Survive by keeping up with information technology

Report helps HIM professionals stay abreast

Changing forces in the health care industry today are creating a "survival of the fittest" environment, a new report says, and the burden is falling on health care information systems to operate a more efficient business, improve profitability levels, and deliver a higher level of care.

"If you're not technologically advanced, you're not going to survive for a couple of reasons. One, because you won't have the information to support the organization from a financial viewpoint, and two, because you won't have the information to deliver quality of care," says Mary Verhage, director of Healthcare Industry Service for Aberdeen Group in Boston. Aberdeen Group is an information technology research and consulting organization.

Aberdeen Group's 72-page report Transforming Healthcare Delivery through Advanced Information Management: 1998 is a resource for health information management (HIM) professionals who are trying to keep abreast of the changing health care environment and technological innovations.

"This report's purpose is to make decision makers aware of the technology that is available today and to try to stimulate them into thinking about how they might apply the technology in their own environments," says Verhage, co-author of the report.

"The report also talks about the changes that are going on within the industry, and specifically, how information technology is being used within it." In addition, the report profiles a number of the major health care systems suppliers along with a number of independent software vendors.

Before considering how to apply technology in a hospital setting, HIM professionals first need to understand the changing health care model.

"If you think in terms of the health care model today, you have what I call the three Ps: providers, payers, and patients. The dynamics of that model are clearly changing," Verhage explains.

Here are some of the dynamics affecting this model, according to the report:

r System rewards efficient organization.

The fee-for-service emphasis once encouraged extensive tests and frequent patient visits. Now the system rewards providers that keep people healthy and run an efficient organization.

This transformation creates an immense amount of pressure to automate processes and improve how information is used across the health care enterprise, the report says.

r Capitation is forcing providers to know and manage their costs.

"Under capitation, profitability results only from improving care quality and cutting costs through more efficient operations," Verhage says.

r Health care services are changing.

Escalating managed care enrollments are changing the composition of health care services, resulting in fewer and shorter hospital stays and more outpatient and home-delivered services.

"Profitability is improved by getting patients healthy faster," Verhage notes.

r Consolidation in the industry is rampant.

"In order to increase market share, offer a full scope of health care services, and gain access to capital, health care providers are merging and acquiring other providers. Some providers are even merging with payers and vice versa," says Verhage.

r Systems must be integrated.

Multiple information systems and applications must now be integrated to match the structure of newly merged organizations.

"Sharing critical patient information is imperative; consequently, there is immense pressure on health care CIOs to integrate or replace existing systems," the report states.

r Health care delivery is increasingly delivered outside the boundaries of centralized hospital environments.

As a result, data access and information sharing demands are increasing. "Hospitals trying to meet these information demands through manual systems are being left behind," Verhage says.

"For hospitals to substantiate their charges, they need accurate information that can be sliced and diced in any number of ways. They can't do that with a manual system anymore. It's too complex," he adds.

"Hospitals and health care providers have to have a dependable, reliable information system," continues Verhage. "If they're going to be on the leading edge of patient care, they need to be able to analyze data. That's the whole disease management piece - to let them know the care they are delivering is being effective. Health care providers need sophisticated information systems to ensure their financial health, as well as to ensure the quality of health for their patient population."

Technological innovations help HIM professionals provide current, reliable data. Some of the innovations that are catching providers' attention include:

r Speech recognition technology.

No longer do physicians have to dictate into a tape machine, send the tapes to a transcription department, and route the typed reports to the physician for a final sign-off and inclusion in the chart. The new technology allows a physician to dictate directly into a computer.

If the organization has an electronic patient record or computerized medical record (CMR), the process can be streamlined. The physician or clinician dictates directly into a form prompt or uses a touch-screen type of device, maybe with a stylus, Verhage explains. "It's all voice-activated. [Users] can see on the screen as they are dictating."

The physician or clinician corrects any mistakes in the record and signs it electronically. The report then automatically becomes part of the CMR.

r Wireless technology.

A number of vendors now have hand-held devices, Verhage says. Physicians and nurses can carry these devices with them in the hospital and can generally use them to access the computer system. "The portability of these devices allows the clinician to capture and enter information directly at the point of care."

r Software modules that enable communications and information sharing between client-server and legacy applications.

This is a key concern in health care, Verhage says. "The technology is used in any number of other corporations - insurance, financial industries." When evaluating what technology to invest in, HIM professionals need to look at the business problems they are trying to solve, she says. "They should take a look at their budgets. Then they should take a look at what technology is available to help them address those business problems."

For example, if turnaround of various physician reports is a problem, then speech technology should certainly be considered.

Any technology decision should be based on the hospital's business plan, she adds. "Hospitals should have some kind of two- or three-year plan. Technology changes too drastically these days to have a five-year plan."