To reach value realization, start right – A 10-point plan
The transformation to value-based care delivery requires thoughtful change management leadership and firm commitment to quality improvement. The risk of allowing the status quo inefficiencies that currently plague our health systems to continue is to cripple value-based care before it barely got started. Yet, the rewards of deploying an enterprise imaging platform can be enormous. Let’s explore how to successfully transform individual departments’ medical imaging into powerful enterprise-wide assets that benefit the clinical, operation and financial health of your care system.
1. First develop a strategy, not just a purchase order. To achieve healthcare’s complex objective of delivering value-based care while reducing unnecessary costs, progressive healthcare leaders see new opportunities for quality and collaborative practice, as underutilized medical images evolve into a strategic asset of the organization. Yet hasty action on this awareness also can prove a cautionary tale, as some “early adopters” neglect to fully define enterprise goals and mistake a big-box storage infrastructure topped with a viewer layer as a complete solution. The successful approach to empowering physicians to make informed decisions through multispecialty collaboration is a multiyear strategy to achieve secure access to a single comprehensive patient record. The goal must not be simply to archive imaging data – the goal is to provide tools that, hourly and daily, foster a re-invigorated environment of collaborative and informed patient management. Images are key data in the continuity of care and therefore need to be managed via standardized workflows and accessibility to serve the aspirations of value-based care.
2. Emulate EHR convergence. Our lives are constantly improved by innovation that converges technologies and disrupts the status quo, bringing benefits to both our professional and our private lives. Your own smartphone, for example, converges dozens of once-standalone devices and applications (you can quickly name more than five, right?), delivering significant convenience and cost savings. Similarly, EHRs converge multiple patient information systems that were once standalone, unconnected silos. Health systems often have as many as 70 different service lines that capture and consume imaging – clearly, a similarly converged single platform technology is required to bring order and drive value of these disparate systems, workflows and behaviors across the enterprise. Choose a vendor with deep knowledge and wide breadth of experience connecting the most healthcare disciplines, who can help you design your strategy to align with broader clinical, operational and financial goals.
Consolidation reduces cost, complexity and the resource-draining need for multiple integrations. Look for a purpose-built platform consisting of modules to leverage your EHR investment incrementally as part of your organization’s strategic plan, not the vendor’s.
3. Be the wise leader. Long-term success benefits from a right beginning, and your success will be accelerated by collaborating with a vendor that brings to the project experience in governance best practices that include step-wise metric assessment. As with any large IT project, adoption is key to a successful return on investment. Change management initiatives can be an expensive PowerPoint deck without adoption. Source a team with a proven record in helping institutions build a governance framework, including a cross-departmental strategic decision-making body, implementation processes and agreed-upon critical metrics definitions.
Only consider a vendor that respects and values your long-term success and offers consultative experience to align the program with your leadership goals. Demand a team that will work with you to support your goals of quality delivery of care and cost containment as well as define measurement units for goals such as clinical productivity improvement, process efficiencies and improved revenue capture. Look for a team that seeks to understand your multiple clinical workflows and challenges to develop adoptable processes and support your institution’s change management. Seek out a vendor that is proactive in developing a baseline and monitoring success – measuring for you and with you before, during and after the step-by-step deployment and course-correcting throughout the process. Additional information can be found in the Enterprise Imaging Governance: HIMSS-SIIM Collaborative White Paper.
4. Standards, protocols and frameworks. Interoperability is a priority for lasting IT, and hence clinical, value. Insist on a deep commitment to industry standards to help support your technology investments today and in the long term.
5. Massive and incremental scalability. Anticipate the IT needs for interoperability due to mergers and acquisitions (M&As), accountable care organizations (ACOs) and other regional collaborative initiatives. Look for a solution that is natively built to grow and connect previously disparate systems as needed.
6. Advanced care coordination through seamless access to shared information. Assure your institution gains a network-aware platform to drive collaborative care both within the hospital walls and with affiliates. Easy access to patient images helps foster an environment of collaborative and informed patient management, supporting today’s model of shared decision- making and value-based care across multiple points of care, regardless of specialty. Set as your strategic goal to improve the quality of care by enabling pervasive multispecialty imaging and data access. Format should become a non-issue – the long-term solution should house studies from virtually any device, from virtually any format, DICOM, or not.
Secure, unfettered information sharing – online, in the cloud, and with a single-click url – puts the patient first and helps reduce unnecessary imaging exams and fragmented care. This is the clinical apex of enterprise imaging and why I place it as a central consideration in this list.
7. Risk mitigation, anyone? Enterprise imaging enables accurate attribution of metadata to episodes of care, providing actionable information and a trail of documentation, for use in revenue and risk mitigation gains. Look for a solution that enables a controlled environment for managing and sharing images, including a secure single sign-on framework that provides context controlled and audited access to data. By consolidating the number of systems to manage, the long-term enterprise imaging platform helps to limit the total number of potential points of data breach by replacing “rogue media” such as thumb drives or personal email attachments with a controlled, audited enterprise-wide multimedia platform.
Contextual, intelligent indexing of medical images and document data from each episode of care leverages their clinical value across the enterprise – providing powerful, proven support of clinical productivity and patient satisfaction.
8. Encourage secure communication and engagement among stakeholders. Advances in easy-to-use mobile applications allow both patients and clinicians to review sophisticated information on demand yet securely. Expect efficient use of patient and system time with universal, zero-footprint applications that enable engagement such as “medical selfies” to speed rapid, remote assessment of healing states, or mobile viewer access to images to help speed discharge by busy physicians.
9. Support multiple imaging departments’ productivity with standardization. Task-based workflows provide consistency and efficiency. Demand task-based standardization to bring one learning curve application across multiple service lines, with enough flexibility to support unique actors and workflows. Non-radiology departments such as ophthalmology, wound care, dermatology, cardiology or surgery cannot thrive with radiology workflows and so require their own flexible processes. Encounter-based workflow will enable the appropriate level of metadata to be associated with those images at the point of acquisition without a lot of overhead for the person who’s actually acquiring those images. Business Intelligence reports should be available to help identify inefficiencies. Measure and modify, then repeat.
10. Information lifecycle management. Work with vendors to identify organizational objectives and records management policies and create solutions to the challenges of information lifecycle management (ILM). Among the issues: How should a data retention policy guide read/write access to medical image metadata? By what criteria should your organization decide how and when to delete or dispose of medical images?
These 10 points can assist to accelerate and maximize the usefulness of your enterprise imaging program while achieving actionable and measurable value realization. From department image acquisition workflows through interoperability of disparate systems, to clinical decision drivers and patient experience enhancement, a thought-through enterprise imaging platform strategy is a must-have initiative to improve the delivery of quality care by replacing costly, risky inefficiencies of the past.
About the Author:
Miriam S. Ladin, Director, Marketing & Communications - North America, AGFA HealthCare