Hospitals

The Future of Consulting

By Rob Merkel, IBM Global Business Services

Consulting services for the healthcare industry are in the midst of tremendous change. While cost and quality issues continue to drive the need for transformation across the industry, advances in technology and government stimulus will accelerate the rate at which it is implemented. In particular, three trends will shape the future of services.

First, technology advances are providing a foundation for capturing, sharing and analyzing information. As the industry becomes more interconnected and instrumented, a proliferation of both structured and unstructured data will be captured and shared to significantly improve care delivery and individual health.

Bypassing third-party governance allows Spectrum Health to meet physician-practice needs across three hospital systems.

In 2007, Spectrum Health became a development site for the deployment of a new concept in health information exchanges (HIEs). The integrated health system in Michigan, which includes seven nationally accredited hospitals with more than 2,000 beds and 140 service centers, set its initial focus exclusively on clinical-result distribution. By leveraging the HIE technology, Spectrum Health was able to eliminate fax delivery of information in 130 offices and streamline delivery of patient data to more than 930 physicians.

Communication among ED clinicians and federally qualified health centers in the Milwaukee area was improved, including real-time access to patient historical-encounter data.

A successful health information exchange (HIE) depends on more than just sharing data, according to Kim Pemble, executive director of the Wisconsin HIE (WHIE). In order to optimize impact for clinical care in the community it serves, a successful HIE should be able to bring patient information together in real time through collaboration and information sharing across multiple healthcare organizations, he contends. Additionally, such projects should consider secondary applications of the data, such as in support of public-health surveillance.

Wisconsin has experienced firsthand the challenges of establishing a successful regional HIE. The WHIE recognized the importance of engaging a broad spectrum of stakeholders and sought members from all area healthcare providers, payer organizations, state and local governments, public health officials, community interest, patient advocacy, pharmacies, reference laboratories, and numerous other stakeholders.

Wireless mobile-computing workstations are instrumental in bringingthree dialysis facilities together for videoconferencing.

In a typical day at the Dialysis Center of Lincoln (DCL), in Lincoln, Neb., doctors and nurse practitioners examine dozens of patients during dialysis treatment. While accessing the patient’s electronic medical record (EMR), they carefully check the patient’s skin color, the point of access for the dialysis equipment and other health conditions related to the patients’ kidney disease.

It sounds routine – except that many of the patients are 80 miles north, at DCL’s Columbus facility, or 45 miles south at its Beatrice clinic. The visual exams and documentation are completed using DCL’s telehealth system, which utilizes wireless mobile-computing workstations.

Electronic health-record implementation provides dramatic productivity improvements, $600,000 in annual savings, and a return on investment of slightly more than two years.

A few years ago, Robert Carroll, M.D., the chairman of emergency medicine and medical director at Eastern Connecticut Health Network (ECHN), took a step back from a day of controlled chaos and realized he needed a better way to gather data that would identify bottlenecks in his emergency departments (EDs). At the time, the staff used paper forms and charts to treat and track patients, and paper was not pulling its weight.

The emergency departments at the two hospitals of ECHN together handle an average of 180 patients a day and more than 68,000 visits a year. The 249-bed Manchester Memorial Hospital and 102-bed Rockville General Hospital are affiliates of ECHN, a not-for-profit, community-based health system serving residents of 19 towns in eastern Connecticut.

Patient monitors have typically tethered patients to their beds with restrictive cables, presenting challenges for caregivers and patients alike.

Patient monitors have typically tethered patients to their beds with restrictive cables, presenting challenges for caregivers and patients alike. For caregivers, wired monitoring restricts the ease of patient transport between care areas, limits flexible acuity monitoring (the ability to add or remove incremental clinical measurements as the patient’s status changes), and hampers data integration between devices and systems. For patients, being tethered to a bed restricts mobility and comfort, potentially inhibiting rapid recovery, particularly in critical-care patients.

Hospitals are rapidly adopting wireless technologies that have the potential to change the way doctors, nurses and healthcare institutions operate. Hospitals, for example, are expanding their use of medical telemetry, a portable system worn by the patient that continuously measures a variety of vital signs and wirelessly transmits data to a central location.

To address compliance and IT security, Piedmont Healthcare chose to establish baseline metrics for IT security risk.

Last year, the new director of IT security for Piedmont Healthcare, Nadia Fahim-Koster, decided to reassess the compliance requirements of the organization, using a systematic and organized approach. She chose to establish baseline metrics for IT security risk, which would provide a picture of the compliance status of the hospital network today and for future comparisons. "This would be a great way to show compliance and progress to the executive team," says Fahim-Koster. "We needed the baseline for historical trending, also. In addition, we wanted to adjust security-configuration controls and comply with new regulations. These metrics deliver clear, actionable compliance-measurement reports quarter over quarter." Fahim-Koster was confronted with several challenges to this goal, including:

Platform offers advanced radiology features, while meeting the integration and image-distribution needs of the IT staff.

Most U.S. healthcare providers are now approaching their second- or third-generation of picture archiving and communication systems (PACS). The staff at St. John Health System in Tulsa, Okla., was no different. They were looking for a standards-based PACS that facilitated integration with existing hospital information systems and radiology information systems (HIS/RIS), as well as existing imaging archives. The St. John staff also needed a platform with advanced features to improve diagnostic accuracy, while simultaneously boosting productivity.