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- Health-care professionals received advice about integrating technology with patient care at the Digital Healthcare Conference, held June 8-9 at the Fluno Center in Madison. Academic and medical experts discussed technologies which have worked in clinical settings and the strategies for installation, as well as the multiple roadblocks to successful implementation.
"I think it's critical to focus on the fact that technology for technology's sake is a problem," said Rod Dykehouse, vice president of information technology at Froedert Hospital
. "You need to think about where you've been and where you want to be in relation to the technology."Balancing bureaucracy, culture and value
Dykehouse, one of three panelists discussing tactics for healthcare technology, said that when upgrading a hospital with new technology there are three factors that come into play: organizational culture, strategic planning and clinical/financial value. If these three don't line up with a chosen technology, that technology will never work for the hospital.
Culture is the biggest issue for installing technology at a hospital, making sure that the physicians and patients can adjust with few problems. The information technology staff has to find technology that the staff can use with little effort, which at the same time does not get in the way of how the hospital looks out for its patients.
"If you think about the technologies that are out there you may think it's the right thing, but if you drop it in and the culture doesn't accept it, it won't work," Dykehouse said.
Unfortunately, with the rapid growth in healthcare technology it has become easier to find technology that does not mesh with the culture. Innovations such as proximity devices linked to a wireless network, voice recognition, PDA's and tablet PC's all come together and present lots of options, which can lead healthcare providers to make bad investments.
The real problem can come when executives at a hospital decide technology would be useful and buy it, forcing their decision onto the IT department. If they split their focus excessively between those technologies and the ones they need internally, nothing gets accomplished.
"Often I see them [IT] bombarded with requests for new technology," said Rick Gillis, director of clinical informatics at the Medical College of Wisconsin
. "All the pieces separately may make sense, but the organization can only do so much."
Seth Foldy of the Medical College of Wisconsin said he agreed it was important to keep focus on the reason for buying the technology to begin with. It is especially important for smaller healthcare providers, who may get caught up in technology and not have the capital to develop it.
"Getting information from point A to point B is crucial, not the device," Foldy said.
The best way to move past issues with technology is to have a strong leadership, one who understands the limits of technology and can combine clinical staff with IT. Executive leadership can make or break a project by working with the legal staff, holding vendors accountable for what they sell, and help get additional members of the staff on board.
Since healthcare technology is such a rapidly growing field due to both research and government regulations, it is important to have a unified body at an adopting hospital. "I think it gets back to, strategically, what you are trying to accomplish," Dykehouse said. "Let's not just hang our hat and say it's the right thing to do, let's go back and analyze it."Digital health in rural climates
One healthcare provider that has been successful in healthcare technology is the Marshfield Clinic, a "digital hospital" located in northern Wisconsin. Staff from Marshfield shared their experiences during the DHC about two decades of upgrading the hospital.
Marshfield will be opening a new clinic on the Weston campus in late 2005 which will be fully digital, operating completely on electronic medical records and four digitized legal departments. They have also implemented a telemedicine program that allows them to use more home monitoring and an imaging system viewable at any of the network stations.
Carl Christensen, CIO at Marshfield Clinic, said that Marshfield has had to look for every possible tactic to get the access they needed. To get bandwidth Marshfield had to "tag along" with cable TV providers moving into the market, used software from the 1970's and 1980's to anchor their programs, and built a phone system into home monitoring to compensate for a lack of Internet connections among patients.
Christensen said that while the technology was difficult to install due to the rural areas they operated in, they stuck with in-house development and partnerships to keep moving. They stuck to a goal of simply getting the right information in the right place, and made sure that each upgrade to the system - from imaging to handheld computers - had this in mind.
"We are a complex business, and those complexities aren't going to go away," Christensen said. "What we need to do is program those complexities into the system rather than training our people to defeat them."
Jack Steinman, CIO at Aurora Healthcare, said he was very impressed with the comprehensive records that Marshfield had developed. He said Aurora is trying to develop a similar method of working with electronic records, serving as a "fast follower" to successful clinics like Marshfield.
"We want to have as comprehensive of a record as possible without looking at the record, [and] it's getting easier and easier as the industry matures," Steinman said.