Going forward, this is an important time for America’s healthcare system. In 2014, we will witness the activation of most of the major provisions provided under the Patient Protection and Affordable Care Act (commonly referred to as “Obamacare”). Building up to this historic event brings numerous legislative and regulatory items to a head in 2013 — many of which directly impact the production, use, and efficiency of data in the healthcare system.
For instance, on July 9, 2012, President Obama signed into law the Food and Drug Administration Safety and Innovation Act (FDASIA). This law contains a provision that requires a unique device identification (UDI) marking system for most implantable medical devices and their packaging; a provision that will require many manufacturers to make expensive changes to their current packaging and production lines. To be effective, the rule also will require track-and-trace systems that can match devices with implant patients and preserve such data for future reference.
Healthcare Reform and FDASIA are set to transform the landscape of the healthcare industry from inventory receiving to the point of care. This article outlines four specific steps hospital IT departments can take to ensure they drive their projects forward successfully.
By - Vivian Funkhouser, director, healthcare solutions, Motorola Solutions
Going forward, this is an important time for America’s healthcare system. In 2014, we will witness the activation of most of the major provisions provided under the Patient Protection and Affordable Care Act (commonly referred to as “Obamacare”). Building up to this historic event brings numerous legislative and regulatory items to a head in 2013 — many of which directly impact the production, use, and efficiency of data in the healthcare system.
For instance, on July 9, 2012, President Obama signed into law the Food and Drug Administration Safety and Innovation Act (FDASIA). This law contains a provision that requires a unique device identification (UDI) marking system for most implantable medical devices and their packaging; a provision that will require many manufacturers to make expensive changes to their current packaging and production lines. To be effective, the rule also will require track-and-trace systems that can match devices with implant patients and preserve such data for future reference.
The FDA is preparing to publish the final rule by mid-May 2013. The challenge faced by healthcare providers is successfully applying these new data standards and associated technologies while realizing the potential upside of billions of dollars in annual cost savings and improved patient safety. This action, along with similar efforts such as GS1 Standards, is designed to digitize information flowing up and down the healthcare supply chain to drive accountability, efficiency, and better care.
While these standards directly affect the medical supply chain, their impact will be minimal if the true value is not carried through to both the patient experience and the continual evolution of a hospital’s records and information systems. To do so requires the analysis, capture, deployment, security and storage of data across hospital operations — from inventory to point-of-care and back again. The ultimate goal of better patient care and more efficient operations requires extracting and aggregating data from multiple — and sometimes incompatible — software systems throughout the hospital. IT will be chartered with bridging those islands of data.
Data is the lifeblood of modern enterprises. Translating that data into useful information and analytics is the challenge. Corporate IT teams are tasked with maintaining and improving the flow of information, including intellectual property, sales, finance, and human resources/benefits. A breakdown in any of these data streams could prove catastrophic to a health system’s operations and, at times, involve life or death scenarios.
Because of this, hospital IT staff often find themselves directing traffic at the crossroads of healthcare regulation, patient safety, hospital administration, and technical innovation. Their daily work environment is marked by high expectations and rising complexities that are consistently affected by underfunding, understaffing, and resistance to change. In short, today’s hospital IT staff has never before been expected to accomplish so much, so quickly, with so few resources, and with such severe consequences.
The Culture Of Healthcare Professionals
Most who have experienced hospital procedures probably encountered this scenario: a nurse captures data on a patient’s pulse, blood pressure, and other vital signs by writing down numbers on a sheet, the back of her hand, or any available scrap of paper or sticky note so she can later record that information in the patient’s chart. For the nurse, the process generally works because she is in control of the immediate situation and has always done it this way.
For an IT person, however, the process is considered highly inefficient and filled with potentials for human error. For everyone involved — including the patient —this method confines all the vital information to a single physical medium — the chart — by a single, subjective entity — the nurse. Nothing can be tracked downstream in the flow of data without that chart being physically present. And updating the most current data is limited by whoever is currently in possession of the chart.
Transitioning this paper chart and workflow scenario into a suite of electronic, mobile technology solutions can transform these procedures, eliminate the risk for error, and provide an objective, reliable means of tracking, verification, and replenishment. The challenge, however, lies less in the tools themselves than in the change management and integration work needed to make this successful across the health system.
