The survey of 475 professionals involved in healthcare quality revealed that clinical and operational personnel now are on the same page as IT staff in their belief that IT can help improve quality in healthcare. "I was amazed to see how consonant they were," Dr. Joseph Fortuna, chair of ASQ's Healthcare Division Fortuna, told InformationWeek.
Milwaukee-based ASQ cited a U.S. Department of Health and Human Services forecast that said healthcare staffing shortages will worsen starting in 2014, as 32 million more people gain health insurance because of the Patient Protection and Affordable Care Act and aging baby boomers become eligible for Medicare. The shortages will likely result in longer wait times in emergency rooms and to see primary care physicians, greater fragmentation of care, and potentially more medical errors, the survey indicated.
But properly implemented IT can help reduce errors, provide better access to health information, and improve care coordination, said Fortuna, who also is CEO of Prism, a not-for-profit organization in Troy, Mich., that assists medical practices with change management. "The idea is, [survey respondents] are tying it to increased efficiency," Fortuna explained. "At its core, it's a technical transformation as much as a clinical and operational transformation."
One quarter of those surveyed said installing and using health IT systems would do more than any other change to improve quality, given the coming shortages, and 29% ranked it second of five choices. Only the creation of fast-track units to treat and release patients with low-acuity ailments such as sore throats and broken wrists ranked higher, with nearly a third saying that would have the greatest impact on quality.
When asked to choose among various information technologies, 41.7% of the survey pool said that EMRs would have the greatest counter-effect to staff shortages. EMRs beat out clinical decision support systems, computerized physician order entry for medications, telemedicine/remote monitoring, automated dose dispensing, and disease registries, though Fortuna said clinical decision support can "dramatically increase efficiency" of healthcare professionals if it's part of workflow redesign.
Fortuna noted that quality can be measured in terms of both clinical and operational quality, and said more efficient operations can help cut some of the $700 billion in a year in healthcare waste that Americans pay for every year. "What we tend to forget is the operational quality," Fortuna said.
Fortuna stressed the importance of workflow improvements so that IT infrastructure can support delivery of the right information on the right patient at the right time rather than just automating inefficient processes. "The important thing is not to put the cart before the horse," Fortuna cautioned.