Facilities are moving forward with a focus on updating current systems or implementing new technologies in order to meet expected requirements of the American Recovery and Reinvestment Act (ARRA), As they do so, we recommend organizations consider the holistic impact of the technology requirements and the implications for people and processes for the day-to-day management of the organization. With every change in technology, there is an expected change in work flow for both administrative and clinical staff to harness the efficiency expected from the use of health information technology.
One way to frame the impact of these changes is to consider the affect on the patient, information, revenue and management work flows. First, the patient flow through any hospital or clinic starts with the initial contact to establish an appointment. From the registration, through the appointment, to departing with the necessary instructions, the use of health information technology should change clinical and administrative staff processes to make non-value- added processes seen by the patient obsolete, making the entire process more efficient.
Within the patient flow, the capture, use and retention of both the demographic and clinic information will experience a change in process or work flow. The revenue cycle, from co-pay collections prior to the visit to the exchange of claim information with governmental and commercial payers subsequent to the visit, will also require work flow changes from execution to communication with external parties. Finally, organizations will require a change in management processes, including the way staff and providers are evaluated and the day-to-day management of reporting and decision making.
So, how can you ensure that your organization is obtaining the expected efficiencies as it strives to meet meaningful use? The first step is identifying the "true" way that work flows and processes are being conducted today. This involves going beyond the current procedure documents and engaging staff in the development of a process map which identifies the steps currently involved in the process, versus the perception of how it is happening. Process mapping conducted in this manner can shed light on inefficiencies within a work flow that were previously unknown.
Next, identify where the selected technology components are expected to play a role in the outlined process. Engaging staff in this component of the process change creates ownership for the change, and allows individuals with the most to gain from the efficiency a part of the process to establish a future state.
Finally, work with the team to prioritize the changes that need to occur, focusing on those that have the largest impact to time, cost and the patient experience. It is important to prioritize the changes so as not to overwhelm staff and providers, and instead systematically integrate change slowly and accurately. A work plan with a timeline for the changes is an effective tool for communication, implementation and change management.
The move to health information technology is no longer a recommendation, but a requirement. The costs associated with implementation go beyond the hardware and software and maintenance required for implementation. Staff time, patient satisfaction implications, financial incentives and productively costs are real impacts that will be felt with each implementation. By focusing internally on operational work and process flows, and engaging staff in the change management of these processes, facilities will not only be on their way to obtaining the efficiencies expected with information technology, but they will enjoy the improved staff and patient satisfaction that comes with increased efficiency.