Insight No.41 : Sep 2012 : Just what the Doctor Ordered: Portfolio Management in HealthcareHealthcare at the Forefront: Using IT to Improve Patient CareBy Amanda Akass
A revolution is currently underway over the use of information technology in healthcare. As Paul Merrywell, Chief Information Officer for Mountain States Health Alliance explains, the development of a comprehensive store of real-time data about the health of a local population will have radical implications for the treatment of chronic conditions, the way doctors record information, and in enabling healthcare providers to tailor their services to the specific needs of the populations they serve.
Mountain States Health Alliance (MSHA) is a not-for-profit healthcare organization based in Johnson City, Tennessee that operates a family of hospitals serving Northeast Tennessee, Southwest Virginia, Southeastern Kentucky, and Western North Carolina, employing some 13,500 staff.
Pcubed was recently engaged by MSHA to assist with resource capacity and portfolio management in IT, as well as its upgrade to Microsoft Project Server 2010.
"The key benefit to us was speed to value," Merrywell says. "Pcubed brought in a very high, very acute awareness of what steps organizations have to go through in order to recognize effective portfolio management.
"They got us to our desired state much faster than we would have done with our own organic staff... In my past experience in a former organization, the transition from a non-managed resource portfolio to a fully managed resource system took six to eight years. We always knew the value of doing it, just not the correct path. There was lots of trial and error, lots of adjustment. With Pcubed we got there in about six months."
That process is part of the ongoing challenge to upgrade the IT potential of the healthcare industry.
For Merrywell, the time is ripe for revolution to strike healthcare.
"If you look at the history of the computerization of the world, every industry has computerized in its own decade. The military was computerized after government and high finance. Retail was done before manufacturing. Upstream entities force on those downstream so the information upstream feeds downstream - it's more useful that way.
"Now all industries are computerized, and people are increasingly wondering why people's health information isn't organized in the same way."
The government is now putting pressure on the industry to start making those technological changes.
"There is a lot of pressure currently around the Affordable Care Act and other regulatory changes in information technology. Healthcare is moving from a transactional system to more of an information system, a knowledge-based system."
Merrywell compares the transition to the IT revolution in retail, before companies began to store customer information: "Originally computers in retail were just being used as cash registers, as they basically are in healthcare now.
"Now there is a drive to bring all of the collected knowledge in healthcare to the point when it can actually improve the health of the population in general - it can be used to make healthcare service providers more mindful of what the population they serve actually needs."
For MSHA, meeting that challenge is an evolving process. "We are starting to expand the use of computers into every area of healthcare, and at every level," Merrywell explains.
"We are beginning to ask patients to use computers to collect information about their own health states. For some, this is with a voluntary online portal, or in certain cases, their health can be monitored from within the home.
"For example, if a patient had some kind of chronic condition, they could sign up for a service where their vital signs, say, blood glucose levels, could be continuously measured and reported. If those indicators went above a certain level, it would set off alarms, alerting the patient if they could treat themselves, or physicians and emergency services if not.
"For many different conditions there is a real value in being able to share this information. Eventually we will build up a very solid real-time knowledge base about what is going on in the health of the community."
As IT takes on an increasingly valuable role within the healthcare system, Merrywell believes it will lead to a real transformation in the way technology is viewed in the medical profession.
"Today in healthcare adoption is the key issue - it's all about overcoming resistance to change," he says. "At some point we will become so accustomed to changes brought by technology that people will come to see opportunity at every change. Now there's still a grieving process around that. No longer will doctors be scribbling notes on a piece of paper no one else can read; but by taking just a little bit longer to input that information into a computer, everyone can read them. They can also be double checked to ensure the most appropriate treatment is being given for that particular disease state."
For Merrywell, this will lead to a radical shift in the way competing healthcare organizations are able to stand out from the crowd.
"As organizations begin to grapple and solve the whole concept of community connectedness, new relationships will be formed [among] historic competitors," he says. "They will compete less in terms of access to data - but will find new ways to differentiate themselves. In only a few years all patient data will be ubiquitous, and with all data shared, health organizations will have to find other ways to be competitive."
Of course sharing all this sensitive information carries with it a significant risk.
"How we monitor who looks at what data will be the next big challenge," Merrywell says. "Now we are all sharing that important information. The question will increasingly be about how we keep that information on a need-to-know basis."
In the short term, Merrywell is focusing on consolidating the work begun by Pcubed.
"The next thing for me is to get formal acceptance of the work Pcubed started with resource capacity management and developing a portfolio system," Merrywell explains. "We now have the tools and technology to do what we want. Now we need the rest of the organization to recognize its value and for it to become ingrained in our culture.
"By doing a good job of resource management, we can take on much more valuable activities - by very precisely describing the value and time a task will take through its strategic and economic value, enabling us to focus on those things which are most important to the company, rather than marginal ones.
"Ultimately, this will mean that what we're doing is what is best for the patient and for the community in which our hospitals reside, and the health of the local population."
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