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June 2014

Who’s Gauging the Cost of HIT?
By Jeff Tishgart
For The Record
Vol. 26 No. 6 P. 10

EHRs are revolutionizing health systems, but being plugged in is just the first step.

The US health care industry is in the middle of completing a sweeping transition, and it’s not just about EHRs, although that’s a seismic change all by itself. It’s also about hospitals and health care networks making vital IT investments in infrastructures, clinical applications, and cloud computing. Plus, patients themselves are beginning to rely on technology to organize, manage, and streamline their care.

After years of evaluation, discussion, and planning, these changes are redirecting the entire system from focusing on volume and fee for service to zeroing in on value and accountability. While better patient care always has been the goal, hospitals and physicians now have the tools to help them better understand those patients and provide them with insight into what’s working, what’s not, and why.

No doubt, it’s a new and exciting era. The health care industry is rapidly giving way to a connected health care community. The fact that patient information can be collected from multiple sources and supplied to an emergency department physician at a moment’s notice will improve outcomes. Hospitals’ ability to capture information around regulatory compliance will make them more accountable and more efficient. When staffing management technologies are implemented, large health care networks can reduce unnecessary labor costs.

Still, connectivity is only half of the solution. Ensuring that all of these EHR systems, physician applications, and IT infrastructure elements are providing a return on investment and that this complex structure of multiple connection points and disparate user groups is functioning well remains the other half of the challenge. Failure to perform isn’t acceptable. For those connected hospitals, care networks, and physicians, technology concerns raise two important questions: Who is impacted, and what does it cost?

Analyzing Poor Performance
“Measuring the Impact of Technology Performance,” a study conducted for Compuware by Intellitrends, surveyed 304 corporate executives and senior managers from global companies across four industries: health care and pharma, finance, retail, and manufacturing. Enlisting such a cross-section of talent allows the health care community to benefit from the experiences of businesses that have been working toward overcoming technology implementation challenges for years, if not decades.

The study found that underperforming technology costs more than everyone realizes. It hurts productivity, decreases customer satisfaction, and harms brand reputations. When asked to name the areas most dependent on efficient technology, almost two-thirds of respondents named customer service and finance, and more than one-fourth listed human resources and research development. Each of those areas is critical to success in health care.

When asked what area of their organization suffers most when technology failures occur, respondents replied in a similar fashion by ranking customer service and staff time/resources at the top of their lists. And when asked to quantify the costs of these failures, the top responses were lost productivity, lost revenue, the need to revert to manual processes, and adding staff.

The following sample of quotes from respondents sheds light on the burning issues:

• “Off-site IT staff with limited experience changed a certain network setting, which resulted in the crippling of software used to run a variety of essential medical equipment.” — CEO in health care/pharma

• “Due to regulatory requirements, we had to start production over again and revalidate manufactured products.” — CFO in health care/pharma

• “Our main patient care system went down for almost 24 hours. Manual processes were put into action, but patient safety is at risk and routine work becomes error prone and slow.” — senior IT manager in health care/pharma

For most of the respondents, the situation isn’t improving. As illustrated in the following findings, technology problems aren’t just occasional hiccups; they’re a continual source of frustration and waste:

• Forty-eight percent said technology performance issues occur daily.

• Seventy-five percent said the frequency of failures is increasing or staying the same.

• Fifty-one percent have experienced major failures within the past four to 12 months.

• Eighty-one percent said the same major technology failure has occurred multiple times.

To make matters worse, organizations aren’t doing what’s necessary to stem the bleeding. Many turn a blind eye to these issues or attempt quick fixes that don’t resolve the underlying problem. Measuring and monitoring are afterthoughts. The study concludes that this lack of insight into business impact correlates to the following issues:

• failure to grasp the issue’s root cause and, as a result, a reduced ability to conclusively resolve it;

• failure to grasp the severity of the business impact, oftentimes leading to an inappropriate response. For example, excessive resource allocations have the potential to be as damaging as underresourced efforts; and

• dissonance between IT and business, including a lack of alignment and inconsistent perceptions of severity and time to resolution, causing near-term revenue and productivity consequences as well as long-term reputation damage both internally and externally.

It’s an old saying that what gets measured gets fixed. If facts and figures are attached to a problem, the appropriate resources, including money, people, and tools, are allocated.

Uncovering performance problems and dedicating the appropriate time and effort to their resolution are even more important in health care. When IT fails to function well, the following areas suffer:

Patient care outcomes: Despite this being the core responsibility of health care providers, I have heard numerous stories from chief medical information officers who recall frustrated clinicians accusing them that their “technology decisions are killing my patients.”

Return on investment: Poor application performance will force clinicians to revert to old habits. These manual efforts translate to poor adoption of the application and the circumvention of defined processes. When you consider that EHR and enterprise resource planning solutions deployed across a large health care provider can cost up to $1 billion (for licenses, hardware, labor resources, project, module integration, etc), poor performance translates into costly delays, unmet return on investment, and compliance violations.

Clinician satisfaction: To the latest crop of medical school graduates who were raised and educated in the digital age, deficient or underperforming technology is a turnoff. Also, technology deployment and its performance are key selling points in the recruitment and retention of clinicians.

Patient experience across the care continuum: Applications in the health care industry go beyond clinicians inputting data in EHRs. Providers feature applications spanning admissions, pre-op, operations, post-op, telemedicine, remote diagnostics, and myriad other areas. Poor performance affects patient loyalty (and proper health maintenance) in a similar manner as it would a shopper on a slow eCommerce site.

In Summary
When you consider the across-the-board costs plus the negative impact on patient outcomes, the health care community must take the important next steps in its transformation toward becoming a truly connected, accountable, and value-focused industry. With so much investment and so many lives at stake, it would be a shame if leadership didn’t approach new IT environments from a broad and proactive perspective.

— Jeff Tishgart is global director of strategic business development for Compuware APM.