Almost everyone agrees that advanced clinical and information technologies offer unprecedented promise to enable healthcare solutions. But right now, many hospitals are grappling with how to optimize technology and the financial investment it requires. This article discusses the top technology issues hospitals will face in the next five years. While the response to these considerations must be tailored to each individual hospital's goals and vision, there are issues that apply to all situations.
One general comment to begin with: To implement these strategies takes a lot of effort at the enterprise level. Where do you get the expertise? Don't forget your in-house experts: department directors, clinical managers, nurses, and support staff. Associations offer conferences profiling case studies that focus on these initiatives. In addition, consultants offer expertise developed through an iterative process of implementing numerous projects.
High tech translates into high dollars. As technologies integrate with other systems, the resulting bundles are pricier since the scope has expanded; even though per unit costs may have dropped. In fact, technology is evolving so quickly, it's almost impossible to determine if a new development just around the corner will supersede this year's latest and greatest advancement. What's more, the Institute of Medicine (IOM) has established such a broad spectrum of initiatives, how can a hospital determine what its technology budget should be?
Here are some guidelines for developing a capital equipment strategy:
Prioritize resources (both people and money);
Align to your institution's core values and major initiatives (e.g., reducing medical errors);
Coordinate with annual capital management programs; and
Coordinate with major capital projects (new facilities).
If reducing medical errors has been defined as an initiative for your hospital, then a best-in-class positive patient identification technology that helps mitigate human error, such as RFID, would align with that initiative. Safety and code-required improvements receive top priority. Initiatives such as going wireless and/or paperless may follow close behind. Recent reports of electromagnetic interference suggest a tailored test plan for compatibility for your hospital is in order.
When evaluating your capital strategies, consider the synergy you can achieve by coordinating your major capital projects with your annual capital management programs. The advantages of volume purchasing, for example, can be gained by grouping your replacement and new equipment schedule as one order.
Once a strategy has been developed, the next step is to identify parameters for prioritizing what to buy. Associations such as the Healthcare Information and Management Systems Society (HIMSS) provide the benefit of a collective knowledge base. In response to a recent survey by this organization, chief information officers listed their organizations' top IT priorities for the next two years to be:
Implement technology to reduce medical errors/promote patient safety;
Replace/upgrade/implement inpatient clinical information systems;
Implement an electronic medical record (EMR) or components of an EMR;
Connect IT at hospital with remote environments (e.g., the physician's office);
Integrate systems in a multi-vendor environment; and
Address business continuity/disaster recovery.
Of these priorities, business continuity has received the most press of late. It's a diverse and critical initiative, so seeking the expertise of a consultant is common. A key component to address with your consultant is having a robust data center-the sole backup for your entire health system.
Historically, hospital data centers have grown from telephone switch rooms that never included the features common to modern data center designs. Today's hospital data centers have rigid requirements for power and cooling, as well as physical/electronic security and safeguards against extreme weather conditions.