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Healthcare IT proffers smarter reform

By Phil Colpas, Managing Editor

s we prepare to go to press on this issue of Health Management Technology, we await the Supreme Court’s decision on President Barack Obama’s polarizing healthcare law. Regardless of your po- litical ideologies and whether the justices uphold or denounce the law or declare parts of it unconstitutional, there is one thing upon which we can all agree: Rising healthcare costs must be controlled. How, exactly? Well, that’s where the debates really ensue. At its best, healthcare IT can help determine the most-prudent courses of ac- tion through analytics, establishing best practices and improving workfl ow. At its worst, IT just adds more layers of confusion and red tape to an already disjointed, disorganized, unwieldy and unruly system. The latter is especially true when implementation is mandated from the top down, instead of being allowed to grow organically – as needed to improve processes – from the bottom up. “Unraveling the IT Productivity Paradox – Lessons for Health Care,” an article in the June 14 issue of the New England Journal of Medicine, states: “Debates about the productivity yield of IT are new to healthcare but not to other sectors of the economy. During the 1970s and 1980s, the computing capacity of the U.S. economy increased more than a hundredfold while the rate of productivity growth fell dramatically to less than half the rate of the preceding 25 years. The relationship between the rapid increase in IT use and the simultaneous slowdown in productivity became widely known as the ‘IT productivity paradox.’” Several studies and a few decades later, the debate over “the paradox” rages on. Conventional wisdom supports IT as a boon to both productivity and return on investment (ROI) – provided three key criteria are met, according to NEJM: measurement, management and usability. The fi rst component, measurement, is fairly self-explanatory and all-pervasive – especially in healthcare. It has to do with the diffi culty of quantifying and tying processes to ROI that may be far removed from the revenue stream. Problems in this area actually dovetail nicely with healthcare’s recent (and late) obsession with analytics; to solve it will take advanced algorithms and the ability to assign value to less-quantifi able items, such as productivity, the quality of treatment and the overall patient experience. Proper management and usability both depend on having the right systems in place to support the new technology, whatever that may be. Again, these prob- lems are exacerbated by the top-down – as opposed to bottom-up – approach. If a solution is implemented organically, supporting systems grow along with the technology. But if software is purchased simply to fulfi ll a government mandate, chances are much higher that both management and usability will suffer. The NEJM article suggests focusing on the “delivery reengineering needed to create a productivity payoff” and paying “greater attention to measuring and improving IT usability.”


Granted, that’s easier said than done. But since we can’t journey back in time, we must play the hand we’re dealt. Enjoy the issue.



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