The goal of the Affordable Care Act (ACA) is to reduce costs while improving quality. I believe those of us in healthcare IT maintain a similar goal.
Delivering high-quality clinical care is impossible without the support of strategic, integrated, and agile IT systems. Today, aligning clinical care with technology requires IT systems and staff to improve an organization's ability to adhere to the requirements of the ACA, which is separate from achieving Meaningful Use. For those of you who confuse the ACA with the HITECH Act, I recommend this article by my colleague Dick Taylor on the subject.
There are 10 titles within the ACA. Title I -- Quality, Affordable Health Care for All Americans -- has received the most press attention and scrutiny. Here, I will examine three other titles that complement much-needed healthcare IT (HCIT) reform.
1. Title III: Improving the Quality and Efficiency of Health Care
There are more than 100 sections under this title, but I will focus on just a few and analyze their influence on healthcare IT.
Hospital value-based purchasing program: Healthcare IT needs to support a model that measures the value of the work being done. Too many health systems treat IT as a sunk cost, instead of seeing it as part of the organization's strategic vision and realizing the high value it can yield. For example, some recent HIMSS Davies Award winners show how disciplined healthcare IT can improve an organization's clinical quality and ROI.
Hospital-acquired conditions reduction and hospital readmissions reduction programs: These areas focus on holding organizations accountable for avoidable complications. We have already seen this accountability requirement in healthcare IT, most acutely regarding HIPAA violations. We believe accountability in healthcare IT will continue to increase, and as healthcare systems get larger, it will be important to learn from mistakes quickly to prevent issues from occurring chronically.
Establishing community health teams to support the patient-centered medical home: As defined by the National Committee for Quality Assurance, "The patient-centered medical home is a way of organizing primary care that emphasizes care coordination and communication" for improved outcomes. That concept is endorsed in the ACA. In healthcare IT, this can translate to strong governance and great customer service that is focused on today's rapidly transforming environment.
I have worked with healthcare IT groups that listen to the loudest voice in the room, as opposed to addressing organizational priorities. This behavior often leads to inefficient processes and even louder voices clamoring for attention and resources.
[Patient engagement is key to successful healthcare reform. But how do we overcome the barriers? Read What Consumer-Driven Healthcare Really Means.]
In contrast, MultiCare's 2009 Davies Award Application outlines an exceptional example of governance during what is perhaps a health system's most critical IT moment: going live with an EHR system. Its approach was engaging and elegant, and it earned buyin across the organization. Many organizations do not take the time to set up this type of governance. I have seen processes like MultiCare's work at a number of organizations at go-live and as a long-term system prioritization tool. It is amazing how different an organization's relationship with IT is when operational leaders understand the scope of work and are accountable for determining priorities.
2. Title IV: Prevention of Chronic Disease and Improving Public Health
Prevention in healthcare IT means ensuring that robust disaster recovery is in place. I recently read an article describing how a health system managed 10 days without its EHR system. We can all agree that downtime of this magnitude should be avoided at all costs, just as we can likely agree that moderate physical activity reduces Type 2 diabetes. But how many of us incorporate such prevention before being diagnosed as pre-diabetic?
Similarly, we need to change our mentality regarding disaster recovery. There are simple steps we can take to ensure that end users are never without the clinical information in our IT systems, which they use to make important -- sometimes life-and-death -- decisions. We need to ensure that distributed computing, graceful degradation, redundancy, and regular testing of operational processes are in place to ensure robust disaster recovery. As technology becomes an ever more important part of healthcare, we cannot afford the cost of system outages.
3. Title V: Health Care Workforce
My debut InformationWeek column reviews our perspective on how healthcare IT needs to rethink its hiring practices. In summary, we believe it is important to look beyond lack of experience and focus on a candidate's ability to learn, attitude, and fit within the organization's culture.
Your own reform
I hope this helps you start the conversation in your own organization about healthcare IT reform. It will likely be a long discussion. Some may try to repeal the need for reform, but resistance is futile. To thrive, healthcare IT leaders need to start their own reform beyond the HITECH Act requirements. As an industry, don't we want our customers to feel fortunate they have us in their corner as they undergo this significant transformation?
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