Best Practices for Successful IT Transformation in Hospitals

The healthcare industry, particularly hospitals, managed care groups and clinics catering to chronic illnesses are undergoing a profound transformation, thanks to the advancements in Technology including Automation Technologies and Artificial Intelligence. 

 

These technologies are not just enhancing existing treatment protocols and care processes; they're redefining the way hospitals and doctors operate, treat patients,speed up recovery and prevent health risks.

Embarking on an IT transformation journey is essential for modern healthcare institutions seeking to stay competitive and agile in a rapidly evolving digital landscape. To mitigate risks and maximize the benefits, consider these best practices, with simple examples to illustrate each point:

1. Seek Incremental Progress

Breaking down large transformation projects into smaller, manageable phases can significantly reduce complexity. For example, instead of overhauling an entire electronic health record (EHR) system at once, start by digitizing patient intake forms. This allows for early wins, creates organizational momentum, and enables continuous assessment and adjustment.

2. Ensure Strong Management

Robust program management frameworks are crucial for overseeing and guiding the transformation process. 

Imagine a hospital managing a facility-wide IT upgrade. By using a strong program management framework, they can ensure each department's needs are met, resources are efficiently allocated, and timelines are adhered to, avoiding project delays and budget overruns.

3. Redesign from scratch

Adopting a design which allows for a complete redesign of products and processes. For example, a hospital could design a new patient management system from scratch, rather than trying to patch and adapt their outdated database. This method helps organizations move away from legacy systems and create more efficient and modern solutions.

4. Create a Culture of Innovation

Fostering a culture of innovation within the organization is vital. For instance, a healthcare system could set up an innovation lab where employees can experiment with new technologies like telemedicine platforms or AI-driven diagnostic tools. This encourages continuous adaptation and integration of new technological advances.

5. Aligned Incentives for all stakeholders

Ensure that all stakeholders, including medical staff, IT departments, vendors, and integrators, have aligned incentives. A practical example would be aligning the goals of a software vendor with those of the hospital's IT department by structuring contracts based on performance and patient satisfaction metrics, ensuring both parties work towards common objectives.

6. Build internal capabilities

Invest in developing internal capabilities and forming strategic partnerships. For example, a healthcare organization could partner with a tech university to train their staff on the latest healthcare IT systems. This enhances the organization’s ability to innovate and implement new technologies effectively.

7. Technology Decoupling

Design technology architectures that minimize dependencies on specific vendors or technologies. For instance, a hospital could adopt a cloud-based solution that works with multiple providers, rather than relying on a single vendor. This approach enhances flexibility, reduces risk, and allows the organization to pivot more easily when necessary.

By adhering to these best practices and incorporating simple, relatable examples, healthcare and hospital administrators can navigate the complexities of IT transformation more effectively, ensuring they reap maximum benefits while minimizing potential pitfalls.

 

Patient Provider Communication : Using IT to facilitate Information Therapy

True engagement comes about through two-way, mutually beneficial conversations.

Technology must look to create multiple ways to facilitate both formal and informal Patient- Doctor Communication. The telephone made a huge impact on the way we communicate, and so did email. Newer technologies must be used to offer ease of use, increase reach and lower costs. Many providers today communicate with their patients using skype, google chat and even facebook. Technologies must build on such success stories. 

Doctor–Patient Communication will also benefit if technology vendors link Communication mechanisms to Provider Information Sources and Health Information Exchanges

-- Provide integrations of these mechanisms with clinical and diagnostic software (EMR's, EHR's , etc)

-- Emailing of schedules and reports to patients is a must.

-- Using SMS to send Medical alerts, reminders, and schedules

-- Go the extra distance and use Social Media to provide alerts and reminders to patients via Facebook Messages, Twitter DM's, etc.

This is the 4th Article in a series of Articles on Using IT to facilitate Information Therapy by Nrip Nihalani and Aditya Patkar . 

Improving Patient Care through EMRs

EMRs-Electronic Medical Records are a modern revolution in the field of healthcare improving the standards of quality in healthcare and raising it to a higher level. With all the numerous benefits of EMRs to doctors, it eventually signifies the benefits to patients and thereby improves patient care.

