT strategic planning to last week’s post-election discussion in my last reflection, this time I wanted to focus a little more on the lessons learned from the case study. During the presentations today, team Mason showed an IBM advertisement for a new health IT system. It looked like a great product! However, our class began questioning its validity just as we have been taught to do since the first day of this MHA program. How were we supposed to know if it was working accurately?

We began discussing the case study with our teams while still in this skeptic mindset. How necessary are these smart pumps? Did they truly work only half the time, or was that an exaggeration? Why do they need to come out of the IT budget? Before making any decision, it’s important that all of these questions are considered so that we are armed with all necessary information. However, we should always keep the bigger picture in mind as well. If these smart pumps are taken out of the IT budget, then we won’t be able to complete the CPOE implementation. How might that affect the organization? Would the pumps or the CPOE system be more beneficial at this time for Moyen Sante as a whole? While there are strong arguments made for the pumps, it is the job of the executives to make the best decision possible for their entire organization, rather than focusing solely on department-specific benefits.

One last question that was brought up today that I wanted to discuss was about the impact of advancing technology on IT strategic planning. How are we supposed to account for technologies that have yet to be invented when we formulate a 3 to 5 year IT strategic plan? The fear of creating a plan that will soon become obsolete should not be a deterrent, however. In my opinion, the best plan would detail the first year thoroughly and then provide more of an outline for the following years. An IT strategic plan should always be monitored and revised to keep up with the times, both internally and externally of the organization. Taking this approach should make the process of developing a comprehensive HIT strategic plan a little less daunting. Health IT will only continue growing in importance and it is vital that we, as health care students and one day health care administrators, learn how best to adapt and embrace this ever-changing environment.

Week 6

This week's class dialogue strayed from the usual informatics topic and was instead invested on the class response to the elections.  Instead of dwelling on the emotions I have towards the results of the elections, I want to stay on track with informatics.  I firmly believe information technology will never be lesser of a priority with this presidency or with any other presidency.  As we have read from this class and others, health care has invested far too much and has had bipartisan support all along.  Although our MHA community as well as the rest of the health care community has been shaken with the results of the elections, health care has historically time and time again been resilient through change and has been able to sustain because ultimately people believe health care is a human right for all.

In terms of strategy for health IT, I think one of the more larger scope strategies will be to ensure there is healthy competition between vendors.  This is something that regulators and legislators will need to get more involved with.  Over the years, large entities such as Cerner, EPIC, and McKesson have held a strong hold over health care delivery systems.  This is the case because they have contracted with delivery systems that are able to afford the services.  However, there are plenty of smaller entities that have been surviving when the larger entities refuse to invest due to smaller payments not worth the time.  I think legislators will need to work more aggressively to ensure that a few companies do not monopolize the health care industry and continue the legacy and practice of the failure of interoperability.