Why is a customized approach to digital solutions so important in healthcare?

Health care institutions today have a very challenging task. They are expected to keep up with an ever evolving standard of care based on the best available evidence. They often host a diverse group of physicians and other health care providers with varying ideas on the best approach to patient care. Hospital systems need to be customized according to the resources available to the hospital based on staffing and number of beds. Considerations like available specialties can also dramatically affect work flow in the hospital. As a result, there is no single model that manages to consistently deliver excellent patient care in addition to seamless operational flow within the hospital.

Hospital systems need to be customized according to the resources available to the hospital based on staffing and number of beds.

Studies show that physicians spend a quarter of their time trying to communicate with other physicians [1]. Time spent coordinating care translates as a significant loss for hospital systems as their highest paid provider would be wasting this time that could have been spent seeing patients. Furthermore, lack of clear systems of practice often contribute to interdepartmental conflict which leads to poor patient satisfaction or worse - poor patient outcomes.

Lack of clear systems of practice often contribute to interdepartmental conflict which leads to poor patient satisfaction or worse - poor patient outcomes.

A recent study found that inefficient health care systems in the USA contribute to over 760 billion USD in losses annually. Six domains were identified as the main culprits in these losses: failure of care delivery, failure of care coordination, overtreatment or low-value care, pricing failure, fraud and abuse, and administrative complexity [2]. Organizational work flow has far reaching impact on both staff and patient satisfaction, yet the evidence on best practices remains fragmented and piecemeal [3].

Organizational work flow has far reaching impact on both staff and patient satisfaction, yet the evidence on best practices remains fragmented and piecemeal

In an era of value based compensation for health care, insurance companies will increasingly look for efficient health care systems that reduce the cost of health care. It becomes of paramount importance then to get systems right from the start.  

Today we see an increase in healthcare investment in Oman and the Gulf. This is driven by bed and staffing shortages that are exacerbated by an ageing population, requirement for foreign investment and resulting increased immigration in addition to rising concerns about future geographical silos in the event of another global event. Existing private hospitals need to develop an understanding of the market share they are aiming for and upcoming private clinics and hospitals would ideally aim for untapped markets and fulfilling current gaps in care.

Increased investment in healthcare in the region is driven by bed and staffing shortages and the expected rise in immigration as a result of encouraging foreign investment.

Each clinic or hospital would have a unique catchment area and local expertise. This means that triage systems would have different outcomes depending on the particular specialization of each hospital. Processes that work well for smaller hospitals are likely to fail once a certain size threshold is crossed. The reverse would also be true. Each clinic or hospital would need to optimize it's work flow and algorithms according to the available expertise.

Electronic medical records (EMR) are often designed to capture large amounts of data. They also facilitate communication between members of a large health care team and even in some settings across institutions. This has transformed patient care and dramatically reduced potential for medication error as a result of poor communication amongst healthcare providers. The potential that EMR's bring would be remarkably diminished unless intra-institutional processes are updated to optimize and capitalize on this improved data-exchange mechanism. Sometimes various digital softwares are used even within hospital departments (radiology and medical labs often have their own softwares) which counters the potential benefits of having a one-size fits all EMR. Data structures of the EMR itself can cause it to become slow and frustrating for clinicians if it wasn't designed to accommodate the data requirements of the hospital.

The potential that EMR's bring would be remarkably diminished unless intra-institutional processes are updated to optimize and capitalize on this improved data-exchange mechanism.

EMRs are a significant financial investment as well as a time investment. It can take 6 months to 1 year to fully train and acculturate staff to a new system. It is also important to handle the data-transfer as seamlessly as possible and have adequate technical support for the transfer from one system to another. Given that such a change is intimidating, many healthcare institutions prefer to function with their old bare-minimum systems because change seems too challenging. One way to overcome this issue is to have a group of healthcare systems embark on this change together and share the costs. This can result in improved collaboration and referrals amongst those institutions in addition to reducing the inertia for embarking in system improvement.

Given that such a change is intimidating, many healthcare institutions prefer to function with their old bare-minimum systems because change seems too challenging.

It must be noted that the healthtech industry is booming and the choices new EMRs can be quite overwhelming. Matching the right product to the right client is a daunting task and the plethora of choice available itself can inhibit healthcare institutions from attempting improvement of their digital systems. Executives understandably look for clarity on the bottom line which end users like clinicians can struggle to articulate. This translates to difficulties in providing high quality care and sometimes can negatively impact patient experience [4]. Failure to use EMRs effectively can also diminish the potential benefit of the EMR in the first place.

Matching the right product to the right client is a daunting task and the plethora of choice available itself can inhibit healthcare institutions from attempting improvement of their digital systems.

Al Sorat consulting prides itself on customized solutions using a wealth of experience and evidence based approach to help you avoid the common pitfalls in hospital systems. We can help address a broad range of quality and cost metrics in order to best position you for long term success. Using a collaborative approach to help the institution build in-house expertise for long term benefit, we can help you set up systems optimized for your needs and targets. We can also provide follow up support to ensure best implementation and ongoing assessment.

References:

1. Pennacchini, Maddalena & Pensieri, Claudio & Binetti, P. (2012). Hospital communication between perception and cost savings: An Italian Case Study. La Clinica terapeutica. 163. e149-55.

2. Shrank WH, Rogstad TL, Parekh N. Waste in the US Health Care System: Estimated Costs and Potential for Savings. JAMA. 2019;322(15):1501–1509. doi:10.1001/jama.2019.13978

3. Cain C, Haque S. Organizational Workflow and Its Impact on Work Quality. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 31.

4. Rose D, Richter LT, Kapustin J. Patient experiences with electronic medical records: lessons learned. J Am Assoc Nurse Pract. 2014 Dec;26(12):674-80. doi: 10.1002/2327-6924.12170. Epub 2014 Sep 18. PMID: 25234112; PMCID: PMC4307644.