Developing IT in Healthcare Industry

Developing IT in Healthcare Industry Setting Pathway for Accelerating Prodia Growth

Prof. Richardus Eko Indrajit [email protected]

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Agenda for Today

(c) Richardus Eko Indrajit, 2009

Part One: IT General Industry Environment

What do we want in the future? What do we need to develop in order to win the competition?

What do we have currently? How is the legacy system managed and structured? Part Two: Organisation Existing System

Part Three: Organisation Ideal System

Part Four: IT Strategic Plan

What are the gap defined? How to fill the gap in aligned with organisation plan and strategy?

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Agenda for Today

Introduction

1. Classical IT Myths and Reality Check in the Society at Large 2. IT Roles and Implementation within Healthcare Industry Practices 3. General Check-Up of Existing IT Repository and Architecture 4. Governing Development and Deployment through IT Strategic Plan

Questions and Answers


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Agenda for Today

Introduction




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The Promise of ICT Values to the Stakeholders


cut costs

create revenue

improve services

increase efficiency

integrate process

avoid redundancy

promote transparency

ensure compliance

flatten organisation

enhance quality

fasten response-time

optimise resources

There are so many values ICT can give to the company and business

leverage investment

elevate morality

distribute knowledge

ease administration gain competitive-edge

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The Facts in the Field of Implementation


high investment-operation ccoossttss

rapid tteecchhnnoollooggyychanging rreeqquuiirreemmeennttss

high ddeeppeennddeennccyy

silos eennvviirroonnmmeenntt

low ppeeooppllee lliitteerraaccyycomplex ppoolliittiiccss

rigid aarrcchhiitteeccttuurree

not aauuddiittaabblleelate iimmpplleemmeennttaattiioonnbad qquuaalliittyy

out of date ssyysstteemm

There are so many issues and challenges that ICT brings to the table

un-alignment ssttrraatteeggyy

fail ppiilloott pprroojjeecctt

slow aaddooppttiioonn solid rreessiissttaanncceedifficult iinntteerrffaaccee

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The Biggest Fear on ICT Implementation


Fact COSTS + RISKS

Expectation VALUES & BENEFITS >

…whether it is TANGIBLE or INTANGIBLE !

Old Organisation + Technology = Old and Expensive Organisation

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Balancing Values and Risks are Always a Concern


BBEENNEEFFIITTSSCCOOSSTTSS

There is a way of making sure that BENEFITS will exceed COSTS

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Governance is Not Just a ““Management”” !


Communities + Consensus + Coordination

Without an appropriate governance in place, a risk exposure is increased

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Agenda for Today

Introduction




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Changing Paradigm in Healthcare Industry

§  ILLNESS paradigm § REACTIVE and PREVENTIVE

behavior § PUSH into healthcare facilities § AD-HOC/SITUATIONAL activities §  LIABILITY oriented process § REFERENCE-based task

§ HEALTHY paradigm § QoLIFE IMPROVEMENT QUALITY

behavior § PULL into communities kiosk § ROUTINE/PERIODIC activities § ASSET maintenance process § NEED-based task


By nature, it is a revolutionary change in culture & people set of mind ! Unfortunately, that is the key to a sustainable business in the long run…

The choice: let the future change you or you invent the future …

OLD and TRADITIONAL View NEW and EMERGING View

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““Shift Left”” in Healthcare through Technology


$1 $10 $100 $1,000 $10,000 0%

100% Healthy, Independent Living

Chronic Disease Management

Doctor’’s Office

Community Clinic

HOME CARE

Assisted Living

Skilled Nursing Facility

RESIDENTIAL CARE

Community Hospital

ICU

Specialty Clinic

ACUTE CARE

COST of CARE/DAY

QUALITY of LIFE

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The Technology are Attached to Key Players


The Customers The Practitioners

The Center

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The Technology for the Healthcare Customers


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The Technology for the Healthcare Practitioners


