Process Improvement and Information Technology: The Keys to Health Care Transformation.

Human beings are inherently resistant to change. In our technologically driven world, change happens fast, thereby regularly challenging us inherently change-averse humans to adjust. Only through rapid, effective, outcomes-driven change can we address the numerous challenges facing health care today. And as health care leaders, it is our responsibility to learn how to become the most effective change leader so that we can deliver the changes in systems, processes, and thinking required to deliver ever-improving quality, safety, and access to care while managing its cost.

Quality and efficiency successes leveraging IT and new processes.

Today, healthcare annually invests billions of dollars in information technology, including clinical systems, electronic medical records and interoperability platforms. While continued investment and parallel development of standards are critical to secure exponential benefits from clinical information technology, intelligent and creative redesign of processes through path innovation is necessary to deliver meaningful value. Reports from two organizations included in this report review the steps taken to reinvent clinical processes that best leverage information technology to deliver safer and more efficient care. Good Samaritan Hospital, Vincennes, Indiana, implemented electronic charting, point-of-care bar coding of medications prior to administration, and integrated clinical documentation for nursing, laboratory, radiology and pharmacy. Tenet Healthcare, during its implementation and deployment of multiple clinical systems across several hospitals, focused on planning that included team-based process redesign. In addition, Tenet constructed valuable and measurable metrics that link outcomes with its strategic goals.

Clinical ROI: not just costs versus benefits.

Although sophisticated economic modeling can be used to quantify intangible benefits, ROI calculations for clinical information systems are driven more by the values and strategic direction of an organization than by any other considerations. But investing in clinical information tools to ensure quality and patient safety is, in reality, required as a cost of doing business and functioning as a safe hospital.

ROI under scrutiny: the radical redefinition of a core concept.

This article offers a three-part analysis for identifying and assessing return on investment in healthcare information technology (IT) projects. Returns to IT can be financial, clinical, or structural. The goal is to identify key areas of measurable returns to both assess the value of a project before it is undertaken and to assess the actual value returned to the organization. Given the choice, many senior executives still prefer to rely on classic financial analyses, but the true value of a project is often found in the clinical and structural returns. Still, project-specific assessments do not answer the core question of whether long-term strategic investment in IT leads to a systemic strategic advantage to healthcare organizations. This article addresses these issues and indicates opportunities for further investigation.

Clinical technology: are you getting your money's worth?

Providers investing in a clinical information technology (IT) system should consider their organization's specific needs and those of the surrounding community. Assessments of clinical IT value should take into account factors beyond cost savings. Providers should be aware of related tangible benefits, such as reductions in length of stay and enhanced administrative and clinical services. The capability of a clinical IT system to help prevent medical errors and improve operational efficiency should weight heavily during a provider's assessment of whether to invest in the system.

Computerized physician order entry: a prescription for patient safety.

Clinician adoption of CPOE/CDS solutions is crucial to helping caregivers reduce medical errors and enhance patient safety. The LeapFrog Group CPOE/CDS report can be a helpful guide, but as clinicians concerned about the quality of health care and the well-being of our patients, we must play an active role in the successful adoption of these solutions by: 1. Making sure that your institution is committed to having the appropriate people involved in the entire process, including nurse leaders. 2. Selecting a vendor that has the knowledge and clearly understands the importance of implementing this type of system. 3. Ensuring that your organization is selecting a system that actually meets the criteria defined by the LeapFrog Group.