Tips for maximizing your information systems
Tips for maximizing your information systems
Plan carefully; seek consultants
Experts on computerized management information systems offer the following suggestions for how hospices can maximize their ability to take advantage of existing and emerging computer technology:
1. The first thing that's needed is a commitment by the organization to give the information systems manager a seat at the table with other senior managers, says Joe Bach, manager of information systems for Hospice Association of Western New York, Cheektowaga. In the past hospices would often do their strategic planning behind closed doors, and then come out and tell their computer staff what they wanted from the information system. By doing so, they failed to incorporate expert advice on the possibilities and the pitfalls for the strategic plan from an information management viewpoint.
2. Hospices also must invest in good financial management generally, says Teresa Craig, CPA, vice president for finance and MIS at Hospice Inc., in Wichita, KS. "I stand by that advice for any size hospice," although smaller agencies could get by with a consultant, a volunteer, or a knowledgeable board member, she adds. Every hospice also needs a usable accounting system, even if it's just an off-the-shelf spreadsheet software like Lotus 1-2-3. With new cost reporting requirements (see related article on p. 57), all Medicare-certified hospices will soon need to be able to track costs, such as direct, indirect, patient care, and administrative costs, Craig says.
3. "Whether the hospice is small or large, it needs to stop and see where it is now and where it wants to go," Bach says. "Look at what other services you want to provide, and new ways of doing business, for which you will need to have an information system in place. Then do a solid needs assessment. Bring in outside consultants or work with board members. But the program has to walk through a good needs assessment and develop what we call a `needs requirement document,' which will be the road map to your hardware, software, everything. The bottom line is you really have to know what your needs are" and clearly understand your business, he insists.
4. Computer consultants are readily available to help in designing information systems or specifications, developing a needs requirement document, reviewing proposals, selecting vendors, and negotiating purchase contracts. The money spent for expert advice on the front end will be repaid many times over.
5. "Use your clinical people," Bach urges. "We've done something new here: We brought in an LPN [licensed practical nurse] to work in our three-person information services department. She works exclusively with clinical staff, teaching nurses how to access patient information from the information system. It has really drawn the whole process together and allowed us to use the information system more effectively in the clinical area." The nurse had worked with the hospice for several years, but also had a side interest in computers. The hospice provided on-the-job training for her new role, Bach says. Smaller hospices should at least designate one clinical staff person to play a liaison role in any computerization process, he adds.
6. It also is important to streamline the current charting process as much as possible before automating it. Understanding how the current process works is essential; otherwise you run the risk of merely automating bad practices. "You need to have a good business process in place and a good clinical process in place; then automating is much simpler," says Kit Stroup, chief information officer for Hospice of Michigan. "This hospice has a standing committee, called the Patient Services Committee, which is constantly looking at making adjustments in the charting process to make sure we're capturing every bit of data we need and none that we don't need."
7. There are a surprising number of opportunities to obtain grants for computerization projects, Bach says. The Hospice Association recently received $15,000 from Bell Atlantic to develop its wide area network. Other local and national foundations or corporations also give grants in this area, he adds.
8. Small hospices may join buying groups or networks to increase their clout in purchasing information technology from vendors. Given the growing demand for information at all levels, some hospices might even seek mergers or affiliations just to gain access to the information systems they will need to survive.
9. "Don't spend dollars on technology you don't need," Stroup admonishes. "If you're a small operation, a 'mom-and-pop' vendor might suffice to give you what you need. I only spent the money I needed to spend, and no more," for Hospice of Michigan's more elaborate system. "Keep in mind there are two end results you are looking for: quality patient care, and compliance with state and federal regulations. If you are meeting those goals, then who cares what your software is?"
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