Power Point

Copyright 2006, Health Tech Strategies, LLC, All Rights Reserved

Performance Management and HIT

Terry Hill, Executive DirectorRural Health Resource Center

Duluth, Minnesota


Technical Assistance & Services Center (TASC)

• Federally designated resource center

• Funded by HRSA’s ORHP

• Supports Flex Program/CAH

implementation in 45 states

• Located in Duluth, Minnesota


Current Federal Contracts

• Technical Assistance & Services Center (TASC)

• Rural Network TA Center Web Support

• Small Hospital Improvement Program (SHIP)

• Delta Rural Hospital Performance Improvement (RHPI)

• Rural Hospital Education Project

• Rural HIT Project


Dealing with Change


CAH HIT Survey

• Purpose: to assess level of HIT use in CAHs for a national performance measure

• Collaborative effort of Flex Monitoring Team, TASC, and ORHP

• Web-based and phone survey

• March – April 2006

• Random sample of 400 CAHs

• 333 CAHs (83.3%) responded

– 210 by web, 123 by phone


• Half of CAHs have a formal IT plan

• 76% of CAH budgets include IT funding

• 78% have hospital web site

• All CAHs have some type of internet access

• In 36% of CAHs, clinicians use PDAs for patient care

HIT Survey Results: Infrastructure


HIT Survey Conclusions

• Medicare cost-based reimbursement has permitted many CAHs to make initial investments in HIT infrastructure

• CAHs have high use rates for administrative and financial IT application, but much lower rates for clinical applications

• CAH HIT use rates are lower than overall rates for hospitals

• Future efforts need to focus on increasing use of clinical applications and interconnectivity of CAHs and other health care providers


• The full report is available at:http://www.flexmonitoring.org/documents/BriefingPaper11_HIT.pdf

Additional Information


Supply regulation

1970s

1980s

1990s

2000s

Managed behavior

modification

Consumer-driven health care

Price regulation

The History of Cost Containment


Consumer-Driven Health Care

• Bringing profound change

• Driven by:

- High costs

- Growing quality and patient safety concerns

- New demands for transparency

- More informed/demanding consumer


The New Medicare Consumer


Internet-based Health

• 30,000+ health sites

• Increasing demand for web-based services

• “The World is Flat”

• Health providers slow to respond


Consumer-Driven Health Care Initiatives

• Pay for Performance (P4P)

• Public Reporting

• Health Savings Accounts (HSAs)


The Journey to Performance Management

• Quality Assurance

• Quality Improvement

• Performance Improvement

• Performance Management


Performance Management Definition

“A set of processes that help organizations optimize their overall performance. It is a framework for organizing, automating and analyzing methodologies metrics, processes and systems that drive business performance…

Performance management is seen as the next generation of business intelligence, and helps businesses make efficient use of their financial, human, material and other resources.”

- Wikipedia.org


Performance Management Definition

“A framework for getting people, processes and resources aligned and moving in the same direction. The ultimate goal is to achieve strategies that benefit the customer and the bottom line and that result in organizational excellence.”

- RHRC


Performance Management Systems

Performance Management Systems have 3 distinct dimensions:

1. Strategies- Make strategy the central organizational agenda

2. Focus and Alignment- Have resources and activities aligned with strategies

3. Organization- Provide the logic and architecture to link all departments and employees behind strategies.

Kaplan and NortonHarvard Business School


Brief History of the BSC

Strategic Management

HarvardBusinessReviewArticles


Glossary of Terms

Financial

Customer

Internal Business Processes

Learning & Growth

PerspectivePerspective Key QuestionKey Question

As financial stakeholders, how do we intend to meet the goals & objectives in our hospital mission statement?

As customers of our hospital’s services, what do we want, need or expect?

As members of the hospital staff, what do we need to do to meet the needs of our various customers?

What type of culture, skills, training and technology are we going to improve in order to support our key processes?


Understanding the Balanced Scorecard

“A successful Balanced Scorecard program starts with a recognition that it is

not a metrics project…

IT’S A CHANGE PROCESS”

Robert KaplanBalanced Scorecard Collaborative’s

Government Summit. Sept. 2004


The Power of the Balanced Scorecard


RWHC Eye On Health

"OK. I understand a lot is going to change. But how do I stay the same?"

RWHC Eye On Health


RWHC Eye On Health



System for Managing Performance and Change in Rural Hospitals

1. Frameworka. Studor Pillars b. Balanced Scorecard

2. Empowering Culturea. Change orientedb. Customer Centeredc. Collaboratived. Designed for retention

3. Ongoing Educationa. On siteb. Online


System for Managing Performance and Change

4. Skilled Workforcea. Nurses and techniciansb. Medical Staffc. IT expertise

5. Ongoing Process Improvementa. Clinicalb. Businessc. Operations

6. Leadership Developmenta. Boardb. Executivesc. Middle Managementd. Physicians


7. Technologya. HITb. Medicalc. Management and Systems

8. Partnershipsa. With physicians/cliniciansb. With other hospitals and health providersc. With the Communityd. With educational institutions

9. Access to Capitala. For improvements to plantb. For investment to infrastructure

10. Outside Technical Expertise

Systems for Sustaining Performance and Change


On-Track to Performance Improvement


Valley of Despair

Choices, Planning, Execution

Determines extent of Slide

Leadership and Management

Determines how long you’re in the valley of despair.

Good Choices and

management determines

level of productivity and

satisfaction

Little or No HIT

Implement EHR

Implemented and Supported

Pref

erre

d Fu

ture

Possible Future

Time

Pro

duct

ivity


HIT Theme Strategy Map

Increased cost efficiency

Increased market share

Finance

Increased revenue

As financial stakeholders, how do we intend to meet the

goals and objectives in the hospital’s Mission

Statement?

Patient safety outcomes

Physician satisfaction outcomes

Patient

satisfaction

outcomes

Increased margin to fund mission

Community health outcomes

Customers & Community

Internal Processes

Learning & Growth

As customers of the hospital’s services, what

do we want, need or expect?

As members of the hospital staff, what do we need to do to meet

the needs of the patients and healthcare

community?

As an organization, what type of culture, skills, training and

technology are we going to develop to support

our processes?

Redesign

Clinical processes

Acquire HIT expertise

Ensure a skilled workforce

Redesign

Business processesRedesign

operational processes

Establish an empowering work culture

Enhance leadershipInstill change management

Acquire needed HIT systems

Provide education


“Even if you’re on the right track,you’ll get run over if you just sit there.”

- Will Rogers


Terry J. Hill, MPA

Executive Director,

Rural Health Resource Center

600 E. Superior St., Suite 404

Duluth, MN 55802

218-727-9390, ext. 232

[email protected]

mailto:[email protected]

Power Point

Business

technical

balanced scorecard

performance

performance

managing performance

services center

hospitals

clinical applications