Top CEOs offer checklist for better healthcare

By Bernie Monegain
10:18 AM

Some of the nation's top healthcare CEOs have issued a 10-item checklist for spurring high-value healthcare that includes health IT best practices.

The checklist is part of a discussion paper the CEOs authored that bears the emblem of the Institutes of Medicine. However, it also carries a disclaimer that the views expressed in the discussion paper are not necessarily those of the authors’ organizations nor of the IOM.

"The Checklist’s 10 items reflect the strategies that, in our experiences and those of others, have proven effective and essential to improving quality and reducing costs," the authors write.

On the topic of IT, they state: “Reliable information systems are critical not just to ensure care quality, but also to improve efficiency in administrative and other process measures.”

In keeping with their precept of “continuous improvement,” the CEOs ask themselves and their senior leaders these questions about IT:

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  • How well is our IT system used to help providers streamline administrative tasks and improve the care experience and patient outcomes?
  • How well is our EHR aligned with meaningful use requirements?

They also present examples of how IT best practices resulted in better care and millions in savings at their organizations.

At Geisinger Health System, for example, IT helped lower costs over the past five years, saving $1.7 million from reduced chart pulls; more than $600,000 from reduced printing and faxing; more than $500,000 per year from reduced nursing staff time through ePrescribing; and more than $1 million from reduced transcription.

The checklist and a list of the authors and their affiliations are on the next page.

The checklist:

Foundational elements

  • Governance priority – visible and determined leadership by CEO and Board
  • Culture of continuous improvement – commitment to ongoing, real-time learning

Infrastructure fundamentals

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  • IT best practices – automated, reliable information to and from the point of care
  • Evidence protocols – effective, efficient, and consistent care
  • Resource utilization – optimized use of personnel, physical space, and other resources

Care delivery priorities

  • Integrated care—right care, right setting, right providers, right teamwork
  • Shared decision making—patient–clinician collaboration on care plans
  • Targeted services—tailored community and clinic interventions for resource-intensive patients

Reliability and feedback

  • Embedded safeguards – supports and prompts to reduce injury and infection
  • Internal transparency – visible progress in performance, outcomes, and costs

The CEO authors of the checklist and discussion paper:

  • Delos Cosgrove, MD, president and CEO, Cleveland Clinic
  • Michael Fisher, president and CEO, Cincinnati Children’s Hospital Medical Center
  • Patricia Gabow, MD, CEO, Denver Health and Hospital Authority
  • Gary Gottlieb, MD, president and CEO, Partners HealthCare System
  • George Halvorson, chairman and CEO, Kaiser Permanente
  • Brent James, MD, executive director, Intermountain Institute for Care Delivery Research
  • Gary Kaplan, MD, chairman and CEO, Virginia Mason Health System
  • Jonathan Perlin, MD, president, Clinical and Physician Services, HCA, Inc.
  • Robert Petzel, MD, Undersecretary for Health, Department of Veterans Affairs
  • Glenn Steele, MD, president and CEO, Geisinger Health System
  • John Toussaint, MD, CEO, ThedaCare Center for Healthcare Value