Four Pillars of Strategic Healthcare IT Management and Diagnostic Imaging

2013-07-09
 

Healthcare IT Success Factors

There are many metaphors through which you or I can view the transformation of health care delivery currently occurring and the application of information technology to the challenges presented.

Back at last spring’s HIMSS conference in New Orleans, the company I work for, McKesson, explained the metaphor we use daily: four pillars supporting a platform of a more optimized future.

I feel that these four pillars are just as applicable to the narrow area of our medical imaging solutions as the metaphor is applicable the broad area of all of healthcare:

1. Optimization of performance and quality

System optimization is essential in order to achieve the 10% to 20% savings required to stay financially viable and still deliver quality patient outcomes. Such optimization requires that decisions are based on actionable enterprise intelligence. Organizations must learn from their data, predict based on anticipated trends and hardwire process change for ongoing improvement.

This is particularly applicable to diagnostic imaging, because this area of medicine is in the process of a massive change of perception within healthcare management. Previously, the primary measure of suitability of a PACS or CVIS was the ability of the users, in particular radiologists and cardiologists, to interpret and report as many procedures as possible. Now, with capitated care and other outcome-driven models coming to the fore, a naïve administration would see only increasing costs of ever more complex imaging procedure options. But often the most directly inexpensive imaging procedure is the not the one that is going to get to a definitive treatment decision. For example, an imaging procedure performed on a more expensive to operate imaging device may result in the best patient outcome at a lower total cost. This may be by reducing the total number of procedures performed or the time other resources are devoted to providing interim care to the patient.

Likewise, other activities performed by the radiologist and cardiologist beyond simply interpreting images become equally important, because services like procedure selection consultation and discussion of likelihood of potential differential diagnoses can ensure the most effective use of resources to aid the patient.

Without the full context of how imaging fits into a patient’s care, broad-brush changes “to reduce costs” can have a negative effect on both health outcomes and the overall efficiency of delivery. Optimization requires information.

2. Evolution to a patient-centric ecosystem

To create a more connected, patient-centered ecosystem, as an industry, we must enable hospital-to-physician connectivity, physician-to-physician networking, provider-patient interaction, and, ultimately a full continuum of care that’s both clinically and financially connected.

In diagnostic imaging this means ensuring that the imaging information flows between organizations and individuals smoothly by leveraging imaging data exchange standards and common initiatives. In particular, a duplicate imaging procedure should never be performed simply because the prior procedure at another institution was not readily available for reference.

3. Maximization of technology value

Within the four walls of health systems, most organizations are focused on the value of an integrated clinical and revenue cycle hospital information system (HIS). To better utilize scarce resources and sustain a competitive advantage, healthcare providers must plan strategically how to best streamline technology resources, share information across care settings and gain economies of scale.

Likewise, in diagnostic imaging this can manifest in numerous ways of minimizing total cost of ownership while serving the broadest range of users. Having a single, highly available imaging repository that can cover all of the facilities within your organization, in particular, is a path to success. Not only does this provide the economy of scale mentioned above, it also minimizes the number of data connection points that need to be set up and monitored as imaging becomes increasingly integrated with other systems at your institution.

4. Navigation of evolving payment models

It’s clear that in the United States in particular the lines between payer and provider are blurring. The Patient Protection and Affordable Care Act set the foundation for drastic shifts in reimbursement models.

As complex healthcare payment models emerge, organizations need to leverage the expertise and assets of payers in order to take on financial risk. Utilizing performance analytics is essential to stratify patient populations, identify opportunities to further manage cost and quality, as well as to report and understand gaps in care outcomes.

We touched on some specific examples of making the right choices in diagnostic imaging when discussing the first pillar, Optimization, above. Additionally, most organizations are going to be simultaneously dealing with a mix of capitated and non-capitated payments for imaging procedures for some time to come. But the majority of the costs are going to remain per-imaging-procedure. Radiologists and cardiologists are sometimes going to on-salary and sometimes paid via complex volume-plus contracts. A healthcare organization’s imaging solutions are going to have to live in both worlds simultaneously and provide it with the appropriate management information depending on the context of the relevant payment model.

To learn more about how our commitment to these four pillars can help improve the performance of your health care organization, I encourage you to contact McKesson directly.

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