Information sharing speeds healthcare advances
Because the product is both visual and textual, it is effective for people across a wide range of working styles. "Some think in rows and columns, and some think more visually," Gordon points out. "MindManager allows both skills to come together in the same working environment."
Impending disease
The ability to share information globally can change the course of contagious diseases. During the SARS outbreak, for example, being able to identify cases and quarantine infected individuals was an important factor in limiting the spread of the disease.
"The progress of SARS was substantially impeded by the availability of up-to-date information," maintains Daniel Rasmus, director of Information Work Vision at Microsoft. His department conducts scenario planning to predict the effect of social, economic and technical developments on the role of IT in healthcare and other industry sectors.
One of the top needs in healthcare today, according to Rasmus, is for systems that automate information management so that medical personnel can spend more time with patients. "Keeping track of the paperwork, whether it relates to insurance, prescriptions or medical records, is a huge job," Rasmus says. "This information should be easy to retrieve and share, so that healthcare personnel can concentrate on the medical aspects of their work."
MMC's balanced scoreboard
The need to use information effectively applies equally to organizations that want to improve their performance level on a daily basis as it does to those in "crisis mode." For example, at Maine Medical Center (MMC) in Portland, the chief operating officer chose the balanced scorecard as a method to measure performance, and wanted to draw upon information that would indicate whether the targets were being met. A steering committee for performance improvement established a strategic plan and spent several days on a retreat discussing how to build measurements around the plan. Small groups followed up after the meeting to design metrics and targets for specific service lines such as cardiac services.
At first, information was analyzed manually and distributed in printed reports, but MMC wanted a quicker turnaround and greater flexibility. MMC was already using statistical software from SAS, and decided to expand its use with a subscription to SAS' Performance Management software. An electronic institutional balanced scorecard was developed and rolled out to staff members throughout the organization.
Much of the data collected is required by organizations such as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and Medicare. Data on more than 200 factors is collected for compliance purposes. MMC also included some of its own unique safety and efficiency measures. "We want to be sure we are providing the best and most efficient care," says Debra Tillotson, director of the Center for Performance Improvement. "We are looking at evidence-based care, relationships with our medical partners and many other indicators."
A significant majority of measures for which data is being collected (78%) are showing improved outcomes. Tillotson attributes that change to the availability of timely information to people who care for patients. "Employees can see that the care they provide is making a difference," Tillotson observes. For example, a new fall risk prevention protocol is in place that has cut the patient fall rate by 35%. Such accidents are most likely to occur with patients who are elderly and highly medicated. By moving such patients closer to the nurses' station, placing alarms on the bed and using companions to sit with the patients, MMC has improved care.
Other quality control
In another quality control initiative, MMC established a medication observation process to look for systemic problems. The observer goes to a medical unit, watches the entire delivery process, checks the medication delivery process and verifies that the correct medication and dosage was given. MMC is also using a physician order entry system to eliminate legibility-related prescription errors. With those new accuracy systems in place, the small percent situations where medication delivery does not match instructions tends to be for events such as a delay requested by the patient or other non-hazardous reason. The goal is for every MMC physician and employee to review his or her performance relative to the collected metrics. "The SAS performance improvement tool is very visual and easy to navigate, so the staff has no trouble using it," says Tillotson. "By getting accurate feedback on their performance, employees can focus their time on areas that need attention." In addition, training requirements can be matched to those needs. Employees whose performance is meeting or exceeding target levels do not have to spend time on unnecessary training.
Increasingly, healthcare providers are evaluating their performance with an eye toward improved care, better risk management and cost effectiveness. "Managing performance and becoming evidence-based enables healthcare leaders to break down political barriers, says Melissa Fitzpatrick, principal healthcare strategist at SAS. "Using data to drive clinical and operational enhancement is essential if collaboration, accountability and sustainable improvement are to be achieved."
Geospatial information for disease monitoring
The Centers for Disease Control (CDC) is incorporating GeoStan, Spatial+, and other geocoding software from Group 1 Software in its National Electronic Disease Surveillance System (NEDSS). The NEDSS system is designed to support the integration of public health surveillance systems at the federal, state and local levels, so accurate disease monitoring information can be delivered in a timely manner. The Group 1 products will help monitor the occurrence of infectious and environmental diseases by providing standardized reporting methods for geographic data on public health. Spatial analysis allowed by those products helps track the spread of disease so that outbreaks can be detected and contained.
Healthcare stands to benefit substantially from better sharing of information. "The quality of care will improve, while the cost of diagnosis and engagement will decline," predicts Rasmus. "All of the stakeholders will benefit." Whether the issue is a pending crisis such as a pandemic, or the day-to-day activities of a hospital, the payoff is high.
Judith Lamont is a research analyst with Zentek Corp., e-mail jlamont@sprintmail.com.