Maximizing IT Value

Towards Clinical Transformation

Health-e-NationMelbourne, Australia

24 March 2004Dave Garets, FHIMSS

Executive Vice President

Healthlink Incorporated

Slide 2

Agenda

Key business drivers in healthcare IT State of the industry What drives CEOs and CIOs to invest in

technology? The disconnect between vision and execution Thoughts on achieving IT success The path to Clinical Transformation

Slide 3

Key Business Drivers in Healthcare IT

Error rates are too high Quality is inconsistent Research results are not

rapidly used Costs are escalating New technologies continue

to drive up costs Demographics of baby

boomers will greatly increase demand

Capacity for early detection of bioterrorism is minimal

Slide 4

State of the Industry

In the United States:• Budgets are increasing for IT – from $34B in 2001 to $48B in

2006 (healthcare IT spend according to Gartner)• Irreversible trend towards clinical computing• Satisfaction with results are declining – few examples of

positive ROI• Vendors are starting to deliver applications that work• Government pushing NHII• Infrastructure is taken for granted – it’s a commodity

In Britain:• The great experiment is on to the tune of $13-$15 B• Vendors are now trying to figure out how they’re going to

succeed

Slide 5

State of the Industry

In Australia:• Focus on managing clinical information (absent clinical

systems) increasing rapidly– HealthConnect– MediConnect– Quality and Safety agenda

• Facing the same dilemmas as sister countries– The “record” is paper or at best images– Clinicians can’t share information– Inadequate access to knowledge, patient records– Very few hospitals with clinical IT– Even general practice could be using clinical IT more effectively

• Most public hospitals are implementing patient management systems rather than advanced clinicals at this point

• EHR=summary data, not full record

Slide 6

CEO/CIO Rationale for IT Investing

“Transformation of healthcare delivery” will never happen without IT

IT is the only way to increase efficiency and effectiveness and ensure efficacy of clinical activities

Patient safety is a huge public relations issue Spiraling costs are not sustainable Consumer demand for participation, information is not

subsiding Demands for accountability becoming deafening

Slide 7

Principal purpose of IT = Value creation,

not overhead cost reduction.

“…the principal purpose of investing in IT is not overhead cost reduction but value creation. Cutting costs can contribute to profitability, but in the long run one does not prosper through shrinkage. The objective of all investments should be to improve overall organisational performance.”

Paul StrassmannThe Squandered Computer

What the Winners Know?

Slide 8

Disconnect between Vision/Execution

Too much hype from vendors, early adopters, pundits for under-educated buyer community

Expectations not correctly set Too many stakeholders with conflicting incentives, desires Not enough rational thought/solutions Pendulum has swung too far

• Replacing systems rather than optimizing existing ones• Wholesale replacement of best of breed with single vendor

Nowhere near enough attention to process redesign

Slide 9

Transfer/Discharge

DocumentProvideCare

DeliveryOrder

Admit &Begin Care

Schedule &Pre-register

CompleteRecord& Code

Bill &Collect

Schedule

ContractMgmt.

Register/Admit

CreateMedicalRecord

AssessPatient

GenerateOrders

ReceiveOrders

Provide Care

DeliverServices

EvaluateCare

GenerateResults

Transfer/Discharge

CaptureCharges

Bill

Collect

Pa

tie

nt

Ac

ce

ss

HIM

Pa

tie

nt

Ca

reP

atie

nt

Fin

anci

als

Car

e A

nal

ysis

OutcomesAnalysis

Clinical Decision Support

CompleteRecord

Process

Technology

People

Three Elements of IT Success

Slide 10

The Path to Clinical Transformation

Knowledge base of clinician memories, journals, registries, paper patient records, images, and some digital data

Health continuum process redesign

Computer assisted clinical, financial, administrative workflows

Normalised repositories

Decision support

Standards, identifiers, IT protocols, standard nosonomy

UI and Access

Slide 11

The Path to Clinical Transformation

Knowledge base of clinician memories, journals, registries, paper patient records, images, and some digital data

Health continuum process redesign

Computer assisted clinical, financial, administrative workflows

Normalised repositories

Decision support

Standards, identifiers, IT protocols, standard nosonomy

UI and Access

Healthcare Financing Mechanisms

WorkforceAvailability

ConsumerExpectations

Clinician adoption and utilisation of IT

Patient safety

Political cycles

Tort reform/medical indemnity insurance

Expense!

Ageing population/increased

demand

GPs are ahead of the game

Slide 12

The Path to Clinical Transformation

Knowledge base of clinician memories, journals, registries, paper patient records, images, and some digital data

Health continuum process redesign

Computer assisted clinical, financial, administrative workflows

Normalised repositories

Decision support

Standards, identifiers, IT protocols, standard nosonomy

UI and Access

HealthConnect

Internet

iSoft, IBA, Cerner et. al.

Accenture, CGE&Y,Healthlink, et. al.

Governments, standards bodies

Maximizing IT Value

Thank

Healthlink Incorporated3800 Buffalo Speedway, Suite 550

Houston, Texas 77098

1.800.223.8956

www.healthlinkinc.com

You