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Paradigm Change from Then to Now …


20th Century 21st Century

Provider-centered Price-driven Knowledge-fragmented Slow diffusion of innovation Paper-based Episodic care Fragmented care Limited choice Little quality measurement Management by process Adversarial government regulation Persistent escalating cost

Patient-centered Value-driven Knowledge-organized Rapid diffusion Electronically-based Continuous care Coordinated care More choice Ubiquitous measurement Management for outcomes Collaborative regulation Overall cost decline

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Technology can Help You in Re-Invent the Future

MATURITY ICT STRATEGIC ROLE VALUE

§ Level 1 : Support the Business efficiency § Level 2 : Enable the Business effectiveness § Level 3 : Drive the Business rapid growth § Level 4 : Transform the Business sustainability


Learning from the past experience of successful ICT implementation, it is better to start with SIMPLE applications, followed by FAST replication,

and continued with GROWING MODULES that create quick wins …

ICT in Healthcare: to meet the UNMET stakeholder and customer needs

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Various Applications of Technology in Healthcare


Information technology can help reduce errors in medications

Use of computerized physician order entry (CPOE) can reduce medication errors by 80% (foundation for e-health)

Picture archiving & communication system (PACS) eliminates need for films, allows interaction on a global scale: savings, improved quality & cost reductions

Improvements in diagnosis & treatments with technology help the quality & availability of care

Telemedicine/telehealth: monitoring chronic diseases over distances allows for access to care, quality of care, & reduces costs

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Healthcare Institution is Assigned a Spectrum of Roles


Clinical Aspects

Business Aspects

Management Aspects

Research Aspects

Legal Aspects

HR/Personnel Aspects

 Hospitality  Personal Care  Responsiveness  Prompt Treatment  Community Support  Medical Practitioners

 Cost Efficiency  Cost Effectiveness  Competitive Advantage  Strategic Alliances  Networking

 Decision Support  Resource Management  Policy Formulation  Monitoring System  Financial Portfolio  Office Automation

 Medical Records  Information Quality  Data Accessability  Statistics Development

 Confidentiality  Document Management  Legal Protection  Audit Processing

 Experts Pool  Personnel Management  Analysis Tools  Training & Development  Personal Assistance

The Multi Dimensional Roles of Healthcare Institution

Managing today’’s healthcare without IT is somewhat impossible …

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Classic Persistence Issues on Healthcare System

Example of Needs Issues: § Quality of care

§ Patient safety § Availability of care

§ Affordability of care

§ Access to care § Responsibility and payment for

care

Example of Cost Issues: 1.  Necessity of the HC system

2.  Cultural ideals of the population 3.  Complexity of the HC system

4.  Hospital inpatient costs

5.  Outpatient services costs 6.  Physician cost drivers

7.  Role of medical/healthcare technology


In reality, technology might answer some of the above issues …

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Example of Healthcare Value Chain in Hospital


IN-PATIENT I/S

EMERGENCY I/S

OUT-PATIENT I/S

SUPPORT I/S

Patie

nt

Evac

uatio

n

Adm

issio

n

Medi

cal A

dvise

an

d Tr

eatm

ent

Diag

nost

ic Stay

In

Serv

ices

Day C

are

Serv

ices

Oper

atio

n an

d Su

rger

y ICU

& IC

CU

Serv

ices

Mortu

ary

Serv

ices

Patie

nt

Relea

se

Administration and Operation

Procurement and Materials Management

Supplier and Liaison Management

Financial and Accounting System

Human Resource Development

Corporate Services and Public Relations

Decision Support System and Executive Information System

Firm Infrastructure and Technology

VISION and MISSION 1. Education 2. Prevention 3. Treatment

4. Early Diagnosis 5. Rehabilitation

CA

RE

CU

RE

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Example of Management and Governance Framework


Patients Clinical

Services Administrative

Services

KNOWLEDGE COMPLEX

(pharmaceuticals, biotechnology, information technology, instruments, etc.

