5 IT Must-Haves for Quality Initiatives in Healthcare
Healthcare IT teams are guardians of data—the data healthcare organizations depend on to successfully accomplish quality initiatives. Data is the heart of any quality initiative; it establishes a baseline, determines what changes lead to improvement, allows for performance comparisons, and evaluates procedural changes.
IT’s role in improving care quality and patient safety is undeniable. IT manages and protects the vast quantities of data health systems capture by implementing effective data governance, security measures, and user-friendly systems and tools. IT’s responsibilities encompass more than just managing data assets—IT facilitates the creation and maintenance of a data-driven culture, engaged clinicians, and data literacy.
As guardians of healthcare data, IT teams can maximize their contributions to health system quality initiatives by incorporating five must-haves (these points will be expanded below):
- Real-time feedback
- Interoperable infrastructure
- Data best practices
- Engaged frontline staff
These five must-haves will help healthcare leaders and IT teams do more than just accomplish quality initiatives; they will improve data literacy, cultivate a culture that values analytics, create user-centered systems and tools, and transform IT teams into long-term care quality collaborators.
The Future of Health IT and Quality Initiatives in Healthcare
Healthcare organizations are facing expanding regulatory requirements that will place increasing demands on their systems and resources. Solutions, such as enterprise data warehouses (EDWs), help by providing a platform for analytics and clinical decision support. Healthcare organizations also need collaborative, multidisciplinary teams to thrive in this complex, rapidly changing regulatory environment.
The Office of the National Coordinator for Health Information Technology (ONC) documented its 3-, 6-, and 10-year goal posts for effective health IT and quality improvement: “an electronically-enabled quality improvement ecosystem that promotes better healthcare, improved communication and transparency, rapid translation of knowledge for all stakeholder, and a reduction in the burden of data collection and reporting for providers.”
ONC’s 3-year goal (2017)
Quality reporting programs must reduce collection and reporting burden on providers. Providers, payers, and health systems need reliable, comparable, and universally accepted performance indicators for priority health conditions and patient safety initiatives.
ONC’s 6-year goal (2020)
Health IT data must be standardized, linked at the individual level to clinical data as appropriate, and optimized for interoperable sharing and aggregation.
ONC’s 10-year goal (2024)
The nationwide use of interoperable Health IT will be pervasive. Patients and their care teams will use quality and safety data and measurement as an expected aspect of care delivery. Individuals will view themselves as the hub of their health and care and a member of their care team. Individuals will routinely use advanced technology to manage and monitor their wellness and healthcare, and generate data for use by multiple IT systems and analytical tools.
The industry has a long way to go before meeting ONC’s 3-year goal of reducing the collection and reporting burden on providers. But healthcare IT teams willing to embrace the five must-haves and collaborate with organizational leadership are best positioned to create and implement the clinician-centric tools and processes that significantly reduce this burden. The underlying strategy to reducing this burden is data literacy. Clinicians and frontline staff need to be able to understand, interpret, and communicate data. Data literacy is essential for engaging clinicians and reducing data misinterpretation.
5 Must-Haves for IT
Given the ONC’s rapidly approaching deadline for reducing collection and reporting burden on providers and the industry’s growing dependence on IT to protect, communicate, and use data effectively, healthcare IT teams are in the industry’s spotlight. The five must-haves will enhance IT’s effectiveness and improve health systems’ ability to achieve quality initiatives:
Collaboration is the foundation of every IT must-have. Healthcare leaders understand that data is an integral part of the care quality equation. They also understand that IT’s role in quality improvement is a big one. But as guardians of data—not owners—IT’s collaboration with healthcare leaders and operational directors is more important than ever.
A scenario that’s all-too-common in healthcare: health system leadership asks the IT team to identify a software solution that meets requirements x, y, and z. Rather than working as part of a multidisciplinary, collaborative team comprised of leadership, finance, clinicians, and other stakeholders, IT works independently to select software that meets the specified criteria, and then pushes the solution out to clinical or operational areas. Inevitably, without input from key stakeholders, the selected solution does not end up meeting the health system’s needs.
Collaboration brings the right people to the table; it leads to the healthy—and, at times, tense—dialogue that comes with two-way communication. Health system leadership’s role in this dialogue is to keep stakeholders focused on the quality initiatives at stake, facilitate decision making, and, ultimately, take responsibility for the resulting decision.
IT is a key member of a multidisciplinary team (leadership, clinicians, finance, etc.) collaborating to achieve the organization’s quality goals. Health system leaders identify and drive quality initiatives, and help create the data-driven culture necessary for quality initiatives to thrive. Cultivating a data culture that embraces data-driven decision making requires significant behavior change; a change leadership can help motivate, inspire, and encourage.
Continuous improvement is a multidisciplinary effort that centers on collaboration. IT must collaborate with health system leaders and key stakeholders to create user-friendly tools, develop appropriate assessment measures, and accomplish quality initiatives. Healthcare IT teams are not managers of short-term IT projects; they are change agents of long-term continuous improvement.
#2: Real-time Feedback
Rather than analyzing data retrospectively, real-time feedback (about staffing, patient flow, productivity, etc.) empowers health systems to be proactive about their quality goals:
- Facilitates decision making.
- Analyzes past performance.
- Anticipates future needs and trends.
- Addresses issues as they occur—in real time.