Using EMR in medical practice can improve patient care in the following ways:

Safe and secure medical records: Electronic medical records are safely and securely maintained in a PC in contrast to the paper-based records let out in open leading to forgery, loss of records or damage due to natural factors. Records inside the PC cannot be damaged or lost and thus a patient is tension-free with respect to the security of his records.    

Make better decisions: A patient history well maintained helps you make better decisions in your treatment. EMR is a tool to maintain such patient histories and take decisions accordingly increasing patient care.

Less time in management and more relief to patients: Paper-based records and registers pile up and become difficult to manage. Moreover, it takes a lot of time for the receptionist to search the record and hand it over to the patient. Instead through EMRs, the doctor searches the records in a single click and reduces the time spent in searching them inside the clinic. This eventually gives a relief to the patients as their waiting time is curbed.

Email the reports to non-local patients: Mailing the reports is a great way to showcase care for patients. If they are paper-based, it becomes a tedious task to deliver it to the patients who are not in the same city, state or country. However, if the doctor uses EMR and mails the reports it saves time and improves patient care. 

Reduction in chaos, happy patients: A messy clinic with cluttered papers, chaos and mismanagement gives a bad impression of the doctor and the clinic. Instead resorting to EMR with no papers lying around, a clean clinic and proper management smoothens the practice giving a good impression to the patients. 

Say no to Memory-based treatments: A memory based treatment proves dangerous for both patient and the doctor. So no more risk of giving bad treatment to your patients with EMR having records of the diagnosis and treatment available within seconds. EMR based treatments have proved safer in contrast to the memory-based treatments improving patient care.

A specialists’ and colleagues’ opinion: EMR stored inside a PC is easy to share with your fellow colleagues and specialists to discuss a rare clinical case. Paper-records require a lot of time to share as compared to an electronic record. With a handy device and a sharing access, medical record distribution is a cost-effective solution.

Handwritten Prescription Risk: A hand-written prescription can prove highly dangerous for the patient. Drugs which are spelt similarly or having a difference of few alphabets/structure are more liable to be misunderstood by the pharmacist and handing over wrong medications. Resorting to a PC-based prescription along with the record neutralize the perils of handing over some other drug increasing patient care.

Quick response to emergencies: Digitized records on a centralized server ensure quicker response to emergency situations for patients. Entire patient history can be referred by the doctor in a short time and proceed with the treatment unlike the paper-based records where it requires a lot of time to search and refer patient history.

 

Adverse Drug Reactions: Side effects of drugs if not informed to the patient can lead to a patient’s health in danger. EMR software which records ADR definitely makes you inform the patient while prescribing the drug. Patient safety and patient care ensured.             

                                             

Patient’s access to records: Giving another dimension to EMRs; from a doctor’s accessibility to patient’s accessibility of medical records, EMR is a boon to patients as well. Not only does it eases access of records in faster and simpler manner but is helpful when a patient is at different locations. A medical record integrated with a doctor’s portal is accessible worldwide limiting it only to the doctor and the corresponding patient providing patient care.

Patient Consent: Smart EMRs with consents help patients make decisions about the choices available in the treatment they are about to undergo. Issues related to patient consent are reduced with EMRs that give you options of the treatment and lets the patient beware of the risks and benefits associated.

An in-depth medical knowledge may care and cure the patient but added services like EMR will retain patient care.

 By Pooja Raval

Learnings from Japan: National Health IT Networks are required

The past few days have involved almost all of us praying for Japan which was ravaged by a severe earthquake and tsunami. Japan's most powerful earthquake in 140 years struck the north-east coast on March 11^th 2011, triggering a massive tsunami leaving behind many homeless and stranded. (Information and Situation Report from WHO)

As we continue praying for hope in Japan, we are also learning all we can about how disasters can impact the way we live and seek to improve. Sadly, Japan now faces severe logistical problems and with the latest news on the mishap at a nuclear reactor, the situation only seems to be getting worse. While Japanese officials have more pressing issues on their hands, a problem that will arise as time progresses will be that those left alive may find themselves without their medical records. Natural disasters wipe out everything — including paper medical records as well as computer and communication networks.

