New information system can lend competitive edge

Buy for data gathering and benchmarking needs

Now that the Joint Commission on Accreditation of Healthcare Organizations requires electronic reporting of outcomes within the next two years, many health systems are shopping for information technology. Why not turn this to your advantage?

A new, more powerful information system may be your ticket to compiling the reports and benchmark data necessary to prove how indispensable and efficient your health system is, say managers who have plunged into the computer age. "Most managers have a clinical background, but they need to learn to include an information system component into any plan they make," observes Meredith Pence, RNC, MBA, CNAA, director of women’s and children’s services at John Muir Medical Center in Walnut Creek, CA.

"When dealing with an employer-based market for your services, you must realize that they have [high-powered computer capability] in their corporations. They’re used to it. When they call on Tuesday and want information for that quarter for a Wednesday lunch meeting, you better be able to produce it."

The system at John Muir was purchased from Cygmet in San Jose, CA, but was modified to meet Muir’s needs. The Muir database allows Pence and her colleagues to perform outcomes research and determine best practices. This helps them to monitor performance internally, Pence says.

It also helps them make a stronger case to health care funding sources that they are doing the most efficient job possible, she says. In addition, the impeccable data and clean records help defend malpractice cases in court, Pence says.

She and her colleagues are now laying the groundwork for hooking outlying hospitals to Muir’s computers, so patient information can be instantaneously exchanged. This will allow Muir’s physicians, for example, to look at the chart of a woman in labor at a primary care center and advise the physicians there whether she should be transferred to Muir’s tertiary care facility.

Marilyn Stockman, RNC, director of women’s services for Health Midwest, a network of 14 hospitals and 28 physician services in Kansas City, MO, has five OB/GYN hospital units that use the same information system. The data collected by these five units have, in some cases, modified the kind of care they offer. For example, Stockman and her staff were able to track the progress of infants in the neonatal intensive care unit (NICU) and compare the outcomes of those who were breast-fed vs. those who were not.

"We were able to show that babies who were breast-fed left the unit three to five days sooner than bottle-fed babies," she says, adding that this information helped persuade her neonatologists to be more supportive of breast-feeding. It also allowed Health Midwest to demonstrate that it was getting better results in the NICU than its competitors, which "helped our system to win some contracts," says Stockman, whose hospital system uses a custom-written program.

The old use of computers merely for billing is outdated, says Vinson Hudson, MSEE, president of Jewson Enterprises in Menlo Park, CA. Hudson specializes in physician’s office management/medical information systems for ambulatory or outpatient care settings.

"Now we’re in the world of capitation and clinical care," he says. "Information systems have to be used for outcomes measurement, cost control, and cost accounting."

The right information system can help you identify and standardize the best treatment protocols, analyze medical records in a longitudinal way (alerting you to a woman who needs a Pap smear or is at higher risk for osteoporosis, for example), and spot where financial losses are occurring.

Deciding what computer system to use is a major job, one probably best assigned to a chief information officer (CIO). But each manager has a role to play in seeing that the new system meets the needs of his or her group.

"First, you define your needs," Hudson says. "What the heck do you want and why? You look at the operation you have now. How do you handle a client who walks up to the check-in counter? How do you get bills out the door? How do you get the right forms to the caregiver? You diagram the process you follow for each task. Then you take your diagrams to your CIO or to a consultant and you say, ‘This is what I need help with.’"

Hudson urges managers to take the initiative in stating their computer needs instead of waiting for a new information system to appear in their offices. The more the experts understand, the more likely you will get an information system you like.

But be prepared for continual change. Just as health care management is in flux, so is the computer business, with vendors of hospital information systems consolidating as rapidly as hospitals are. At the moment, no one vendor has all the answers, says Hudson, who edits an annual directory, Healthcare Computing Publications’ Directory of Medical Software, that lists more than 1,000 vendors.

[Editor’s note: Here are a couple of sources for software programs that meet your data gathering and benchmarking needs. Both offer extensive coverage of health care software programs on a monthly basis as well as directories of software products.

Health Data Management magazine, c/o Faulkner & Gray, 11 Penn Plaza, New York, NY 10001. Telephone: (212) 967-7000.

Healthcare Informatics magazine, 4530 West 77th St., Suite 350, Minneapolis, MN 55435. Telephone: (612) 835-3222.]