The Pivotal Role of Technology in Federal Healthcare Industry Perspective
Executive Summary The goal of every health system is to deliver the best possible care to patients. However, that objective can be difficult to achieve, especially for federal health providers. Their populations are among the largest that require care. For instance, the Defense Department treats 9 million Americans per year and the Department of Veteran’s Affairs’ cares for 6 million veterans. Compare that to a private sector giant like Kaiser Permanente who has only slightly more members – approximately 10 million. What’s more, immense patient populations aren’t the only challenge. Mounting healthcare costs, disruptive technologies and inefficient processes all compound the difficulties providers face in promoting individual health in a complex care environment.
of individual healthcare organizations. Rather than applying one-size-fits-all solutions, providers are creating unique care plans and processes that manage health and budgets simultaneously. They’re doing so by deploying smart applications on top of their own resources. Infor provides a host of business applications to make that possible. In this industry perspective, we’ll explain what specific challenges create the need for healthcare providers to transform the way they do business. Then, we’ll explain how integrated technology can meet those demands and ultimately help healthcare systems deliver better patient care.
Providers in both the private and public sectors, however, are learning to overcome these challenges with new tactics. Healthcare leaders are building patient-centered supply chains, optimizing their nursing workforce and creating interoperable health IT data to improve patient care. What’s more, health systems are able to achieve those goals without raising costs to providers or patients. How? Beth Meyers, Chief Nurse Executive, and Joel Rydbeck, Director of Healthcare Technology and Strategy at Infor, sat down to discuss tactics for federal agencies to consider with GovLoop. They said the answer lies in applying an integrated suite of tools that makes the most of the existing data, processes and systems
The Pivotal Role of Technology in Federal Healthcare
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The Current Healthcare Landscape The challenges facing federal healthcare systems in the U.S. have few historic parallels. Between aging patients, shrinking per-patient budgets and greater demands for transparency, federal healthcare leaders must make careful choices to assure good outcomes. But publicly funded hospitals don’t stand alone in facing these obstacles. Private health systems confront similar issues as they meet the realities of healthcare under Affordable Care Act (ACA) reforms. Under the ACA, private providers are transitioning away from being paid per procedure or treatment. Instead, they are paid based on the quality of care. This model of value-based care is better aligned to the business model of publicly funded hospitals. “Today, the challenges that the commercial sector – particularly privately funded hospitals – are running into are not that different from what we see federally funded or public sector organizations encountering,” said Rydbeck. “This is good news for federally funded hospitals,” Meyers said. “As private-sector hospitals streamline their processes and IT vendors create tools and technologies to help them, the federal systems can take advantage of these new ways of thinking. They can share new processes between federal and privately held organizations.”
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What both commercial and public providers have found is the need to pursue a trifecta of goals: lowering the cost of care, improving patient outcomes and improving the patient experience. Those three goals have to be achieved in concert. As Rydbeck explained, if only one or two objectives are pursued, the others will be neglected. Even if costs decrease and patient experience improves, positive outcomes would decline without attention and resources. Similarly, improved experience and outcomes would be fruitless if costs weren’t contained in the process, and patients weren’t able to afford that care. To ensure all three objectives are met simultaneously, many healthcare systems are focusing on integration. “They’re integrating all of the many different computer systems, software systems, equipment and everything else that makes a hospital,” Rydbeck said. “By connecting those in meaningful ways, they’re able to drive directly at these three criteria at once.” More specifically, leaders have found that building a patient-centered supply chain, optimizing their nursing workforce and creating interoperable health IT data can improve patient care without raising costs. In the remainder of this industry perspective, we’ll explore how to pursue those three solutions.
Industry Perspective
The Patient-Centered Supply Chain The first action that Rydbeck and Meyers suggested is consolidating disparate technologies in the care setting, in order to create a patient-centered supply chain. They explained that most hospitals rely on over 500 individual software and hardware systems to keep their institutions functioning on a daily basis. Unsurprisingly, managing and organizing that many systems is cumbersome. As a result, many providers end up creating a complex but disconnected infrastructure. “Specifically, there’s a chasm of information in hospitals,” said Rydbeck. “The clinical systems have a lot of information that’s relevant to the supply chain. Conversely, the enterprise resource planning (ERP) or supply chain systems have a lot of information relevant to clinical procedures of the hospital system. Unfortunately, there’s a massive chasm between the two.” As a result, providers are unable to appropriately plan and allocate resources. That leads to higher costs for both health systems and their patients, as well as diminished patient care when necessary tools become unavailable. To remedy this gap, Infor facilitates what it calls a patientcentered supply chain. A patient-centered supply chain involves the fundamental redesign of how supplies are selected, moved and delivered to the patient care setting. This relies on connecting the clinical systems to supply chain systems so they constantly feed and act on information from each other.