REGULATORY & GOVERNMENT SERVICES

FDA; CDC&P; state & local agencies; NIH, NIMH, NCI, joint commission; CMS, etc.

INFRASTRUCTURE

financial services; third party payers; education; legal services; patents

CARE CURE

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Case #1: Electronic Medical Record


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Case #2: Laboratory and Pharmacy on Hand

–  MMoosstt wwiiddeellyy uusseedd PPDDAA pprrooggrraamm bbyy mmeeddiiccaall pprraaccttiittiioonneerrss

–  RRxx,, ((DDrruuggss && CCoommpplleemmeennttaarryy mmeeddss))

–  SSxx//DDxx ((SSyymmppttoomm && DDiisseeaassee RReeffeerreennccee))

–  LLaabbss && ootthheerr ttoooollss.. –  iiPPhhoonnee vveerrssiioonn hhaass bbeeeenn rreelleeaasseedd


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Case #3: Clinical Learning Center


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Case #4: Patient Handling Simulation Center


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Case #5: Multimedia Healthcare Library


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Case #6: Personal Healthcare Assistance


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Case #7: E-Learning for Professional Certifications


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Case #8: Medical Calendar Software


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Case #9: Appointment Scheduling System


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Case #10: Medical Clinical System


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Case #11: 3D Medical Processing System


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Case #12: Pharmacy Information System


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Case #13: Hospital Management System


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Case #14: Outpatient-Inpatient System


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Case #15: Patient Dashboard Management System


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Case #16: Mobile Medical System


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Case #17: Mobile Medical Unit


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The Movies: Healthcare in the Future


1

2

3

4

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The Movies: RFID Implementation in Healthcare


1

2

3

4

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The Movies: Electronic Patient Record in Action


1

2

3

4

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The Movies: The Emerging Tele Medicine Technology


1

2

3

4

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The Movies: Healthcare Information System


1

2

3

4

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The Movies: The 3D Imaging System


1

2

3

4

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The Movies: Pervasive Devices and Gadgets


1

2

3

4

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Agenda for Today

Introduction




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The Wholistic System should be Analysed


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The Holistic Framework of General Check-Up


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Diagnosis #0: Understanding Organisation Needs


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Diagnosis #1: Revisiting Business Processes


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Diagnosis #2: Analysing Governance Structure


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Diagnosis #3: Studying Key Performance Indicators


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Diagnosis #4: Measuring Maturity Level


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Diagnosis #5: Profiling People and Stakeholders


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Diagnosis #6: Determining People Strenghts


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Diagnosis #7: Perceiving Potential Internal Resistance


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Diagnosis #8: Managing Change and Challenge


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Diagnosis #9-#12: Checking & Testing IT Architecture


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Agenda for Today

Introduction




Page § 66

IT Governance Follows a Circle of Processes and Tasks

Plan and Organise

Acquire and Implement

Deliver and Support

Monitor and Evaluate

the IT resources, which are:

INFORMATION APPLICATION INFRASTRUCTURE PEOPLE (H/W+S/W+B/W)

By having a good practices in governance, the objectives will be fulfilled


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COBIT is the Best Practices of IT Governance

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There are Some Instruments to be Developed Pr

inci

ples

Polic

ies

Proc

ess

Proc

edur

es

Perf

orm

ance

The governance structure should be institutionalised …..