The clinical staff’s focus is on patient care and improving outcomes; anything that gets between them and the patient or potentially introduces complexity with the risk of delay or slowdown in an acute situation is considered suspect. New technology options must be tailored to the environment and come with an education program designed to get the “buy-in” of users (nurses, admissions, etc), approval from IT and others in hospital administration.
No Shortage Of Problems To Solve
The healthcare industry receives constant reminders from insurers, government officials, news organizations, and the public-at-large to be cost conscious. While the hospital IT department might be seen as one road to control spending, they can only achieve this with a clear understanding of requirements and opportunities. Even these might affect their own operating costs. Priorities must be set in a dynamic, cross-functional manner where patient care can never be compromised despite complex and competing directives. Below are four recommendations to help hospital IT drive projects forward strategically and tactically.
1. Prioritize patient-centric solutions
You cannot solve every problem in one funding cycle. Priorities must be set and those priorities should address as many issues as practical. By putting the patient experience at the center of this decision-making process, IT staff can better measure costs for any proposed project and its potential return on investment. As a result, IT can demonstrate, for example, how mobile solutions can aid in supply replenishment, better dosage monitoring, and tracking for any defective devices as well as higher integrity in care between the emergency department, surgery, recovery, and admission/discharge/transfer, for example. This laser focus on the patient experience can help create an environment that can easily adapt to address other priorities in the future.
2. Evolve IT to the role of trusted adviser
Historically, healthcare has been slow to adapt to new ways of doing business. There are many legitimate reasons for this, the least of which is the risk and impact to patient care if technologies have not been proven elsewhere first. However, the pace of change is certainly accelerating, if for no other reason than to comply with regulations and reimbursement terms. And this pace will likely accelerate further when the results of change derived from data analytics drive new phases of innovation. This is a good thing, but accelerating change requires analyzing and parsing new information and doing so with greater velocity. As good things happen across the healthcare system, expectations are likely to rise even further.
Few hospital IT departments have the resources to keep up with this change. To succeed, IT leadership must evolve their relationships within the hospital structure to the role of trusted advisers who can aid in the analysis of new innovations or mandates, and speed the implementation of priorities. Trusted advisers who can provide a strategy for doing more with less in a time of rapid change will drive change and help their employees embrace change to benefit the patient experience and improve outcomes and the bottom line.
3. Make the right connections first
One of the first implementation priorities should be integrating the hospital’s clinical operations with the outside world of supply chain systems. At a minimum, this means establishing a path so the systems can talk to each other. What does this mean for patient care? For starters, linking the codes scanned at inventory with the codes scanned at the point of care can automate supply replenishment and charge capture while ensuring the integrity of medicines, equipment, and devices procured from the supplier and consumed at the bedside. This translates to enhanced inventory controls (hospitals spending what they need when they need to), real-time track-and-trace systems for the delivery of patient medications or devices (better oversight of medical care), and improved accuracy of patient billing (increased itemization, more timely submission/reimbursement and reduction of errors).
4. Improve wireless security
Patient data is sacred. It is the basis of individual treatment and this highly sensitive, personal information is entrusted every day to the hospital staff. The Health Insurance Portability and Accountability Act (HIPAA) of 1996 placed strong emphasis on patient privacy and established real penalties for misusing information or failing to adequately protect it. The prospect of mobilizing data as much as possible understandably creates HIPAA concerns. Since its inception in 1996, this protection of patient data refers to the patient’s records and encompasses all communications about that patient that may travel through the air or be on a device at rest. Today, a mobility strategy in healthcare must consider HIPAA-ready and HIPAA-compliant networks and devices that are reliable and yet secure enough to protect patient information.
A wireless local area network (WLAN) and the deployment of secure, enterprise-grade mobile handsets, tablets, bar code scanners, and other devices is a necessary step toward tying together medical operations and data collection/storage. One important hurdle for IT is getting end users to recognize that, while many consumer electronics devices may be looked at as popular options, they are in fact not designed to operate within hospital conditions where issues of durability, security, and sterilization are all of equal importance. It will fall to the IT staff to guide the investment toward an enterprise-based solution designed to work within these requirements and ready the hospital for future innovations.
Employees in the medical community will find themselves in a fast-moving, high-pressure environment for the next few years. All of these impending changes have resulted in a tremendous responsibility that now rests upon their collective shoulders. By working together, the IT staff (as trusted technology advisers) and the medical staff (as established experts on patient care) can achieve their most important goal: providing each patient with a better, more efficient, lower cost healthcare system.
