| Information technology: Achieving
efficiencies in clinical and corporate management.
Professor Steven C.
Boyages, CEO Western Sydney Area Health Service, Westmead, NSW, Australia 2145
Health services are large,
complex and costly systems that deliver diverse health services to a range of clients in
the community, in the ambulatory setting and within hospital environments. Western Sydney
Health provides 2.3 million non admitted patient occasions of service and 140,000
inpatient events per annum. This activity represents about 10.3% of the state’s
health activity. Information technology systems provide an investment opportunity to
ensure that this type of health care is delivered safely, effectively and in the most
efficient manner. At present, health services are at a key transition point where new
corporate and clinical systems promise to deliver future benefits.
The challenge for health
services in the near future is how to manage large scale implementation to realize these
benefits and to mitigate the risks. The challenge is not about trying to articulate why
these systems are important; as I believe those arguments are self evident. It should also
not be an argument about what should be implemented in health IT. There may be differences
in terms of specific aspects of health IT delivery but there is generally broad agreement
as what type of functionality is required whether on the clinical or corporate side of the
organization.
As in any other business
domain, information systems need to be driven by the nature of the business rather than by
the availability of the technology. Strong governance relationships are required to
assess, manage and implement new information systems to ensure linkage to the broader
strategic direction. If not, there is always a danger of being seduced by the attraction
of the latest "gee wiz" device or technology. The "Gee-Wiz" factor is
important but needs to be managed within the broader organizational enterprise and its
architectural requirements.
A key determinant of
architecture is a clear understanding of patient flow or the patient journey.
Traditionally, organisations in health have largely been structured around the provider
and/or around facility design. However, the future will increasingly demand patient
centred care that will be driven by information systems that allow the disparate settings
of health care to be connected. On the provider side of the equation, a broader
understanding of workflow will also be required. These constructs will demand a new set of
skills in health care, skills that understand and articulate the "software" of
the organization. This "software" will be the ability to map, communicate and
re-engineer business processes.
Re-engineering of health
care delivery will not come without strategic investment and cost. The cost of this
investment has to be seen not just as a capital cost, but as the price (cost) of doing
business. Capital costs in health care have traditionally being treated as a free good.
Developing metrics that link the input costs of IT to outputs or outcomes will allow
central agencies to be confident of the value of such investments. Developing a common
currency in health IT will lead to the necessary rationalization or consolidation of
expensive infrastructure, whilst allowing a clearer focus on the business benefits of IT
to be realized. |
