Rx for Success

 
 
By Samuel Greengard  |  Posted 2010-04-08
 
 
 

Niall Pariag has seen the future of medicine, and it’s as much about wireless computing, business intelligence (BI) and virtualization as it is about X-rays and MRIs. The senior network administrator at Riverside Health Care Systems, a 400-bed community hospital network in New York state, is well aware that performance and cost controls are inextricably tied to an IT infrastructure.

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“It’s important to provide the level of availability, resilience, scale, performance and security required in today’s world,” Pariag explains. “It’s also important to have the flexibility to address future needs.”

At Riverside Health Care, this line of thinking has resulted in a robust IT infrastructure that, among other things, supports bedside registration, drug administration and verification, and mobile access to data, along with guest access.

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And Riverside isn’t alone. Health care providers are turning to a spate of solutions and technologies to boost performance and trim costs. What’s more, as U.S. health officials push for greater adoption of electronic medical records (EMR) and a variety of reforms, IT is paving the way for other gains.

“From a technology perspective, we are seeing a convergence of back-office, front-office and operational systems,” notes Daniel Garrett, partner and leader of the PricewaterhouseCoopers (PwC) Health Care IT practice.

For business and IT leaders, the current environment translates into both opportunities and challenges. There’s enormous potential to improve medical care and weed out inefficiencies. However, getting a handle on a tangle of initiatives—including EMRs, virtualization, mobility, analytics, telemedicine, home health and compliance issues—is nothing short of daunting.

“There’s a need to focus on end-to-end business integration,” points out Dadong Wan, innovation lead for Accenture’s Technology Labs.

A Healthy Outlook

The face of health care is changing rapidly. An aging population, growing pressure to reform the industry and escalating medical costs are heaping enormous pressure on health care providers. At the same time, the need for technology—for health care professionals, organizations and consumers—is growing.

“The cost of health care is rising faster than the GDP [gross domestic product],” states Eric Brown, research director at Forrester Research, “and everyone recognizes that something must be done.”

Information technology is at the nexus of this changing landscape, and IT departments are on the front lines of the revolution. At Riverside Health Care, for example, a robust network and a wireless infrastructure have paid dividends. The provider has introduced bedside registration and order entry, nursing bedside documentation systems and bedside drug administration via tablet devices.

Nurses and health care professionals carry handheld units, including iPod touches and iPhones. And Pariag soon plans to introduce RFID patient tagging.

An Aerohive controllerless wireless system provides a secure network with robust provisioning, configuration and policy management capabilities. It also manages a separate guest network. If an access point fails or a network problem occurs, there’s no single point of failure because configuration and policy data reside at each access point.

The result, Pariag says, is a “far more efficient system for managing work and patients. People and equipment are connected throughout and across facilities.”

Getting physicians and other health care professionals the information they need is also a priority at Good Samaritan Hospital in Vincennes, Ind. The 247-bed facility, which provides care for individuals in five counties in southwest Indiana, has made patient records and other information available to doctors from inside the hospital, as well as from remote offices and from home, according to CIO Charles Christian. “Physicians are able to pull up medical records and images before they come into the hospital to start a procedure,” he says.

At the center of Good Samaritan’s IT initiative is a Web portal with links to more than half a dozen major applications. Physicians and nurses can use tablet PCs and smartphones to access data over a wireless network. An Imprivata authentication system tied into Microsoft Active Directory provides single sign-on functionality.

“Physicians can review charts, listen to dictations, view prescriptions and react to problems—including chart deficiencies—faster and better than ever before,” Christian says. “Through a combination of technology and changes in workflow, we have been able to take a huge step forward.”

To be sure, smartphones, mobility and wireless technology are rippling through the industry and changing things in a profound way. According to mHealth Initiative, more than a thousand medical apps now exist for the iPhone, and many doctors are turning to these devices to manage their practice more effectively.

Hospitals are also using bedside touch-screen devices that allow patients to communicate with doctors and nurses, watch TV, browse the Internet, and e-mail family and friends. Many are also turning to remote monitoring for heart and diabetes patients.

Rx for Success

Building a better health care model isn’t only about delivering services faster and better. It’s also about using information technology to become smarter and more efficient. As a result, business intelligence is moving into the mainstream.

“BI is a transformational technology,” says Forrester’s Brown. “Tapping into clinical and demographic data through analytics, data mining and data warehousing represents a huge opportunity.”

Many health care organizations are already using business intelligence and predictive analytics to develop more efficient processes and programs. Some are turning to these tools to rate the probability of patients contracting certain diseases, including diabetes. Others are studying patient usage patterns and adapting programs, purchases and scheduling to reflect consumption and anticipated demand. Still other organizations are adapting marketing campaigns to fit the preferences and needs of different customer segments.

Martin’s Point Health Care in Portland, Maine, has placed a heavy emphasis on analytics. With more than 65,000 patients at nine practice sites, the organization built a dashboard to measure eight key metrics, including the percentage of patients that see their primary care physician versus someone else within the office; how preventive care plays out; and the relationship between patient charges and collection rates. “In the past, doctors and administrators didn’t have a good grasp of patient care and outcomes,” acknowledges Jeff Guevin, manager of business intelligence administration.

The health care provider, which uses an IBM Cognos BI system to link 13 business units across 20 databases, has become far more efficient, notes David Halbert, an internist with Martin’s Point. “We’re identifying patients that have dropped off the map,” he says, and “we’re able to be more proactive about patient care and lab work. There are fewer callbacks, and processes occur quicker and better than at any time in the past.”

The result? The organization estimates the ROI for the BI initiative at more than 1,000 percent, and the average annual gain exceeds $335,000.

But there are other benefits as well. According to PwC, 90 percent of health care executives believe that the use of secondary data—often collected and stored in EMRs—significantly improves the quality of patient care. In addition, nearly two-thirds of these executives say that they expect their use of secondary data to increase significantly during the next two years. PwC reports that the effective use of this information leads to significant quality gains and cost savings.

More Efficient Data Centers

Information technology is also changing the face of health care in less obvious but equally tangible ways, such as virtualization and cloud computing. “Virtualization provides a robust framework that supports many of the essential patient-facing systems,” says Accenture’s Wan. “It’s helping organizations manage costs and build more efficient data centers.”

That’s the case at University of Pittsburgh Medical Center. Four years ago, the health system, with 20 hospitals and 400 outpatient and long-term care facilities, found itself running out of data center space. It turned to server virtualization and today has 1,200-plus virtual machines running on 22 Windows servers.

The rack space required for these servers has declined from 54 to 2-1/3. Likewise, the organization has trimmed Unix servers from 167 to 14, and it will soon consolidate to four. “We are experiencing an enormous cost saving in terms of power, racks, floor space, network ports, storage and air conditioning,” says Paul Sikora, vice president of IT transformation.

The virtualization initiative has also helped the medical center construct a private cloud that manages EMRs, financial systems, time and attendance, and other functions. This virtualized environment, created with help from IBM, provides full disaster recovery capabilities.

The result? “Instead of running our EMR system at 50 percent capacity if we go into disaster recovery mode, we can operate it at 100 percent,” Sikora explains. Equally significant: The medical center has avoided approximately $80 million in capital and operating costs as a result of the project.

In the end, one thing is certain: The demands on IT in the health care industry aren’t going away. Russ Nash, global managing director for health industry initiatives at Accenture, says the current wave of health technology is all about providing greater access to information, more sophisticated ways to examine information, and identifying ways to put computing and data to greater use.

“Technology offers the potential to create more efficient health care providers and a significantly better health care system,” Nash says.