5 Keys for Hitting the Healthcare IT Triple Aim

Daniel MarinoOur Industry Needs to Make Better Use of IT

By Daniel J. Marino, President/CEO
Health Directions – (@HDirections)

While health care’s complexities and challenges are unmatched by other industries, no one would disagree that our industry needs to make better use of IT. The success of healthcare IT projects depends on their ability to deliver on three main objectives comprising the Healthcare IT Triple Aim:

  1. improve care,
  2. reduce costs, and
  3. enhance the worker experience.

By adopting the Triple Aim, we can ensure that healthcare IT solutions have a positive impact and advance health care’s stature with regard to leveraging IT. The following are five keys to hitting the technology Triple Aim.

I. Technology is the Enabler, Not the Driver
The Triple Aim is the driver and technology is the enabler, not the other way around. Technology implementations are complex and sometimes develop a life form of their own, and before we know it, assume the role of driver. Another challenge is that IT departments often end up driving the implementation of IT solutions, which is not the best approach. Solutions should be driven largely by stakeholders and users who will benefit from the solution. IT departments are not necessarily to blame for assuming control as they often end up filling a void created by the lack of leadership.

II. Trust the Technology
Remember when eCommerce came into being? One of the key issues was consumer trust in these new, Internet-based technologies that a user could not touch, talk to or see. Fear of stolen identity, financial loss and general mistrust of this new, technologically advanced way of doing things slowed adoption. We are in a similar place today with health care technology. Physicians, hospitals and patients are being asked to be more transparent and share information. We are entering a world where electronic visits and remote health monitoring are moving toward the norm. Health care providers are being asked to look at and respond to clinical and financial performance data, and are being told that their income will depend on that data. Like it or not, health care is fueled by data, and there is likely no escape.

III. Pay Attention to the Often Overlooked Driver
Of the Triple Aim objectives, improving the health care worker experience is the one most often overlooked. Technology projects are usually born out of a desire to save money and decrease risk exposure thereby improving quality of care. Some electronic health record (EHR) projects were started with the notion that they would make a physician’s job easier. However, EHR implementations, in general, have not delivered on that objective; in fact, most have had the opposite effect. If technology doesn’t simplify a job, the job may not get done; or if the job does get done, it will be done at the high cost of lost productivity and worker dissatisfaction – negatively impacting the quality and cost of care.

IV. Measure It
Is our technology improving care? Reducing costs? Enhancing worker satisfaction? If so, how and to what degree? These are questions that should be asked and measured specifically and quantifiably. Create key performance indicators (KPI) detailing the goals that support the overarching Triple Aim objectives. Items to be measured will vary by worker group. For example, physicians, nurses, schedulers, billers and administrators should all have unique KPI dashboard measures related to their specific objectives, and their capacity to impact care and cost. In addition, they should have their worker satisfaction evaluated on a regular basis. KPI’s may also vary depending on what issues the technology solution is intended to address but could include:

  • patient waiting time
  • gaps in care
  • patient satisfaction surveys
  • number of visits per day
  • number of same day visits
  • worker satisfaction surveys
  • hours required to wrap up the day after the last patient visit
  • traditional billing and financial measures.

V. Improve It
Improvement naturally follows measurement. With regard to IT improvements, there are two important things to keep in mind:

  1. Today’s solution may not suffice tomorrow, and if we think it will, we’ll get left in the dust.
  2. The complexity of health care’s issues require adjusting on the fly.

If we wait for the perfect roadmap, the project will never get off the ground. Complex implementations such as ambulatory EHR solutions leave users feeling like overwhelmed. Likewise, data intensive accountable care models are complicated and not fully defined, requiring a lot of discovery and invention along the way. There is no linear path; missteps and rabbit trails will be the norm, not the exception. Many consulting firms and health system IT departments have assembled EHR optimization teams that follow implementation by 90 or more days, and work to improve processes of adoption after everything has settled. Technology optimization initiatives that involve a systematic plan of reviewing and responding to performance metrics should be widely used.

Seasoned veterans know that the devil is in the details when it comes to applying IT solutions to the complex issues of health care. Sometimes the biggest challenge is getting the proper stakeholders to spell out objectives and play a key role in the execution of the project to ensure that they are met. If you are considering a new technology implementation or find yourself in the throws of adversity from a previous implementation, it’s not too late to revisit the project and align with the Triple Aim objectives.

About the author: Daniel Marino is the President and CEO of Health Directions. With a broad background in all aspects of practice management and hospital/physician alignment, Dan is nationally recognized as a strategic leader in Accountable Care Organizations and clinical integration development.  This article was originally published on Health Directions and is republished here with permission.