The Pivotal Role of Technology in Federal Healthcare
Rydbeck offered an example of how this connectivity could change operations for the better: “You could have depletion of an item in the surgical instrumentation management over in the clinical system, and instantly an order is placed through the supply chains and connected over to your ERP system. The order is automatically placed with the vendor because you dropped below a par level count in your inventory. Now, all of a sudden, a new component’s being manufactured, loaded onto a truck and shipped to your hospital.” Moreover, Infor’s supply chain technology can consider care-specific supply needs. For instance, it will track an individual patient’s supply use within the hospital and use analytics to ensure the correct supplies are available for his or her defined care procedures and needs. This helps care providers focus on the patient, rather than on ordering supplies. That scenario is a stark contrast to how many hospitals operate today. When systems are disconnected from one another, an administrator most often manually downloads a spreadsheet of clinical needs and references that list by walking the halls and checking individual supply locations. As a result, individual patient needs are often overlooked or handled on a one-off basis. The patient-centered supply chain, fostered by connected information systems, eliminates that laborious and cost-intensive process so that clinicians can focus on using their necessary supplies to deliver better care.
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The Optimized Nursing Workforce Technology not only helps healthcare systems better integrate their software and hardware, it can also streamline staffing and workforce procedures. The challenge for most health systems is that no two healthcare organizations have the same combination of patient census, union rules, government regulations and organizational policies driving their nurse scheduling processes. This is especially true in publicly funded hospitals, where additional concerns like military and federal security procedures might also be required. Yet tools to manage the nursing workforce often deliver one-size-fits-all solutions that don’t integrate with other software, including electronic health records (EHRs), in the environments. That creates unnecessary labor costs, which are already the most significant cost in healthcare settings. Additionally, it decreases productivity among both managers and frontline staff, as they spend unnecessary time manually matching patient needs to nursing availability. To meet the diverse requirements of individual hospitals, Infor provides a more customizable workforce management suite of automated solutions. With a set of tools that integrate with the entire organization’s information systems, nursing managers can easily: • Create and edit sophisticated schedules by assigning nurses to meet required demand; • Manage scheduling processes, from demand planning to schedule creation to day-to-day staffing; • Find appropriate replacement employees when necessary;
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• Access real-time workload coverage indicators and key workforce summary statistics; and • Standardize scheduling practices across your organization, while maintaining flexibility for unitdriven staffing processes. This automated solution set also allows nursing managers to make the best decisions for their staff, rather than working from templates that don’t understand the unique needs of their care setting and workforce. With sophisticated workforce scheduling, leaders can predefine unique patterns of day, evening and night shifts, build in the appropriate number of rest days for their staff and evenly distribute night shifts across the employee population. It also helps managers match staff to specific patient needs, because the suite of workload management solutions connects to the EHR. “Care is documented in the electronic health record,” Meyers said. “We leverage that documentation to determine specific workload the patient requires, allowing a better understanding of each patient as an individual. The workload can then be tied back to how many staff a unit should have at a given time to optimize care for the unique patient load.” Simplified and automated processes like these create better working conditions for your employees with schedules that match the needs and challenges of your care environment. Ultimately, it allows your nursing workforce to deliver better care and improve patient outcomes without sacrificing productivity.
Industry Perspective
The Interoperability of Health IT Data To decrease costs and improve patient care, health IT solutions must have access to reliable, near-real time data from across the health system. There is an incredible amount of data buried in the many silos of clinical systems in health systems today. IDC Health Insights estimates more than 25,000 petabytes of health data will be created by 2020.
That data translation allows users to pull information from multiple systems to easily gain a holistic view of how patient outcomes, care processes and staffing protocols interact with one another. With that information, everyone from clinicians to administrative executives can make better-informed decisions about changes.
That data is most often a mass of unintelligible bits and bytes today. However, with the right tools it can provide a wealth of unique insights into better patient care and in-hospital workflow. Most IT administrators are not able to gain those insights because the systems creating that data aren’t integrated. Different systems create different types of data, in different languages and terminologies, in completely disconnected environments.
This information benefits frontline clinical staff and the patients they serve. When a practitioner treats a patient, he or she can immediately pull from a wealth of health data – including information not originally placed in the EHR – to make quick, informed care decisions.
To make the most of disparate data, “health systems must create a foundation of swiftly flowing normalized health information,” Rydbeck explained. “You must get every system speaking to each other, and do it fast.” This means translating terminology, codes, protocols, data structures, and other format differences between systems. “That’s what Infor does for over 2,500 health providers around the world. We translate and connect information from these systems,” he said. “We make it so that inpatient EMR #1 can speak one language and ambulatory EMR #2 can speak a different language, and yet these two systems can now have a meaningful exchange of your patient data in real-time.”
