Glaser on health care IT : perspectives from the decade that defined health care information technology

290 Pages·2016·34.706 MB·English

by  Branzell, Russ, Glaser, John Patrick

Glaser on
Health Care IT
Perspectives from the Decade
that Defined Health Care
Information Technology
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Glaser on
Health Care IT
Perspectives from the Decade
that Defined Health Care
Information Technology
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1. John P. Glaser, PhD
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a Foreword by Russ Branzell, President & CEO,
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CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742
] at © 2016 by John P. Glaser
1 CRC Press is an imprint of Taylor & Francis Group, an Informa business
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3. No claim to original U.S. Government works
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1. Printed on acid-free paper
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e This book contains information obtained from authentic and highly regarded sources. Reasonable efforts have been
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a made to publish reliable data and information, but the author and publisher cannot assume responsibility for the valid-
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Contents
Foreword xv
Preface xvii
Acknowledgments xxi
About the Author xxiii
Section One
] at HIT Applications and Analytics Challenges 1
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3. How the Internet of Things Will Affect Health Care 3
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1. Health Care Applications 4
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A Nationwide Effort to Advance Interoperability 9
Where Do We Go from Here? 10
Solving Big Problems with Big Data 13
The Scope of Big Data 14
Final Thoughts 17
The Role of IT in Understanding and Managing Cost 19
When “Good Enough” Just Isn’t 20
Retooling for the Future 20
The Age of Transparency 23
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Heeding the Call for Health Information Exchange 25
Improving Care across the Continuum 26
Key Considerations 27
A Critical Linchpin for Better Care 29
The Growing Role of Analytics and Business Intelligence 31
The Focus and Nature of Business Intelligence and Analytics 32
Ramifications for the BI and Analytics Management Ecosystem 33
The Learning Years 35
From the Transaction-Based EHR to the Intelligence-Based EHR 37
The Transaction-Based EHR 38
Tackling the Accountable Care Challenge 38
Toward the Intelligence-Based EHR 40
Smarter Tools to Manage Big Data 41
Surviving a Revenue Cycle System Conversion 43
Preparing for the Unknown 44
at Charting a Course for Success 44
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1 Six Key Technologies to Support Accountable Care 49
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RCS Checklist 59
The Next IT Revolution: Nearly Ubiquitous Computing 61
The Four Waves of IT Revolution 61
The Fifth Wave 62
The Potential of the Fifth Wave 63
Ramifications of the Fifth Wave 63
Accountable Care Organizations and Health Information Exchange 65
The Need for a Health Information Exchange 66
Targeted Interoperability 66
A Foundation for Targeted Interoperability 66
Differing Levels of Information Exchange 67
Contents vii
Information Technology for Accountable Care Organizations 69
The Accountable Care Organization 69
Health Information Technology Ramifications 70
It’s All about the Data 72
The Variability of Patient Care 73
Iterative and Sequential Care 73
A Need for Agility 75
Managing Clinical Decision Support 77
Leverage Existing Committees 78
Examine Committee Composition 78
Ensure IT Review and Assessment 79
Define Oversight Group 79
The Service-Oriented Solution for Health IT 81
Applications as Foundations: Laying the Groundwork for Evolution 85
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A Good Prognosis 99
From the Electronic Health Record to the Electronic Health Plan 101
Transformation of the Care Delivery Business Model 102
The Care Plan 102
The Plan-centric EHR 103
The Evolution of the EHR 104
Business Models in Other Industries 105
The New Business Model 105
The Evolution of Accountability and Collaboration 107
Five Key Areas to Explore 108
Where Do We Go from Here? 111
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Ensuring IT-Enabled Gains in Organizational Performance 113
Two Studies Worth Noting 114
Ramifications for Health Care 115
Managing Complexity with Health Care Information Technology 117
The Primary Value Proposition 118
Mastering Three Sources of Complexity 118
Architecture Is Fundamental 121
A Caveat for Leaders 121
Expanding Patients’ Role in Their Care 123
Getting There from Here 124
Little Things Can Make a Big Impact 125
Portal Power 126
Technology Is Only Part of the Equation 126
Ready, Set, Go: Performance-Based Reimbursement 129
at Money on the Line 129
] Game On 130
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Nursing in the New Era of Accountability 141
HITECH Requirements 142
Nursing at Center Stage 142
The Road Ahead 143
Providing Consistency Amid the Chaos 145
A New Era in IT’s Strategic Importance 147
Impact on Providers 148
Looking Forward 149
IT Strategies for Process Improvement 151
Focus on Core Processes 151
Contents ix
Define the Scope of the Work 152
Adopt an Incremental Approach 152
Enhance Processes with Intelligence 153
What Happens After EHR Implementation Is Done? 155
The Myth of IT’s Competitive Advantage 159
The Fundamentals of Sustained Collaboration 163
Individual Gain Is Apparent 163
High Degrees of Interdependency in Achieving Gain 164
Clinical Data Exchange as a Commodity 164
Collaboration Efficiencies 164
Minimally Invasive Approach 165
Summary 165
Success Factors for Clinical Information System Implementation 167
Managing Threats to Large IT Projects 171
at The Board’s Role in the IT Discussion 175
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Summary 182
Section Three
IT Management Challenges 183
The Risky Business of Information Security 185
Numbers Don’t Lie 186
Warding Off Danger 187
Not If but When 189
Hitting the Restart Button: We’ve All Been There 191
Doomed from the Start? 192
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Failure to Launch 192
No Guarantees 194
Always a Lesson to Be Learned 195
Organizational Effectiveness in Implementing IT 197
Critical Factors 198
Managing Change 198
IT Governance 199
Strategy Considerations 199
Bringing It All Together 200
The Scope of an IT Strategy 203
The IT Asset 203
IT Strategy Elements 204
IT-Centric Organizational Attributes 205
IT Strategy Considerations 205
More Than a List 206
at Thinking Strategically about New Information Technology 207
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Necessary Downtime 219
The Legacy of Leadership 221
IT Effectiveness, Part 1—The Fundamentals 223
IT Effectiveness, Part 2—Evaluating the IT Department 227
Linkage of the IT Agenda to the Organization’s Agenda 227
Governance 228
System Implementation 228
IT Service Levels 229
IT Staff 229
Summary 229