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Hitting Snooze on HITECH

October 27, 2009
by Pete Rivera and Rob Drewniak
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We can all take some lessons from the experiences of getting ready for Y2K and HIPAA

The healthcare industry has had many challenges since 2000; beginning with Y2K, which was primarily a technology-focused effort, and then the implementation of HIPAA, which impacted technology, operations and policy. What did the healthcare industry learn it needs to do?

  • Plan and plan well - strategically and tactically

  • Take action and not be a straggler, as it costs more in the end

  • Communicate to all of our staff (leadership, physicians, clinical and business staff, board members and business associates)

  • Educate the organization

  • Keep the patient and delivery of quality care our primary focus

George Santayana famously said, “Those who cannot remember the past are condemned to repeat it.” In the case of Y2K and HIPAA, too many organizations used the “head in the sand” approach and waited to see what everyone else was doing. By the time they were ready to move forward, most of the technical and professional services needed to assist them were already committed. What was left or available were service offerings and staff that came late in the game from those hoping to capitalize on the opportunity with very little skill sets.

Action Tasks for HITECH

Analysis and Review

Plan and Implement

Training Communication

  • Provide education and training for the organization - obtain sponsorship and understanding

  • Develop communication and participation plan/schedule

  • Ensure all in the organization participate and understand the goals

  • Review alignment with standards - meaningful use, certified EHR, other

  • Review readiness for HIE

  • Review compliance with HIPAA standards

  • Develop a program for capturing and reporting on quality metrics

  • Review current strategies and priorities

  • Review current budgets

  • Develop ongoing “strategy and EHR restructuring” programs

  • Develop priorities and integrate to budgets

  • Develop plan for HITECH incentives and funding

  • Continue to train and educate ALL staff

With all that is occurring today, including the economic downturn, challenges in staffing, and healthcare reform, including ARRA, it becomes clear that better scenario-based planning needs to occur, not just strategic 5 to 7 year planning. Organizations must look closer at today's industry drivers and retool their strategies to keep pace with weekly/monthly challenges. The budget plan formulated last year, based on metrics from the previous year, is no longer applicable.

The IT strategic plan needs to be created to support - and integrate with - the organization's strategic business plan. That's not a new concept. However, the need to visit and revisit the operations, workflow, and relationships with physicians, patients and regulatory agencies will be required in order to identify and prioritize/reprioritize budgets, tools and schedules. There will be a need to focus on continual restructuring of plans to meet the ever-changing environment - being late may not be an option.

So at what point do you “break the glass case” of your strategic plan and revise projects and strategies in order to respond to unexpected opportunities or challenges? You do it in the event of regulatory changes, economic hardships, or business opportunities. The Health Information Technology for Economic and Clinical Health (HITECH) Act falls under all of these categories.

As we look at revising strategic plans to fit a new clinical system, we need to recognize the challenges inherent in the healthcare industry. Healthcare is more than a building or a person who cares for the ill; as such, we cannot always draw examples from other industries. We are a fluid process, with complex procedures and a high level of variance of clinical challenges. In healthcare, we are a community, and we need to deliver quality care to patients and address disease management.

Inserting a complex clinical system to document, maintain, interface, produce and report clinical information is a daunting task. We now have an opportunity to implement an EHR and address one of the biggest concerns faced by CFOs in championing such a system: “Where's my return on investment?” The HITECH Act promises to provide significant financial incentives through the Medicare and Medicaid programs to encourage doctors and hospitals to adopt and use certified electronic health records. Physicians will be eligible for $40,000 to $65,000 for showing that they are meaningfully using health information technology, such as through the reporting of quality measures. Hospitals will be eligible for several million dollars in the Medicaid and Medicare programs to similarly use health information technology.

Health Outcomes Policy Priorities

Care Goals

2011 Objectives

  • Improve quality, safety, efficiency, and reduce health disparities