- Tracks and improves care for patients and entire populations.
- Helps clinicians respond more quickly to patients.
Real-time feedback is an important building block of an organization’s data-driven culture. Health systems should start and finish the day with data, through user-friendly dashboards, best practice alerts, etc. As guardians of data, IT teams must prioritize the ability to provide real-time feedback to frontline staff so clinicians can make timely, accurate care decisions that improve patient outcomes and save lives. Providing frontline staff with timely, actionable data is a catalyst for change and improvement.
An unfortunate side effect of real-time feedback is alert fatigue, which can be distracting and annoying to clinicians and other frontline staff. Clinicians feel more burdened than benefitted by these systems; systems they blame for increasing their workload and wasting time. Using the carefully chosen applications, systems, and tools—like an EDW that consolidates vast health system data into a single integrated source of truth—IT can avoid alert fatigue by providing frontline staff with only the most relevant, useful real-time feedback to monitor and improve care delivery. It takes discipline to identify and relay only the highest priority items, rather than broadly alerting just because the technology exists to do so.
#3: Interoperable Infrastructure
When it comes to reimbursement, coordinated care is the trend. IT must prioritize interoperable systems to improve coordinated care by seamlessly sharing information across settings, sources, and systems, and providing clinicians with information about the whole patient.
Integrated systems improve coordinated care by establishing system-wide definitions that facilitate data sharing across settings and providers. Health systems frequently pursue improvements that focus on a specific department, like the emergency department. When other departments aren’t integrated, bottlenecks occur. Integrated systems reduce bottlenecks and increase efficiency.
Creating an interoperable infrastructure to improve care coordination requires close collaboration with health system leadership and operational directors to remember the big picture; to prioritize health system quality initiatives over short-term projects. For example, a department might submit a request for a tool that meets a particular need. Eventually, the health system has a repertoire of tools, each requiring a very unique skill set to maintain. By keeping the system wide goals at the forefront, IT will support systems and tools with the biggest impact on the most important, overarching quality initiatives.
#4: Data Best Practices
IT supports several important components of quality initiatives: data governance, privacy, security, and access. But these components, while important, aren’t enough. IT must also focus on data best practices, such as data utilization, data transparency, and data quality.
EDWs improve data quality and utilization by integrating systems and providing an integrated source of truth. By organizing data from multiple sources (clinical, supply chain, etc.), EDWs cut down on noise, reduce the collection burden on clinicians, encourage making decisions based on high quality data, and serve as the foundation for quality initiatives. EDWs integrate multiple systems, but IT’s role in maintaining all of the originating systems is critical.
EDWs also facilitate data transparency—a defining characteristic of data-driven healthcare cultures. But creating a data-driven culture that embraces transparency requires the first IT must-have—collaboration—and the willingness to have difficult conversations about data transparency and its impact on cultural change. Frequently sharing data with multidisciplinary teams improves data quality and facilitates decision making by revealing inconsistencies and increasing interdepartmental domain knowledge.
For example, a health system’s frontline staff might assume they’re all inputting data the same way. Through data transparency and frequent data sharing, they discover data input inconsistencies from clinician to clinician and make the necessary modifications that lead to higher quality data. Transparency leads to the necessary retraining and data cleanup that leads to better data quality and, therefore, improved data utilization.
#5: Engaged Frontline Staff
According to the article PCPs Weigh In On HIT, only 50 percent of primary care physicians said health IT positively affects their ability to deliver quality care. IT can change this statistic and garner frontline staff support by creating user-centered tools that work in a variety of technical settings, are meaningful and useful to the clinicians using them every day, helping the health system and its clinical leaders satisfy both regulatory and non-regulatory requirements, and improving data literacy to increase data utilization.
Frontline staff are the care delivery and process experts. Quality initiatives depend on their support and engagement. Just as health systems are more patient-centered than ever, motivated by their goals of delivering quality care and increasing patient satisfaction, IT needs to take a user-centered approach to developing tools. IT is the liaison between the tools and their users, responsible for gathering requirements, capturing user needs, and iterating until they get it right. User-centered systems and tools engage frontline staff by helping them capture important data throughout the normal course of providing care; data that can be used to track patient progress, decision making and drive quality.
Quality initiatives driven by regulatory requirements alone won’t result in the care delivery improvements we are after. IT must work with clinicians to provide tools that help them measure and report on additional, non-regulatory quality measures that are meaningful to the system’s unique goals and needs—as long as they’re supported by system leadership.
Due to the high volume of data frontline staff and clinicians need to consume and interpret every day, training, and education are essential for improving data literacy. Training helps clinicians, frontline staff, and other departments understand how to correctly interpret data and understand key data inter-relationships. IT can facilitate training and education initiatives and become stewards of data literacy.
Transform Data into Care Delivery Improvements
Health systems need more than data to achieve their quality initiatives. They need guardians of data—IT—to facilitate all aspects of healthcare data and analytics, from creating systems and tools frontline staff will actually use to interoperable systems that seamlessly share data.
By focusing on the five must-haves—collaboration, real-time feedback, interoperable infrastructure, data best practices (data utilizations, data transparency, and data quality), and engaged frontline staff—IT can help health systems navigate the industry’s complexities and accomplish their quality goals. And by collaborating with leadership and frontline staff, IT can help create a data-driven culture that continuously transforms data into care delivery improvements.
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