Clinical Transformation Trek… The Journey

By Roni H. Amiel

The pace of change for health care providers is overwhelming at best. In today’s world of collaborative medicine and mobility, access to actionable, integrated clinical information and applications, regardless of location or device, is a “must have” not a “nice to have.”

Blythedale Children’s Hospital like most hospitals have been exposed to the demands of health reform, clinical integration, deployment of electronic health records, and implementation of ICD-10, quality reporting and ever increasing regulation that are putting significant strain on the organization. This establishes a vision and program for a Clinical and Business Transformation Platform.

Transformation Framework
Our journey started with rethinking the clinical and business processes with focus on outcome, clinical quality, service quality and financial metrics. Process transformation required concurrent examination and redesign of key clinical and business processes, technology and the “people”. This helps to create the vision and documented the “Frame of the Future” which set the scope. Leadership team was fully engaged with their commitment to transformation, the ongoing communication and preparedness for a change were fundamental keys to achieve a successful and sustainable transformation.

Our primary goal was to “craft” the future vision so it may reach far beyond the current boundaries of the organization’s business practices and better integrate disparate environments to achieve a more cohesive organization.

Our core team was assembled with individuals from key departments that were considered “experts” recommended by their department head, not technophobes and those who are likely to be receptive to change.

The challenge: To maximize physician, nurse and administrative performance, hospitals must create a fluid HIT environment that provides on-demand access to patient data and patient care applications.

50,000 FOOT PERSPECTIVE: Health information technology is a pivotal factor in creating sustainable health systems that deliver quality services and programs along a coordinated continuum of care. The ability to share patient data along the continuum of care affords optimal clinical decision support and the opportunity to achieve better patient outcomes.

Performance in the future must be efficient, effective, relevant and accountable. Outcomes in patient care, stakeholder satisfaction, revenue management, market penetration and population health improvement must be sustainable. Organization capacity for transformation requires investment in skilled resources; strategic leadership; information technology; program, project and process management; and collaboration with new partners. Monograph provides an understanding of the current environment, identifies the gaps that must be closed and provides a strategic framework for senior leaders to build upon.

Clinical Framework
The Chief Medical Officer played a key role in transforming the provider experiences, productivity and increasing operational efficiencies by outlining new decision-making structures to ensure:

Care is patient-centered and coordinated across provider venues, not just the inpatient stay.Systematic processes encourage standardization and evidence-based practice.Transparent operations ensure clear authority and responsibility for point-of-care decision making.

Technology Framework
Architecture and platforms that leverage Investments in legacy systems with new investments and allows an “accrual” of benefits to maximize the return of investment.Adopt a user-centric approach that ensures the user experience is “seamless, predictable, responsive and secure” regardless of the device used.

Measuring Success
Share a clear vision of the future with executives, physician leaders, management, and staff. It is critically important to design “for” physicians rather than doing things “to” physicians. Plan well and adjust well; Put in place a plan that outlines the goals and critical assumptions of the Clinical Transformation program and includes a realistic estimate of the time and resources required.

Create innovative “end to end” solutions
Manage all the component pieces of the transformation so they “fit” and so that each participant in the process is very clear about their part.

In Summary

The methods and regulations of health reform will be sorted out in coming years. Health care organizations cannot risk waiting until everything is resolved to make necessary changes. The path toward accountability is clear: transformation away from fragmented health care delivery and a focus on acute care to prevention and wellness, care coordination and population health management is necessary. Investment in information technology, outcomes improvement and new processes of care will be essential.