Health Care and Information Technology: Now More Than Ever

Joseph M. DeLuca, FACHE

The history of information technology support for the health care industry would leave some to be skeptical about the promise of the future. The results of the past have been mixed, with high expectations and often poor results – incomplete implementations, partially developed technologies, failed vendor promises, unrealistic investor return expectations.

Such a point of view has merit, and holds considerable truth.

I suggest, however, that there is a greater truth in the opposite point of view. Health care information technology today provides considerable value when designed, planned, implemented and used properly. Consider some recent observations from the field:

• At a recent pediatric hospital management team meeting, I observed a quality assurance presentation. During this session, multi-year statistics were presented, representing the number of medication order and administration errors (ranging from "Likely Fatal Outcome" to "No Likely Adverse Impact") that had been prevented by a physician and pharmacist order entry system.
  
  The number was astounding – thousands, with a significant number of "Likely Fatal Outcomes" prevented. Consider the tremendous individual and social value of this. Human lives, a future Nobel laureate, possibly your or my child, saved. Physicians better educated on medication management, and able to pass this increased competency on to students and residents who may not have computerized support at future environments – a "technology benefit cascade" effect. Eventual reductions in malpractice insurance and, over the long term, health care costs.

• At another client site, a national health care financier and payer, administrative costs are being streamlined using a breakthrough blend of information technologies focused upon diverse audiences (providers, payer staff, enrollees, consumers, employers, and the general population). The organization uses technology tools – Internet enablers and agents, interactive voice response technology, fax form entry techniques, and voice activation – to move and manage information to and from users at the most effective point of service. Driving the potential is an innovative work flow engine linked to an expert system enabled object-oriented database.

For organizations to solve this magnitude of administrative and medical management process problems constitutes what Senge¹ would term a fundamental core process redesign. The social, human, cost reduction implications are staggering… and persistent through time as new generations of users increase their knowledge competencies and drive fundamental system-wide behavioral change.

While health care information technology suppliers have supported features and functions with business benefit before, today we are seeing a different and positive behavior. Suppliers are acting on the realization that technology solutions can drive a health care customer’s medical business strategy.

Suppliers at all stages of development (concept, product development, market entry, market leadership) are attempting to center their organizations in support of a global customer market strategy. The result – technology suppliers truly focused on enabling customer competitive competencies.

Today’s cultural and technological trends offer major opportunities for the next millennium:

• The increased computer sophistication and literacy of the general population will drive a demand curve for access, tailored content, custom usability features, expert system logic, and benefits of exponential proportion.

• Satellite telecommunications capabilities, coupled with cellular digital networks, portable information system appliances and personal digital assistants, will extend the reach, range and maneuverability of applications and content.

• New software techniques, while not decreasing software development costs significantly, will foster increased value through features, content pushing and customization, and enabling an average citizen to be a "power knowledge user."

• New hardware technology will eliminate the cost barriers to capacity-bound software applications, such as continuous stream voice recognition.

Health care management teams, recognizing the definitive role information technology can play, will dedicate increased attention to individual and organization-wide competency development programs (core and distinct) in the subject matter.

The future is truly bright for the synergy of health care and information technology. All points of view – user, investor, society, buyer, supplier – stand to benefit from the continued evolution of the health care information technology industry. To be sure, barriers exist and must be overcome. Yet the foundation and knowledge is there to support expanded social value, increased total system efficiency and effectiveness, and improved clinical efficacy through the intelligent application of capital, technology and management resources.

Joseph M. DeLuca is a frequent national commentator on health care public policy and information system issues. Email: info@itoptimizers.com

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¹Senge, Peter M. The Fifth Discipline: The Art & Practice of The Learning Organization. New York: Doubleday/Currency, 1990.

 

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