““no capex, only opex””

““outsource to third party””

““develop join RFP/TOR””

““conduct join CIO meeting””

““cost per transaction””


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Priority: Develop IT Strategic Plan


Define Realisation

Organization Plans

Refine “Should Be” to “To Be”

Determine “As-Is /

Should Be” Gap Analysis

Gap Analysis / Governance

Define “As-Is”

Competences

Define “As-Is”

Capabilities on the Value

Chain(s)

Define “As-Is”

Strategic Focus Model

Identify Opportunities: Early Wins & Long-Term

Information Tech. Planning

Vision Mission Goals

Targets

Review Existing

Direction & Plans

Conduct SWOT Analysis

Define Organization

Value Chain(s)

Organization Environment

Define “Should Be”

Competences

Define “Should Be” Capabilities on the Value

Chain(s)

Define “Should Be”

Strategic Focus Model

To-Be Scope & Competencies

Define “To Be”

Governance

As-Is Scope & Competencies

Define Org. Value

Propositions & Needs

Phase 1 Phase 2 Phase 3 Phase 4 Phase 5

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Learning from the West in Healthcare Reform


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Projected IT Priorities Source: 19th Annual HIMSS Leadership Survey Sponsored by ACS HealthCare Solutions


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Top Business Issues Facing HealthCare Source: 19th Annual HIMSS Leadership Survey Sponsored by ACS HealthCare Solutions


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Most Significant Barriers to Implementing IT Source: 19th Annual HIMSS Leadership Survey Sponsored by ACS HealthCare Solutions


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Most Important Applications Source: 19th Annual HIMSS Leadership Survey Sponsored by ACS HealthCare Solutions


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Status of Electronic Medical Record Implementation


Source: 19th Annual HIMSS Leadership Survey Sponsored by ACS HealthCare Solutions

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Top Security Concerns Source: 19th Annual HIMSS Leadership Survey Sponsored by ACS HealthCare Solutions


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Security Tools Source: 19th Annual HIMSS Leadership Survey Sponsored by ACS HealthCare Solutions


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Technology Adoption Source: 19th Annual HIMSS Leadership Survey Sponsored by ACS HealthCare Solutions


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2008 Health IT Staffing Needs Source: 19th Annual HIMSS Leadership Survey Sponsored by ACS HealthCare Solutions


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How and Where to Start ?


The Patient Record Info

System

Care Delivery Identifiers & Coding

Security & Privacy

Information Interchange

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It is a Simply Patient Database Repository


Other healthinstitutions

Hospitals

Health centers

Apoteks

Specialists

Director of health

Social securityinstitute

Healthcarenet

Firewall/security

Personal data

Doctor recordsNursing records

Waiting listRecommendations

Admission restrictions

LettersRequests and replies

Test recordsOther data

x-ray

Hospitalapotek

Tests

Surgery

Accidentrecords

Bookkeeping

HospitalsDepartments:

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Let’’s Invent the National Healthcare Future …..


Hospitals

Primary care physician

Specialty physician

Ambulatory center (e.g.

imaging centers)

Payers

Pharmacy

Laboratory

Public health

Current system fragments patient information and creates redundant, inefficient efforts

Future system will consolidate information and provide a foundation for unifying efforts

Hospital

Data repository

Health Information Exchange

Network applications

Payers

Labs

Outpatient RX

Physician office

Ambulatory centers Public health

CLOUD COMPUTING

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Who is Inside the ““Cloud Computing”” Ecosystem?


Healthnet Cloud

Computing

Ministry of Health and National Education

Pharmacies The Research and Development Centers

IT companies

General Directoarate of Health

Specialists

General Practitioners

Hospitals

Healthcare Centers

Public Other partners

The Universities and Medical Learning Center

Icelandic Medicinces Control Agency

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You are Living in a National Healthcare Ecosystem…

Collaboration

is a MUST !!!


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What is the First Next Step Prodia should Do ?


IT TACTICAL PLAN to implement PATIENT-BASED INFO SYSTEM

At the same time, develop ITSP with key deliverables:   Target IT Capabilities and Business Values Proposition   Holistic and Systemic IT Architecture   IT Development and Deployment Roadmap   Projects Portfolio Management Strategy   Implementation Plan and Governance Structure   Estimated Investment and Cost Structure

Short Term Medium Term

Long Term

The End of Document Q&A Session

Developing IT in Healthcare Industry

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