In this time of national crisis, it would have certainly been helpful for Japan to have a robust Healthcare IT network in place. A collaborative one where it is easy to share data, which is securely backed up redundantly in multiple locations that would leverage geographical diversity as a means of countering nature’s unpredictability: Geographical Division Multiplexing if you please;

While Japan does have a Healthcare IT strategy setup, with benefits and stimulus funds, it is relatively new and yet to mature. Health data digitization and Electronic Record Keeping is still in its infancy. Japan does not boast of large scale Electronic Medical Record coverage.

Wouldn’t any country ride out disasters better with health data sharing in place? This should be taken as a wakeup call as well as a learning lesson by all nations which haven’t yet devoted time and money to setting up Nationwide Health IT Infrastructures.

India for one must be looking at learning from this.  Having a Nationwide Health IT Strategy should be treated as important as a Tsunami Alerting System (TAS).  Purists will argue that a Nationwide Health IT System is not intended for alerting and helping contain situations like the TAS. And they are not completely wrong. 

In many cases it has been observed that long term benefits are eventually forgotten. Instead, this concept of “Long Term benefits” must be replaced with Pre-planned Goals which must be “Sought” on maturity of a model.  Now, any system can provide a set of benefits directly on implementation, and an additional set when it has matured.

Similarly, the use case of using a Nationwide Health IT System for predicting and alerting requires a certain amount of usage at first.  A sophisticated and mature Nationwide Healthcare Network built using technology can identify the emergence of possible pandemics. Trends in symptoms can help identify risk areas, and collaborative diagnosis can help is sharing treatment plans and improving them.

One must understand that if maturity of a network is required for additional goals and since that takes time, one must seek to implement early. 

Links of Interest

WHO Page on Environmental Health in Emergencies

WHO page on Myths and Realities in Disaster Situations

Technoclinics- Upcoming scenario in India

Medical industry in India is proud to have adopted the latest medical equipments in every specialization and has achieved tremendous results in terms of rapid and effective treatment. The benefits that the Indian IT sector has made in the global village the past 15 years, are now being extended to the Indian Healthcare industry too! 

Taking advantage of these  some clinics are transforming into “technoclinics” by smartly using technology and software in their practice. Dr. Ankit Khanna (MDS) at Pune, who uses a Blackberry to track his online appointments says, “Advances in technology have definitely changed today’s scenario in the dental practice. Earlier for root canal treatments, X-rays taken were on a thin film which gave information only about pathology and cavity. But with the Digital X-ray, it is now possible to know the bone density, height, thickness along with the conventional pathological details and cavity of the teeth.”

Moreover, the paper-based records are now shaping into Electronic Medical Records storing all the patient details along with the medical history and previous visits. Searching a patient record barely takes seconds and all the information is available at fingertips. Dr. Khanna cites out the benefits of EMR, “With EMR, the medical records are a proof which reduces the conflicts between doctor and patient. If a patient visits two dentists for treatment, with the software now it is easy to show the patient which treatment he came for to avoid the confusion.” Dr. Khanna confides in software stating that he can now provide warranty with the treatment as he successfully manages and tracks the patient records strengthening the patient-doctor relationship.

Most of the clinics are still maintaining the paper based records which eventually lead to frustration and chaos. There are some clinics where the doctors prescribe medicines on a follow up visit memorising the patient history which proves dangerous for the patient as well as the doctor! Imagine how much better it would be if the doctor knew the patient history and accordingly prescribed the medicines? That’s where the software plays the role and reduces the risks of memory-based treatment.

The doctors of “technoclinics” are enjoying their practice because they only have to concentrate on proper diagnosis and treatment whereas the entire clinic administration is managed by the software. Within the coming years, its predicted that the majority of clinics will resort to software, thus improving their practice,  benefit in terms of hassle-free practice, improved profits, time and money savings and also building stronger patient relationships. This revolution is what awaits the healthcare sector in India.

by Pooja Raval and Nrip Nihalani