Vol. 11 •Issue 2 • Page 23
Research Study to Examine the Depth of Clinical Automation in Respiratory Care Departments
By Ian Lazarus
If a computerized, enterprise-wide medical record is indeed the Holy Grail of medical care delivery, it has proven itself to be as elusive as the legendary original.
Health care providers and information technology (IT) vendors have struggled to perfect their electronic repositories, and while they may have had the luxury in the past of iterative experimentation, they’re now faced with regulatory compliance on a timetable established by the Health Insurance Portability & Accountability Act. The Holy Grail may yet be discovered in our lifetime.
To better understand the industry’s use of clinical information systems and electronic health records (EHRs), MediServe Information Systems, Tempe, Ariz., has launched a national research study of IT priorities in health care. MediServe is a supplier of clinical information systems to the ancillary departments of health care organizations. The research is being conducted by Creative Healthcare USA, Phoenix, a consulting firm providing strategic advisory services to the health care industry. ADVANCE will be covering the project throughout the year.
“Health care providers clearly need strong IT solutions, but the question remains regarding how to deploy those solutions effectively,” noted MediServe President Bruce Mortensen. “We are particularly interested in knowing what functional components of clinical information systems are most important, and how to best configure them.”
The study builds on previous research that shows the industry has come far in its acceptance of EHR and e-Health opportunities. Providers are no longer concerned about security and confidentiality because they assume these requirements are “baked into” a commercially available system. These issues have been replaced by an urgency to tap Internet-based applications’ potential as soon as possible.
The study aims to reveal those departments best suited for automation and to assist managers to plan more effectively for IT deployment within their department. Respiratory therapy is a targeted department for investigation in the study.
INFORMATION TECHNOLOGY COMPLEXITY
The complexity of IT deployments in clinical information systems is evident in the multitude of options faced by hospitals: enterprise-wide systems versus configured solutions, licensed versus application service provider solutions, and commercially supplied solutions versus internally developed programs. Add to this the increasing regulation of electronically stored and shared data, and managers find they must face many internal obstacles even after funding challenges have been overcome.
An enduring controversy in IT deployment is whether a single-vendor approach ultimately delivers on its promise of cost-effective data integration. The one-size-fits-all solution has suffered setbacks in recent years. Large companies must identify ways to integrate newly acquired IT products. Hospitals, in turn, must not only consider “best of breed” criteria in IT procurement, but “best of fit,” an indication of how well various applications work together. Many hospitals are finding that a heterogeneous approach is, in the end, a matter of practical reality.
“Care delivery organizations that actively plan for vendor heterogeneity, even if they use one primary vendor today, will be better positioned for the future,” noted Jim Gabler, research director for Gartner, one of the largest IT research firms in health care.
The study aims to identify those functional characteristics that hospitals, including respiratory departments, must have in either a single solution or a collection of integrated systems.
DATA MANAGEMENT AS A “COACH”
A recent study conducted by the Medical Records Institute revealed the key advantage to an EHR is shared comparable data among different sites in the enterprise and improved clinical processes and work flow efficiency. Forty-five percent of respondents believed they would be utilizing handheld devices to capture clinical data and to update existing EHRs. The MRI study gathered input from nearly 300 respondents.
Hospital departments have relied for years on IT solutions that track order flow, completion of therapy charting, evaluation of individual and group outcomes, quality measures, staffing deployment and financial data. In recent years, it’s increasingly common that a physician might order therapy, yet the exact treatment might not be determined until the treating therapist is at the bedside. This emerging trend toward therapist-driven protocols demonstrates the increasing need for effective data management of patient care plans.
“Ideally, a data management system would function as a ‘coach’ for the bedside therapist, who would enter clinical assessment data based on current clinical and laboratory findings,” noted George Burton, MD, a pulmonologist practicing at Kettering Medical Center in Dayton, Ohio, and a medical consultant to MediServe and ADVANCE. Based on such a design, the IT system would propose diagnosis and severity-based therapy from its database of practice guidelines, such as those endorsed by AARC and other sources of clinical best practices.
To further explore these design considerations, Creative Healthcare plans in-depth interviews with 100 health care managers, followed by a much larger stage of data collection over the Internet. Participants will receive immediate feedback from their web responses based on all prior recipients. Complete results also will be shared upon final compilation.
Editor’s note: Readers can visit www.creative-healthcare.com to participate in the study.
Lazarus is managing director of Creative Healthcare USA, Phoenix.