Impact of Health IT on Hospital Productivity

Choosing the Right Hardware for Maximum ROI

Healthcare spending in the U.S. is outpacing economic growth. Moreover, nothing indicates healthcare spending can slow down in the upcoming decade. An aging population, more possibilities for medical treatment and state intervention – all contribute to the increase in healthcare spending. Under the current regulatory climate, healthcare cost containment is one of the most important issues for organizations in the sector.

Hospitals face a formidable challenge – they need to contain spending without sacrificing the quality and accessibility of care. They need to address the issue of clinician and nurse burnout, significant under-staffing, and marry their strategies to the regulations and tight budgets. In the July 2009 issue of Health Affairs, Dr. P. Buerhaus projected the nurse shortage in the U.S. to grow to 260,00 by 2025. There simply are not enough care providers to cover the large patient populations in the new model of care. Unsurprisingly, HealthLeaders reports three out of four hospital CEOs cite cost reduction and efficiency as their top financial priorities.

One feasible strategy to address all these nagging issues is to do more with less, i.e. increase hospital productivity.

Health information technologies (HIT or health IT) are one of the productivity enablers in the sector. Just as IT has revolutionized industrial, business, education and communications sector, it changes the way hospitals work. Technical innovation affects the overall productivity of the medical staff. However, its implementation and the initial time when the end users get used to the new technology may seem like HIT is all about spending and added workload. Its positive effects take time to manifest in quantifiable results, but in 6-12 months they become evident.

For example, a Texas hospital study found that the adoption of health IT, namely automation of medical records, decision support and order entry, reduced cost, complications, and preventable deaths. Health IT helped hospitals reduce waste, improve quality and performance, the report concludes.

Electronic medical records (EMR), medical notes, electronic reference libraries, instant access to professional communities, computerized clinical decision support systems, provider order entry systems have positive effects on communication, reduction of waste and improvement in care quality. They enable automated performance measurement and allow hospitals to see areas that need improvement, or pinpoint strategies that do work and emulate successful methods in other areas.

The study compared urban hospitals in Texas measuring their use of health IT in four areas – medical records, order entry, decision support and test results. Examined were the rates of complications, inpatient death, the length of stay and costs during 2005-2006 for 167,233 patients older than 50.

 Health IT and increased automation account for a 15% decrease in in-hospital deaths.

 Hospitals with higher rates of adoption of health IT had 9% lower rates of death in patients with heart attacks. In patients undergoing coronary artery bypass graft – 55% lower rates of death.

 Patients with various conditions had 16% lower rates of complications at hospitals with automated decision support systems.

 All hospital admissions had lower costs in facilities with higher rates of adoption of health IT. In facilities that deployed automated test results - $110 less than average, order entry systems - $132 less than average, clinical decision support systems - $538 less than the average cost of hospital admission.

Clinical decision support systems help hospitals manage large amounts of data, and help physicians avoid the human error factor, thus reducing complications, deaths, and containing the cost of care. Health IT and automated systems help hospitals collect statistics, have context for decision-making, and find ways of staying within the regulatory guidelines. Health IT provides knowledge in a timely, accurate and easy-to-use manner.

Automating routine processes in health care makes population health feasible and sustainable. HIT and automation in healthcare do not replace doctors and nurses, but free their time for more clinically-relevant duties, improving their productivity.

Automated medication counting (including robotics-reliant solutions), for example, and medication dispensing systems integrated with the medical computers on carts enables nurses to tend to more patients and reduce drug dispensing errors. It rids nurses of time-consuming routines that require little cognitive value, and let them focus on more rewarding tasks.

Patient engagement is another example of how health IT makes a broad range of care delivery processes much more efficient, improving hospital productivity. Automated check-ins, reminders, education slide shows, videos, interactive tutorials on health conditions, easy access to entertainment and productivity apps for patients combined with EHR, vitals monitoring and communications for the medical staff – a multitude of medical tasks performed by one bedside medical computer or medical tablet.

Hot-swap batteries in a medical cart computer, for example, last a full shift. This means nurses no longer need to monitor battery status, look for power outlets, or lose unsaved data when the device shuts down unexpectedly. This computer build goes well with a non-powered cart, which translates into light weight, & maneuverability, reducing physical and mental toll the technology takes on nurses. Let alone the power saving contribution hot-swap technology does to hospital’s electricity consumption.

Health IT does not eliminate human work, but rather elevates medical staff into higher-functioning roles that harness their clinical expertise.

Health IT eliminates the manual work of data input using pen and paper methods, reducing paper waste, use of spreadsheets and other workarounds. A medical cart computer or medical tablet that supports EHR enables clinicians to input data at the patient bedside, eliminating the un-paid extra hours physicians spend on data input.

Health IT helps increase predictable outcomes. When patients stick to a standardized care path supported by health IT, they are more likely to reach predicted outcomes. Patient tracking, clinician decision support system, drug dispensing systems can help detect if a patient has deviated from the recommended care plan, and alert the medical staff.

Health IT helps increase nurse output. A nurse equipped with a mobile medical computer or medical tablet manages a larger pool of patients at one time. Instead of manually scaling your nurse activity as the patient volumes grow or decrease, an IT solution can automatically scale and reassign nurses to tend to the needs of everyone.

Health IT captures any quantifiable data and makes it tangible and actionable. It helps staff feedback reach the higher echelons of decision-makers. This data then enables decision-makers to deploy meaningful optimization and performance improvements that are in touch with the end users’ needs. At every point of the care process, health IT can collect data and feedback, and help organizations assess the processes’ (or technology’s) efficiency, and find ways to improve. Health IT is used to improve its own efficiency over time, becoming more efficient, accurate and helpful.

When looking to comply with regulations, increase hospital productivity, & implement EHR without breaking the bank, take into account:

 Total Cost of Ownership of a health IT solution.

 its overall failure rates, durability (MIL-STD components).

 its medical certificates and safety.

 how it fares with organization’s efforts to reduce nosocomial infections (for example, antimicrobial surface).

 how it helps protect data and comply with HIPAA (for example, Imprivata SSO).

 if it is energy efficient.

 if it helps reduce nurse burnout or increases the workload.

 if it helps achieve device convergence or adds yet another hard-to-use or manage technology to the existing fleet of devices.

 if it integrates well into the existing ecosystem of the facility on the hardware and software level – compatibility.

 if it is upgradeable and customizable, so you can use it for years to come.

 if it supports EHR, medical imaging & other resource-hungry productivity software.