by Melanie Merrifield
There’s no question that technology has driven extraordinary innovation in medical science.However, while such advancement continues apace,the hot topic in healthcare today is information technology.
The sheer volume of data about patients, protocols, medications, utilization, billing and insurance has reached near-epidemic proportions. No part of the healthcare system is immune; hospitals, physician practices and laboratories alike are obligated to manage medical information with rigorous accuracy and accountability.
Hankamer School of Business responded to this need in 2003 by introducing an MBA Healthcare Administration program. “Healthcare information and its management is very important right now,” notes Scott Garner, preceptor coordinator of Baylor’s MBA healthcare administration specialization. “This is clearly an area that’s of interest to growing numbers of students.” A cornerstone of the program is a seven month residency, which falls for most students at the beginning of their second year. The experience provides “real world” experience healthcare providers value greatly when screening candidates. Garner explains. “By taking students through this type of experience, we’re positioning them to compete more effectively in the marketplace.”
TECHNOLOGY THAT STRETCHES FROM BEDSIDE TO THE BANK
With information technology a defining – some might argue the defining – force in healthcare, information technology is becoming central to everything from patient care to administration and medical records, and even blurring the lines in-between.
“A system like voice recognition charting improves accuracy that directly benefits the patient, and also has significant impact on an institution from an administrative standpoint,” explains Dr. Louis Martin, professor of Radiology at Emory School of Medicine and former chief of Interventional Radiology at Emory University Hospital. “The more accurate, easier to read and accessible that chart becomes, the more useful it is to all areas of the organization.”
Numerous other advances impact both care and management, and are quite literallychanging the face of healthcare. “Today, for instance, we’re seeing distance clinics emerge where patients are seen by a nurse practitioner instead of a physician,” observes Sean M. Haynes, Baylor MBA –Healthcare/MSIS candidate. “A physician can be patched in by video and do a distance consult. This is a cost-saving solution, especially in rural areas, and can make available to a facility specialists they could not afford to keep on staff.”
THE CHANGING FACES OF PATIENT CARE
As scanning and monitoring modalities like CT scans, MRIs, heart monitors and numerous others move from analog to digital,their data can be sent real-time around the world. “These images are no longer subject to location. They can be shipped off to be read and sent back.”
“Robotics is another big force on the horizon,” notes Haynes. “These minimally invasive procedures can have patients up and mobile in three days, not three weeks. That’s a significant development for both patient care and for cost management.”
Early detection is another area where technology, and the required IT underpinning will expand medicine’s future scope.
“Cancer, for example, is now considered a long term disease, as diagnosis is enabled by more granular imaging,” Haynes adds.
Close to home, at Dallas-Fort Worth’s Baylor University Medical Center, surgeons have developed a laparoscopic version of the gastric bypass for obese patients, enabling most to leave the hospital within 23 hours. This is a significant improvementover the complex open gastric bypass procedure, which requires several days’ stay, post op.
IT INNOVATION – AND COST
Not only does all this innovation demand new systems and approaches to data management, it also comes with a high price tag. Most institutions are actually earmarking between one and three percent of annual operating budget for IT. Small wonder the business world is taking the challenge seriously.
Senior hospital executives responding to a Modern Healthcare 2005 survey indicated their primary near-term IT priority to be the electronic health record (EHR). A key impetus in the increased interest in the EHR was the 2004 pledge by President George W. Bush to establish an interoperable system of health records within a decade. The total national cost of introducing this system has been estimated at $276 billion to $320 billion over 10 years. Some industry observers believe that the challenges of building such a national infrastructure are comparable to those of putting a man on the moon, and that the project is more likely to require several decades to complete. Much of the cost and complexity of healthcare IT management is a result of the Health Insurance Portability and Accountability Act (HIPAA), originating in 1996 and reaching final form in 2003. This ground-breaking legislation ambitiously proposed to simplify and standardize the transfer and storage of patient information, with a mandate to protect patient rights and privacy with carefully defined security protocols. However, even with stringent HIPAA regulations, there remains room for much subjectivity. It is in both system-building and management of compliance that finely honed management training and skills are essential.
MAJOR CHALLENGES AHEAD: ACCEPTANCE AND COMPLIANCE
Another key issue in this brave new world of medical technology management is the varying degrees of acceptance among practitioners. Clearly, technology is a younger folks’ game, with older practitioners sometimes only embracing technology in a rudimentary way.
“Physicians are using more healthcare information technology in their clinical practices, but in some cases the use may well be fairly rudimentary, such as looking up information about drugs and unfamiliar diseases on the Internet vs. a printed reference” reports Joseph Conn in Modern Healthcare. “But many of them lack sophisticated systems.”
Michelle Nelson, Baylor MBA Healthcare candidate, recently spent her residency at Bearing Point Healthcare Group in San Francisco as part of a Change Management team.
“It was such an enlightening experience. Our challenge was to oversee our client’s adoption of electronic medical records system,” states Nelson. “Because I worked as a nurse for many years, I can see the advantage of all this technology from the caregiver perspective. But there is a sharp learning curve, because this kind of technology assumes and requires a certain level of technical savvy from its users.
“The biggest hurdle seems to be getting everyone in an organization to buy in and take ownership of the change.”
One area where major advances in healthcare technology and IT are at the leading edge is in the military. Kevin Peck,a Baylor MBA Healthcare graduate, is now deployed to Iraq as Chief Information Officer of a field hospital there. He suggests that “the military will end up being a model for the health record, like it has been for so many other medical innovations. EMR development (electronic medical records) is moving forward far faster than in civilian life.”
“The EMR hasn’t been rolled out yet. It’s in field testing now. But there’s so much more standardization across the board compared to civilian life,” says Peck. “For instance, there’s just one form for requesting medication. It’s really much simpler than the various forms in civilian use.”
“Of course, security and privacy are much more guarded in the military,” he continues. “They just came out in April with new ARMY regulations regarding handling of medical records. If you’re negligent, it can end your career. You’re dealing with the uniform code of military justice. In effect, all medical records are the Commander’s possession. All medical records are kept in a records room and under lock and key at all times, with controlled access and afterwards immediately locked down. As CIO, I’m responsible. If anyone wants to see them, release of information must be through patient information division and LEGAL and HIPAA. Rules exist regarding may see records, what parts of records and under what conditions. Everything is documented.”
“Army deployed hospitals are mirror image of what you’d see here. Facilities are every bit as good as what we have here in the States. But in a tent.”
Some tent. It may just define the future of medical IT.
Baylor Business Review, Fall 2006