Management Systems

Does the implementation of enterprise wide systems improve the quality of care and drive down the cost? Cite cases and references.

Enterprise-wide healthcare information management systems have a significant positive effect both on the quality of care and reduction of costs within healthcare providers. Quality of care improves as the accuracy, alacrity and relevancy of information increases over time within any healthcare provider (Hickman, Smaltz, 2008). The greater the depth and extent of information complexity and need throughout an organization, the more potentially significant investments in healthcare information management systems become.

Two specific cases of how enterprise-wide healthcare information systems are driving down costs while increasing the quality of care are provided here. The first is from Espirito Santo Hospital, in the city of Evora, Portugal (Caldeira, Serrano, Quaresma, Pedron, Romao, 2012). This hospital completed an extensive process management and re-engineering of how information workflows could be improved to increase patient treatment quality and reduce cost while increase the use of analytics and measurement of value by a significant amount (Caldeira, Serrano, Quaresma, Pedron, Romao, 2012). The result was a measurable reduction in costs and delays of treatment programs while the many metrics of measuring quality of treatment continued to escalate. Due to the intensive level of information engineering completed, the hospital was able to measure done to the X-Ray level what the quality impact is of their enterprise-wide information system is accomplishing (Caldeira, Serrano, Quaresma, Pedron, Romao, 2012). What is also significant about this specific case study is how the reengineering of workflows actually increased the level of patient satisfaction by respecting their time more effectively than the hospital had ever been able to accomplish before (Caldeira, Serrano, Quaresma, Pedron, Romao, 2012). The combining of intensive information engineering and uses of analytics had a combined effect of completely changing the culture of the hospital and brought about a much higher level of accountability and performance aligned to patients’ expectations. The second case includes forum hospitals located throughout Canada, who chose to keep their specific identities hidden due to their results being so significant from the standpoint of combining radiology and hospital information management workflows (Trudel, Pare, Laflamme, 2012). The four hospitals were able to significantly increase the quality and speed of radiology treatments while integrating results with the broader patient management systems, streamlining treatment programs and measuring results in the process (Caldeira, Serrano, Quaresma, Pedron, Romao, 2012). This had an immediate reduction in cost and an exponential increase in quality of service.

2. Some experts state that full enterprise wide implementation of the HIT details of the Health Information Technology for Economic and Clinical Health Act could cost as much as $100,000 per hospital bed, most of which will not be reimbursed by government subsidies (the Economist, World Edition, 2010). What is the impact of this on already tight budgets?

The estimated cost of a full enterprise-wide implementation of the HIT details would easily cost $100,000 or more when burdened with salaries and the costs of training and change management programs. This will lead to healthcare budgets having to do increase fees, push the costs forward through the value chain, ultimately driving up the cost per care. It is common in highly regulated healthcare industries to lose track of just who the customer is, as is shown in the many case studies and which can be inferred from the lessons learned in the course (Hickman, Smaltz, 2008) (Tan, Payton, 2010). Once the customer is no longer being seen as the patient and the healthcare insurance provider is, the cost increases aren’t scrutinized and looked at. The fact is that with such a large price tag per bed, the patient will end up carrying the majority of the cost and the insurance provider will become even more selective in who is authorized for treatment. In short, the entire value chain of healthcare providers begins to contract as each member of it seeks to protect itself from the severe risk of this requirement. All aspects of the value chain will seek to unify and mitigate, even eliminate this risk, yet will most likely begin being much more selectively about which patients get treatment, for which specific ailments, and will also be required to underwrite this cost more than any other member of the value chain.

References

Caldeira, M., Serrano, a., Quaresma, R., Pedron, C., & Romao, M. (2012). Information and communication technology adoption for business benefits: A case analysis of an integrated paperless system. International Journal of Information Management, 32(2), 196.

Hickman, G.T., Smaltz, DH (2008). The Healthcare Information Technology Planning Field book: Tactics, Tools and Templates for Building your it Plan. Chicago: HIMSS. ISBN 978-0-9800697-1

Tan, J., Payton, F.C. (2010). Adaptive Health Management Information Systems: Concepts Cases and Practical Applications (3rd ed.). Boston: Jones and Bartlett. ISBN 13: 978-0-7637-5691-8.

Trudel, M., Pare, G., & Laflamme, J. (2012). Health information technology success and the art of being mindful: Preliminary insights from a comparative case study analysis. Health Care Management Review, 37(1), 31.