Clinical transformation: Where the rubber meets the road

It’s National Health IT Week and Washington, D.C. has been buzzing with policy discussions and forums exploring the value of information technology and its role in transforming our healthcare system. But amid the prognosticating and back-patting is the realization that although IT can be a powerful catalyst for change, it is merely a tool. Unless the changes are accompanied by true clinical transformation -- fundamentally altering the way care is delivered, not just automating existing processes -- the chances of long-term success are slim.

In a report issued last week, the Institute of Medicine (IOM) identified a set of recommendations that would help the U.S. healthcare system achieve its full potential. At the top of the list – a systematic approach to fostering a “continuous learning” system - is using IT more effectively. The inevitable comparisons were made to other industries (banking, manufacturing) that use data to inform decision-making, improve service and efficiency, and engage consumers. The IOM’s proposals were nothing new, but the message was clear: we’ve got the tools, but we’re not optimizing them.

So where’s the disconnect? While healthcare has been slower to adopt IT than other industries, we are making deliberate and steady progress. But it’s embarrassing that 20 percent of patients report that test results or patient records were not transferred in time for an appointment. Or that 25 percent of patients undergo duplicative medical tests so their provider can have accurate information for a diagnosis. (See infographic.)

The key to success is clinical transformation, where people, processes and technology are aligned to achieve the greatest value from IT investments. Here are some concrete steps for getting there:

  • Reframe the culture – For care transformation to succeed, it must be woven into the fabric of the organization and be supported by the highest levels of governance.
  • Create improvement capability – The organization must use a flexible framework for solving problems and applying knowledge.
  • Collaborate across boundaries – Cross-disciplinary teams – including physicians and all involved departments - are critical when redesigning workflow to ensure effective, long-term results.
  • Make decisions based on evidence – Data, not anecdotes, must drive process improvements and performance.
  • Drive results and benefits – Monitor results ruthlessly and keep tweaking as needed.
  • Maintain constancy and ongoing focus – The attention of leadership on the importance of care transformation must be present, palpable and persistent.
  • Allocate resources – Ensuring the adequacy of people, time and funds in support of an initiative sends critical messages and generates support.

According to the IOM, incremental upgrades and changes by individual hospitals or providers are no longer sufficient. Substantial improvements in raising quality and lowering costs will necessitate embracing new technologies to collect and tap clinical data at the point of care, engaging patients and their families as partners, establishing greater teamwork and transparency within healthcare organizations, and aligning incentives and payment systems to emphasize the value and outcomes of care.

Everyone – government, providers, payers, pharma and life sciences companies, and patients – has a role to play and IT can help connect the dots. But only if it is coupled with a commitment to radically redefining the way healthcare is delivered. Our patients are counting on it.

I’m interested in hearing what barriers you face in integrating IT initiatives within your organization and what you have done to keep pressing forward.  

Copyright © 2012 IDG Communications, Inc.

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