What’s more, any practitioner can pull from that information. In an interoperable health IT environment, data must follow the patient. Rydbeck pointed out, electronic portability of patient data is especially crucial in military and publicly funded care settings where patients are highly mobile throughout the health system’s multiple locations and even private partner health organizations. Data can even be accessed in private hospitals. “Everyone’s heard about overcrowding and long waits at veterans’ care facilities recently,” Meyers said. “One way that the government solved that problem is to offer those veterans care by civilian providers at nonveteran facilities.” That coordinated care is only possible when data can follow the patient. Without it, tests may be duplicated and costs actually increase. Data interoperability lays the groundwork for information exchange, population health management and patient-centered care.
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Better Health IT Data at HUMC To understand how interoperable health IT data can transform operations, consider the case of Hackensack University Medical Center (HUMC). The hospital, part of Hackensack University Health Network in New Jersey, is the fourth largest hospital in the U.S. by admissions. The nonprofit teaching and research hospital also employs more than 10,000 people and has 775 beds. Like many other providers, HUMC recognized the need to eliminate a one-size-fits-all model of care to provide more tailored care for patients. Administrators quickly realized that required a more integrated IT strategy. HUMC’s first step toward its goal was to focus on the flow and exchange of patient information. Leaders wanted it to be more open, comprehensive and accessible to both patients and providers. HUMC’s IT department partnered with Infor to draft standard and aggregate disparate patient information using the Infor Cloverleaf Integration Suite. The Infor Cloverleaf Integration Suite acts as an engine to transform messages across a healthcare organization’s many systems and protocols. More recently, HUMC worked directly with Infor’s senior engineering teams to set a new bar for hospital operations and eliminate paper from their patient admission process. They set an aggressive first milestone of enabling interoperability using Fast Healthcare Interoperability Resources (FHIR) with its Epic EHR system. FHIR is the industry standard for formatted health data.
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HUMC wanted a real working solution that was production-ready in a month. By applying automated solutions that translated data from the Epic EHR and other sources across the health system, the team created a common FHIR service layer. Now, any system can interact and share quality data among partners and clinical research teams quickly and easily. Additionally, HUMC was able to conduct the patient admission process through a smartphone app rather than paper forms in a waiting room. This translates to much higher patient satisfaction. HUMC patients now fill out all their forms, answer physician questions, and schedule their appointment from outside the hospital. Because of this work, the CIO of HUMC was awarded CHIME Innovator of the Year. The team that completed the integration was also brought to the White House to present on the presidential Precision Medicine Initiative.
Industry Perspective
Conclusion Given swift advances in technology, a changing regulatory landscape and cost pressures from all sides, it’s imperative that healthcare organizations transform the way they provide care. Providers must simultaneously improve patient outcomes, better the patient experience and lower the cost of care to operate in today’s environment. Especially for publicly funded and government health systems, achieving that trifecta will be a challenge. Technologies that promote integration across all systems and data to streamline the supply chain and optimize the health workforce are part of the critical foundation to achieving this.
Veterans, military families and government workers really need efficient and effective care. Infor allows healthcare organizations and hospitals to manage and grow staff, oversee facilities and automate delivery of supplies, all while keeping patient outcomes in mind. Being able to rely on interoperable solutions that deliver rich functionality delivers peace of mind for organizations and the patients they serve.
That’s where Infor’s technology suite comes into play. “We want to make it as easy as possible for healthcare providers to focus on their mission of serving patients,” said Rydbeck. By streamlining processes across the entire health system in a case-specific but automated way, Infor lets government hospitals pursue their goals, rather than wrangling technology.
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About Infor Healthcare
About GovLoop
Infor Healthcare offers a complete business platform designed for healthcare. Our intuitive software is designed to improve integration, tracking, and management of staff, supplies, financial resources, and clinical data. 250 million lives around the world are touched daily by Infor Healthcare solutions. 72% of US healthcare provider organizations with more than 150 beds, 7 out of the top 10 children’s hospitals, and 6 out of 6 of the largest US health insurance payers rely on Infor Healthcare solutions.
GovLoop’s mission is to “connect government to improve government.” We aim to inspire publicsector professionals by serving as the knowledge network for government. GovLoop connects more than 250,000 members, fostering crossgovernment collaboration, solving common problems and advancing government careers. GovLoop is headquartered in Washington, D.C., with a team of dedicated professionals who share a commitment to connect and improve government.
Learn more about our work at infor.com/healthcare.
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Industry Perspective
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