Effective Cost Control Strategies

Via Healthcare Information Systems

Go Far Beyond Electronic Medical Records

Typically EMR/EHR Gets The Press, But The Big

Potential Of Health Information Technology

Lies In Multiple Integrated Enterprise Systems

Essentially nobody disputes the notion that broader adoption of information technology by health care providers will impact the economics of this industry in a positive way. But the greatest potential for such impact may lie in implementing systems other than the type of information system to which most references are typically made.

The beneficial use of information technology by health care providers that is most frequently cited in both popular and professional press, refers to systems for managing health data of individuals. These systems are also known as Electronic Health Record (EHR), Electronic Medical Record (EMR) or even Electronic Patient Record (EPR) systems. It's a safe bet that widespread implementation of this type of system will occur over the next several years, given all of the attention, financial incentives, and market promotion that is being given to this product niche in the context of the current national debate over health care reform.

But the public discussion has consistently undervalued the potential impact of enterprise class information management systems of a different stripe.

Commercial Enterprises Can Show the Way

Let's go back to some basics. Health care delivery enterprises are just that: enterprises. Whether they are organized as non-profit or for-profit entities, they are

• made up of a diverse group of people,

• often organized as multidisciplinary teams,

• conducting highly specialized procedures,

• procedures that must be executed in careful coordination with one another,

• presenting a crucial need to share information as efficiently and effectively as possible

The overall goal of the health care delivery enterprise is ensuring the highest quality and the greatest success in providing care to their patients. And we all understand that for a health care enterprise the consequences of these activities can have life-and-death implications. But these five characteristics are not unique to health care providers, and can apply equally to a much wider scope of commercial enterprises as well.

In the early 1980's, commercially-oriented enterprises in many other industries, faced with similar challenges and recognizing the potential benefits from effective information sharing, began to evolve a class of information management systems optimized for use in, and by, the entire organization: so-called "enterprise applications software” or “enterprise systems".

Wikipedia describes enterprise software as "...software intended to solve an enterprise problem (rather than a departmental problem) and often written using an Enterprise Software Architecture".

While there are various uses of the use of the term enterprise systems, and its implied meaning, there are several consistent characteristics of these types of systems that clearly distinguish them from either single-purpose departmental systems, or individually-oriented personal productivity applications.

• there is a single, organized, and authoritative base of data at the system's core;

• functions are provided through specialized applications designed to work with, and share, that core data resource;

• access to the functions and data is secured, allowing only authenticated users

The earliest forms of enterprise applications were often referred to as “client-server”, where the server was a computer set aside to exclusively deliver or “serve” data in response to individual requests requests for records made, typically, from multiple remote computers or “clients”. In those early days, the client software and server software were designed together and meant to operate only with one another. This approach made for a “closed” system of functions and data, locking out any other clients, sometimes called “thick” clients, from accessing and sharing in a central data repository.

Open Trumps Closed, Thin Beats Thick

With the advent of the web technologies, many server software designs evolved to be more “open”, making them more accessible to “thin” clients, which conformed their requests for data to openly published standards or protocols. As a result, clients got “thinner”, less specialized for a particular application, and more accommodating to various types of servers. At the same time, application functions in these open clients were delivered through smaller, embedded pieces of programs called “applets”.

The upshot of this jargon-packed story, is that today's enterprise application software is remarkably flexible, and can provide secure access to large numbers of users through a variety of communication and networking channels. Consequent to this increased flexibility, the extent to which enterprise software systems have penetrated commercial operations, regardless of their scope or scale, has exploded. The lesson? Nearly every aspect of an enterprise's operation benefits from investing in information technology of this caliber. The variety of enterprise class information systems encompasses human resource management, learning and training management, intramural and extramural team collaboration, enterprise resource planning, document management, content management and the like.

Strategic Solutions for the Healthcare Provider

Recent polls have shown that the overwhelming majority of America's health care provider enterprises have not had hands-on experience with any enterprise class information systems. For them, the opportunity to rein in rising operations costs by making a strategic investment in any enterprise information management systems is not so clear. Notwithstanding, the pressure on health care providers, in general, to take their first step in this direction by procuring and implementing an EHR/EMR system is great and growing, despite the open issues, inherent complexities, and substantial costs associated with this particular category.

Certainly, electronic patient records will be a foundation of health care delivery in the future. But it also makes sense “to walk before running”. The benefits of greater operational efficiency can be realized through implementing other types of enterprise applications systems as well. Key business processes, regarding training or resource planning, that are currently measured in terms of days of elapsed time and tens, or even hundreds, of employee hours of effort can be reduced to minutes, with increased accuracy, fewer errors, and greater consistency in their execution. Productivity improvements of this order can have a direct impact on increasing capacity without raising costs, or reducing costs while maintaining the same capacity to deliver services.

Minimizing Risk for the Healthcare Provider

Although these prospects are real, as is the case with any complex change introduced into an enterprise, there are risks that can be anticipated, understood, and planned for. For the health care provider that has not yet tackled implementing an enterprise information management system, there are real advantages to having someone with hands-on expertise in designing, implementing and maintaining such systems in health care, as well as in other, types of enterprises.

Augury is the MSP for Healthcare Enterprises

Augury Network Advisors, LLC is a Managed Service Provider that has a record of advising on, and delivering, such information systems in various enterprise settings. We've been uniquely focused on applying that experience in health care provider enterprises, especially non-profit organizations who deliver long-term care and nursing care services and facilities. Augury's service strategy is based on:

• methodical process analysis

• cost-effective, open source enterprise information solutions

• installation and implementation project management

• tailored support solutions