Measuring Clinical Transformation

By Ken Congdon, editor in chief, Health IT Outcomes

Early this month, HIMSS (The Health Information Management Systems Society) released its first-ever industry survey intended to measure the level of clinical transformation occurring in the healthcare industry. Clearly, the term clinical transformation can mean different things to different people. Therefore, to ensure respondents had a level foundation for their responses, HIMSS and survey sponsor McKesson jointly developed the following definition:

Clinical transformation involves assessing and continually improving the way patient care is delivered at all levels in a care delivery organization. It occurs when an organization rejects existing practice patterns that deliver inefficient or less effective results and embraces a common goal of patient safety, clinical outcomes, and quality care through process redesign and IT implementation. By effectively blending people, processes, and technology, clinical transformation occurs across facilities, departments, and clinical fields of expertise.

In order to be included in the research, respondents had to play some role in the clinical informatics environment at their organization. A total of 175 valid responses to the survey were ultimately collected. The data collected from these participants painted an interesting picture of the clinical transformation environment in the U.S.

First, the study suggests that the leaders of healthcare organizations are (for the most part) supporting and fostering clinical transformation at their facilities. For instance, 86% of the respondents indicated that their organization has a clinical transformation team in place or is presently developing such a team. Additionally, only 12% of respondents noted that organizational commitment is a barrier in regard to being able to report on quality measures. Finally, approximately 75% of respondents reported that organization executives and/or board members have access to scorecards and/or dashboards that contain either clinical or financial data.

Not surprisingly, the top clinical transformation priority for most respondents was the implementation and adoption of a fully operational EHR (49.14%). Meaningful use/ARRA is driving this initiative along with Joint Commission and other quality initiatives.

Despite the high level of executive support, it was clear that there are numerous improvements that healthcare organizations still need to make to enhance their ability to use clinical and financial data to improve patient outcomes. For example, the HIMSS study indicated that data is not always available in a fashion that facilitates user access and reporting. Only 35% of respondents presently import data into a data warehouse, and nearly half of respondents noted that they rely on interfaces to assist with integration. Since not all data is available in an electronic fashion with discrete data elements, reviewing charts by hand is still a primary means for measuring clinical quality. Finally, having the correct resources in place to improve reporting capability is an issue. Nearly two-thirds of respondents noted that their organization needs additional resources in order to report appropriately on quality measures. Additional IT resources, staff, and money were most commonly noted.

The data collected by HIMSS and McKesson mirrors much of the data I personally collected earlier this month at the NG Healthcare Summit in Scottsdale, AZ. This conference provided me with the opportunity to sit down and discuss current IT projects and initiatives with the CIOs, CTOs, and IT directors of several of the nation's leading hospitals and healthcare facilities. EHR projects were the focus of most of these discussions, but every facility was a different point in the process. For example, the goal of most of these health IT leaders was to move their facilities to an enterprise-wide EHR. Some had already deployed and enterprise-wide EHR platform and were focused on sharing data electronically between departments, facilities, and outside the confines of the enterprise. Others were in the process of replacing siloed departmental EHR solutions with an enterprise-wide system. Still others were attempting to create an enterprise-wide EHR infrastructure by integrating these departmental EHR systems together. In any case, despite numerous challenges, the motivation and drive to achieve clinical transformation through IT implementation was overwhelming.

For more information, you can access the complete HIMSS 2011 Clinical Transformation Survey here.

Have a comment or feedback for Ken on this article? He can be reached directly at ken.congdon@jamesonpublishing.com.