Integrating IT Leadership into the Healthcare Delivery Setting

Information Technology has been implemented very successfully in sectors like banking, but, in healthcare the scenario is different. Healthcare sector has lagged behind other industries in incorporating IT in a way where it plays a key role in driving the growth of and organisation.

There are several reasons for this, some of them are as follows:

• Too much variability in the demand from clinicians, who have a direct impact on the hospitals costs, resulting products that don’t meet the needs of the organisation
• No clearly defined role of the Chief Information Officer (CIO) which is in contrast to other sectors where the CIO plays a key part in the running of the organisation
• IT needs of healthcare are different from other sectors
• Healthcare Information Systems are yet to mature

To obtain a leadership in IT the CIO has to manage several issues. Some of them are:

Change management: Not only the clinicians but the managers of the organisation have to understand that implementation of IT will cause a major change at the workplace and other processes should also change accordingly. The processes have to change, and this requires a standardisation and unification of some of them but at the same time, the system has to allow the personalisation of each clinical process

Understand the user demands before providing solutions: Understanding what a clinician wants will help the CIO in preparing a better solution. For e.g. in case of Electronic Medical Records (EMRs), the clinician wants patient data at his finger tips and not necessarily a control tool at services of a hospital manager.

The IT team has to be oriented to a functional level:

IT strategy has to be clear:Technical arguments have to be parked and the CIO should talk about concepts like budget, eprescribing, RHIO, CPOE, clinical workflow, outsourcing, etc Integration is the key for automation Consolidate each step taken forward. Do not keep old workflow as a back up “in case something goes wrong”

Solutions that integrate technology and health management

There are some key elements that are becoming strategic for IT Leadership because of the concrete and demonstrated value that they provide to all end users in the organisation. Such solutions are centred on the concept “value for the organisation and clinical workflow.”

Here are some examples are based on real experience and projects:

It’s very curious to see that some IT companies , that have hitherto not focussed on the healthcare market are now promoting solutions that are of great value to the health organisations. Intel is focussed on everything related to mobility and RFID and Cisco is promoting medical image integration. Cisco is changing the concept of radiology PACS to Medical Image Global Repository by using the MIO (Medical Images Organiser) technology from C2C (www.c2ctsis.com). In this repository, radiology images are integrated with any multimedia data like colour images, cardiology US, EKG, etc. . That makes possible the concept of accessing clinical information into an EMR Project “from the image to the data” and makes telemedicine or even eHealth platforms better for new health services projects. Oracle on the other hand has built a repository of clinical information based on HL7 v3 RIM model; the platform is HTB (HealthCare Transaction Base).

A new concept that is getting popular is the Integration Competent Centre (ICC). This a management concept that manages, analyses, proposes and coordinates all integration processes.

It has three basic characteristics:

• Independent from any provider or implementer of any of the Information Systems that have to be integrated (HIS, GP, RIS, PACS, etc.…)
• Exclusively focussed on integration: standards, training, etc.
• Good knowledge of the selected integration tool, key piece of the ICC. (Last Klas (from HealthComputing ) report, INTERFACE ENGINE MARKET REVIEW 2006, names RhapsodyTM de OrionHealth as best Integration Engine for Healthcare).

The responsibilities of the ICC tend to grow to more functional concepts like clinical portal or health navigator that integrates different “information components” from different applications like Enterprise Master Patient Index (EMPI) and identity management of the professionals.

Another very innovative technology called the Geoespacial visibility solutions is gaining popularity. Combined with RFID technology, it is very well accepted by directors because it allows controlling devices and / or patients through a graphical interface. There are several companies that provide a solution that demonstrates a very deep knowledge of the market being focussed on patient workflow and hospital dependence management (beds, boxes) and providing solutions for processes like discharge, cleaning, bed control, patient transportation, patient family information, ambulatory information screens, etc.

Conclusion

IT Leadership should look at optimising processes by providing automation. For this, the implications of implementing IT to all the units of the organisation must be considered by the CIO. He then need to propose solutions that are robust, reliable and demonstrate clear value to the organisation.