Pulling up the anchor in Health Information Technology


Amid increasing and ever-changing regulation and legislation, as well as ongoing competitive pressures, the race for excellence in healthcare is fraught with headwinds.

Providers have turned to Health Information Technology (HIT) to help navigate the waters and to bring about the meaningful change capable of positioning them to win the race to excellence. Yet many healthcare organizations seem to be running with their anchors down.  Organizations that can demonstrate an ability to deliver critical information to those who need it will ultimately be better positioned for success.

Moving the boat forward

Due to the ongoing investment in HIT projects, organizations around the globe have amassed enormous amounts of data. Because that data typically resides in multiple repositories, the process of implementing a system-wide enterprise information management program can be as challenging as it is immense.

For true benefit to come from this resource, data needs to be liquid so that it can move freely and easily to those who require it as part of patient care or administrative functions. But the enterprise systems that drive the healthcare industry, including the EMR, are designed to deal solely with structured content. Large amounts of critical data such as photos, explanations of benefits, lab results and orders often arrive in an unstructured digital or paper format, causing inefficiencies to workflow processes built to handle only structured content. Despite HIT’s best efforts to achieve utopian environments, the anchor of unstructured paper and digital content is still slowing the healthcare industry down.

To put this in perspective, a recent study from Lexmark International found that users in four Stage 7 hospitals printed an average of 1,381 pages per user per month, for a total of 84.8 million pages across those enterprises. These organizations, despite their advanced systems, still generate over 85 million pages as part of their internal workflows. And paper doesn’t just come from internal sources; external sources are capable of flooding even the most well thought out IT architectures, causing greater inefficiencies and vulnerabilities.

It’s also estimated that only 58 percent of lab results were sent to ordering practitioners in a structured, electronic format.  This lack of structured content in the lab negates many of the gains possible through the lab management functions available in many of the leading EHRs.

We know that mass amounts of unstructured content exist in the industry today. But does it really affect healthcare? The answer is, overwhelmingly, yes. Looking at lab results as an example, a 2009 study in the Archive of Internal Medicine found that 1 in 14 physicians failed to inform patients of abnormal test results. Failure to inform patients in a timely manner (or at all) opens the health system up to catastrophic failures in the care they provide and, possibly, litigation. In this example, the lab management functions inherent in an enterprise clinical system could definitely help reduce these errors, but that can only happen if the information is structured to work with those systems. In addition to the workflow inefficiencies derived from unstructured content, printed output opens up an organization to additional security vulnerabilities, as it is difficult to track, and, in clinical environments, often contains Protected Health Information.

If an organization fails to include unstructured content when developing their information management plans, they are missing out on a large percentage of their data, which makes up a significant portion of their internal Enterprise Data Management.

Pulling up the anchor

The good news is that there are not only solutions to these inefficiencies, but unstructured paper and digital content can actually become a competitive advantage.

First, organizations must include unstructured content in their information management roadmaps.  Of course, if an organization isn’t thinking about information management, it needs to start. Second, as part of the process, there need to be questions asked. Lots of questions. In the studies noted above, for example:

  • Why do we have unstructured lab results coming in from our lab partners?
  • Why do my users print 1381 pages per month?

Once the right questions are asked, the answers will define your next steps.

Charting a new course

Simply asking questions about why people are printing or why laboratories continue to fax or upload unstructured documents will get the process started. The next step is to identify and assemble best-of-breed technologies to solve for the previously identified problems.

The good news for healthcare organizations is that technologies exist to help turn unstructured content from a liability to an advantage. For those seeking to understand why their users are printing so much despite the heavy investments in IT infrastructure, a variety of solutions and methodologies exist to help, either through software or in-person assessments. Many of today’s software offerings can help organizations map the flow of information from user to ultimate destination providing key qualitative data (who, what, when and where). In-person interviews can give you insight into the “why”, which ultimately leads to changes in workflow or technology.

As for the remaining unstructured digital content, the key to increasing its value lies in converting parts of the content (documents, video, audio) into structured content. Only then can it be easily ingested by the core clinical systems, unlocking the investment that your organization had previously made in those enterprise systems. Intelligent Capture tools can extract the necessary information from unstructured digital content like labs, so that it can be immediately valuable in clinical workflows, allowing for alerts, notifications and tracking of results in a way that’s not possible with unstructured paper results.

Anchors aweigh

Healthcare IT is busy focusing on a multitude of technical, regulatory and competitive issues. But until there is focus on removing the anchors associated with unstructured content from their clinical workflows, the true ROI in their HIT investments will remain out of reach.

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