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Convergence by committee

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  By Stephen L. Grimes,  September 24, 2013

Transforming patient care through strategic acquisition and application of new healthcare technologies.

Healthcare is on the verge of a major leap forward as evolutionary technologies are introduced. Advances in imaging, robotics, telemedicine, information and nanotechnologies have the potential to facilitate the delivery of more widely available and higher quality care to the world’s population. However, simply introducing new technologies is not sufficient to achieve the promised benefits. To realize their full potential, technologies must be rolled out strategically with careful consideration of corresponding changes in healthcare practices and supporting infrastructures. Failure to make these changes in practices and supporting infrastructure will only lead to exorbitant healthcare costs, uneven quality and compromised patient safety.

Developing a strategy

The effects of new technologies by providers can have implications that go well beyond the department or service in which they have been introduced. Today, health technologies are integrated or connected via networks and, as a consequence, their successes or failures can have a ripple effect through many other aspects of a provider’s operations. This often involves changes in procedures and workflows that may conflict with legacy technologies in use elsewhere in the provider organization.

To address these challenges, providers must develop a more strategic approach by identifying and considering all relevant factors, including:

  • Improved care outcomes;
  • Improved patient/staff safety;
  • Regulatory compliance;
  • Improved workflow;
  • Improved revenue;
  • Reduced costs;
  • Serving a broader demographic; and
  • Market perception (reputation).

They should consider the following assessment practices:

  • Focus on evidence-based reviews of new technologies that further the service objectives of the organization.
  • Charge appropriate stakeholders with analyzing and planning workflow processes associated with effective deployment of new technologies.
  • Establish metrics that measure predictable benefits of the new acquisitions.
  • Adopt a long view and promote the concept that healthcare technologies are organizational assets that need to be properly integrated technically and operationally to fully realize benefits.
  • Avail itself of appropriate staff expertise, particularly from senior experts in clinical engineering and information technology who can:
    1. Identify required infrastructure associated costs (e.g., facilities, staffing, supplies, training, service/support); and
    2. Conduct a risk analysis to identify vulnerabilities and the degree to which they can be reasonably mitigated.

To successfully take this strategic approach, organizations should consider establishing a technology assessment committee with key representatives from medical, nursing, administrative, financial, technical (clinical engineering and information technology), risk management and supply chain areas. In considering the above factors and applying these practices, a committee consisting of these stakeholders can best ensure that adequate consideration is given to those healthcare technology decisions that can have major clinical, operational and financial implications for the organization.

Modernizing the organization

The increasingly complex nature and expanding role of healthcare technology requires a corresponding increase in the sophistication of infrastructure. A critical aspect of an effective infrastructure is the successful integration and collaboration between clinical engineering, information services and telecommunications. It is also vital that healthcare organizations realize that, while the technologies are converging and the support model (i.e., clinical engineering, information services, telecommunications) needs to adapt, the best elements of each need to be preserved in the process (as illustrated in the following figure). Among the most important aspects of a typical clinical engineering service to preserve is the focus on the nuances of technology application at the point of patient care. Support of medical devices and systems cannot be rendered safely or effectively without this “patient-centered” perspective.

                      

A growing number of healthcare organizations are also bringing their clinical engineering and information services together under a common organizational framework in order to foster collaboration and coordination on technology issues. To preserve the unique capabilities of each group, organizations should consider adopting a common governance framework such as the “Information Technology Infrastructure Library” (ITIL) or “ISO/IEC 20000-1:2005 Information Technology – Service Management.” These guidelines can provide both common touch points and syntax that facilitate better synergy of an increasingly integrated service. They also provide a framework to build a more effective delivery of services and to uncover service gaps.

Healthcare facilities cannot afford to adopt new technology without a plan. Successfully achieving the organization’s goals requires new strategic processes and an upgrade of the infrastructure. By taking a proactive approach, today’s healthcare providers can determine what innovations will help them meet their goals of improved care, controlled costs and an efficient operating environment.

About the author

Drawing from his nearly 35 years of experience with hospitals, healthcare consulting and research firms, Stephen L. Grimes now serves as the chief technology officer at ABM Healthcare Support Services where he specializes in technology management, medical and information technology convergence and integration-related matters.


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