The Green Three R’s of HlT

Discard paper to reduce costs

While American businesses may be struggling with fiscal uncertainty, most companies are “thinking green” by adopting strategic initiatives to implement the three R’s: reduce, reuse, and recycle. For enterprises in the healthcare information technology (HIT) sector – with old operating systems existing alongside the new – the three R’s merit renewed attention since there is a persistent lag in becoming eco-friendly. HIT is not quite as green as other sectors that have embraced the digital age and streamlined operations, with legacy systems still surviving and becoming integrated into many healthcare environments.

While many administrators view the retention of old technology as a compromise to truly optimizing operations, they face a difficult choice: tear down the old systems at great expense and replace them with modern efficient, single-source systems, or find a less drastic but no less efficient alternative.

Dismantling the old systems often represents a multimillion dollar, multiyear project that would consume human resources, financial capital, and raw materials on par with leveling entire city blocks of old, still viable housing to put up new energy-efficient housing. Fortunately, there is now an excellent alternative to undergoing a rip-and-replace approach: solutions designed to overlay multiple legacy HIT systems across a community’s continuum of care within a medical community.

Much like the installation of insulation in the walls of an old house, these products enhance the value of energy sources – legacy systems – and improve the comfort of the people living there: physicians, clinicians, and patients.

Reduce

The benefits of aggregating data from existing HIT applications across the acute and ambulatory healthcare setting are numerous, fulfilling ecological goals while instituting cost-cutting measures. By reducing the use of natural resources, energy, and the added labor and frustration of errors, a comprehensive solution that spans treatment settings benefits clinicians and patients.

Having an aggregated patient summary from all the various clinical applications in a single, easy-to-use, workflow-friendly portal reduces the duplication of invasive diagnostic tests. Keeping in mind that any invasive procedure performed on a patient has the potential for adverse effects, the reduction of duplicative procedures saves money for all stakeholders and concurrently improves the patient experience. Further, a reduction in noninvasive tests minimizes duplicative pharmaceutical transactions and radiological exams.

With the introduction of secure clinical messaging and electronic reminder capabilities, along with the ability to attach appropriate pieces of the electronic health record (EHR), there is also a significant reduction in faxing activities – and all costs associated with this dinosaur of communications. Old World paper icons such as “sticky” notes, telephone logs, and referral forms also disappear. The bottom line is that cutting-edge HIT solutions not only slash the use of paper, but they also mitigate the physical loss of information through misfiling and poor follow-up.

For example, clinical personnel at Bassett Healthcare in Cooperstown, N.Y., now use an HIT solution that allows them to record a million messaging transactions each month, greatly reducing the requirements of previously paper-related functions.

A single access portal that allows all clinicians to view dashboards that display a patient’s status provides vital information including acute care encounters, history of chronic disease, and preventive care activities. With patient information available at every touch point of the healthcare continuum, individuals are relieved of the burdens of making multiple appointments for their health needs, explaining their history numerous times, being treated in an emergency department, being readmitted post-operatively, and enduring extended hospital stays. A modern, electronic portal reduces the incidence of “old school” healthcare issues.

Reuse
 
Replication of data within legacy HIT is commonplace, creating redundancy that fuels inefficiency. The good news is that the best HIT solutions now on the market offer an aggregation platform, enabling users to enter information only once into the underlying source systems and allow them to reuse the information many times within the portal. The advantages are unlimited.

Patient-reported information that is reused eliminates repetition as individuals migrate through the healthcare matrix within their community – from primary care to acute care to specialist. The overall healthcare experience is greatly improved when patients are no longer forced to remember and recite their family history, medical history, acute condition, current medications, and existing allergies. The quality of information and care advances dramatically, especially during traumatic episodes when the patient is unable to communicate at any level. As a result, healthcare systems reap immediate upgrades in patient satisfaction.

Another significant benefit of reusing data is the enhancement of data quality, since each instance of data re-entry has the potential for error. Reuse of data also eliminates administrative tasks, transforming the inefficiencies of current HIT deployments. Clinical personnel are no longer saddled with multiple systems that have no common ability to easily retrieve data, and they shed the inconvenience of frequently logging into various systems, extracting data, and recording it on paper documents for physician reference.

A prime example is Lourdes Hospital, in Paducah, Ky. At one time, nurses at Lourdes had to transcribe information from various systems onto a paper flow sheet for physician review. Now, with top-of-the-line HIT solutions, source data is displayed in a familiar format and reused. This allows physicians to access information directly from source systems, while eliminating multiple sign-on, look-up, data re-entry, and printing.

Finally, the reuse of data lightens the workload for staff members who often complain about repetitive administrative documentation associated with manual processes. This promotes job satisfaction, allowing institutions to retain some of their most valuable and expensive resources – their healthcare personnel. With enhanced retention, hospitals can look forward to reducing high turnover rates, the cost of personnel acquisition, orientation and training, and credentialing – problems that are expensive to address and have plagued the healthcare industry for decades. Turnover is also disruptive to the delivery of care.

The implementation of the latest HIT overlay technology leads to immediate staff satisfaction, allowing existing personnel to be “reused” and appropriately repurposed in a much more clinically focused, care delivery mode. Administrative staff members who once had to pull paper chart information, look up data from disparate systems, and transcribe pre-existing data into other formats can now spend more time doing what they do best: delivering high-quality care.

Recycle

 A mixture of core legacy systems and emerging HIT systems comprise most of the healthcare delivery systems throughout the United States. This environment has grown more complex with the adoption of ambulatory EMRs, remote lab and radiology systems, and other specialty-related HIT that has been promulgated as standalone, stove-piped entry and retrieval systems within a delivery network. Whether a solution is envisioned for an Integrated Delivery Network, a Health Information Exchange, or a Regional Health Information Organization, recycling existing technology is key to achieving value in a timely and cost-effective manner.

Recycling also extends the value of an organization’s investment in a system that may now be antiquated. While the term “recycling” once conjured up an image of simply extracting the raw materials from discarded items, the overall goal of recycling is to renew the raw materials from one product into another.

The best HIT solution does just that. It preserves the initial investment while recycling data captured during regular use into a new and valuable tool in the assessment, treatment, and planning associated with patients and health communities.

The newly recycled features of the legacy system can be used anywhere, anytime by the appropriate clinical personnel to improve the quality and scope of care delivered. Current technology is retained, and the existing infrastructure remains intact, making it unnecessary to retrain personnel. Users simply access the Internet with a standard browser to obtain patient information at the point of care, from home, or anywhere the Internet is available.

Mastering the Three R’s

An eco-friendly IT solution that embodies the three R’s reduces costs, speeds the time to value, and enhances the clinical functionality of existing technology. A green mindset in the IT department sends a positive message throughout the enterprise. There is one word of caution: not all HIT solutions are created green – seek a solution that:

• Utilizes existing technology without a requirement to rip and discard what is already in place.
• Creates a single portal that enables clinicians to access a complete patient record without relying on paper-based processes.
• Allows information from legacy systems to be reused and repurposed throughout the health system.
• Promotes job satisfaction across the enterprise by being easy to use and workflow enhancing.
  

– John Tempesco is vice president, client services and marketing, for Nashville, Tenn.-based Informatics Corporation of America (www.icainformatics.com), which takes technology developed by practicing physicians and informatics professionals at Vanderbilt Medical Center to the broader healthcare market. Direct all questions and comments to editorial@rt-image.com.