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Journey to High Value Healthcare: The Board’s Role in Clinical Transformation

As American health care delivery transitions to a value-based model, transformation leadership will be needed within each organization to create the health system of the future.

In Journey to High Value Healthcare: The Board’s Role in Clinical Transformation, author Pam Arlotto, President and CEO of Center affiliate member Maestro Strategies, provides a guide for boards and the health care C-Suite as they align strategies, decision-making tools, processes, information technology and people to build new organizational capacity for clinical transformation.

This publication defines the role of the board in overseeing this transition and explores the concept of an Information Technology (IT) Committee of the board. It also discusses meaningful use of electronic health records as part of the necessary foundation for accountability.

The author provides a snapshot of where the health care industry is today in implementing meaningful use of information technology. She also discusses eight strategies to help boards develop a clear plan and evaluate progress toward accountable meaningful use. Assessment questions are included to help boards critically examine their own institution’s progress.

This publication can be used as the basis of a board education session or strategic planning retreat that focuses on implementing IT and using health information to drive delivery of more accountable, value-based care. Boards can also use this publication to guide discussion of how they can best oversee information technology resource allocation and implementation.

published by The American Healthcare Association’s Center for Healthcare Governance

To download a copy of the white paper, click here.

Two Canoes … and Four ‘I’s

Change: No two healthcare provider organizations experience it the same way. Some actively pursue development of clinically integrated networks and accountable care organizations, others double down on traditional healthcare practices. Many are paralyzed, not knowing what to do or how. The transition from volume to value has been described as “stepping from one canoe to another midstream.” Although the analogy clearly depicts the challenge, it doesn’t instruct healthcare executives how to successfully execute the step without falling in. The American Hospital Association has tackled this task by publishing a series of white papers describing the journey as moving from “first curve” to “second curve” healthcare. The most recent, Your Hospital’s Path to the Second Curve: Integration and Transformation (January 2014), provides 10 strategies, necessary organizational capabilities and potential paths for hospitals. It depicts a number of case study organizations that are actively “living in the gap” between volume and value, and describes various integrated delivery programs to improve care coordination, physician alignment, performance measures and patient outcomes. While most volume to value publications rarely address healthcare information technology, except to say “implement EHRs” as part of clinically integrated care, this white paper takes it a step further. It encourages health systems to “conduct information exchange” and use information systems to:

  • Implement electronic health records
  • Enhance health information system interoperability across sites of care
  • Use existing data to facilitate analysis and reporting for process improvement and behavioral change
  • Use predictive modeling for population health management
  • Use data analytics for care management and operational management

Yet, many health systems and providers are challenged to successfully execute these recommendations. In fact, we find the operational, clinical, financial, technological and legal unintended consequences of HITECH often undermine the potential benefit. Many clinicians still ask “why” and have not incorporated needed workflow changes.   Healthcare executives question what value they have received for their multimillion-dollar investments. To a certain degree, the focus on Meaningful Use and its incentives has been the “technology tail wagging the dog.” Rather than leading with the business strategy we wanted these systems to enable, the healthcare industry focused on the technology. So while healthcare strategists are actively living in the gap and planning the next step on the journey to value, clinicians and other users of information technology are struggling with the day-to-day impact these systems have left on care delivery. Rather than rushing to select health information exchange applications, layer on business intelligence systems and purchase care management systems, we suggest an alternative approach focused on value creation and realization. It starts with one letter – “i.” My friend Praveen Chopra, Executive Vice President and Chief Information Officer at Thomas Jefferson University and the TJU Hospital System, started his career outside healthcare in retail and supply chain. “Rather than focusing on technology, the healthcare industry should focus on three “i’s” – information, integration and innovation,” Chopra says. At Maestro Strategies, we also want to focus on one more “i” – insight. We believe that a focus on these four words will help drive more value as we take the next steps on our joint transformation journey. Our “i-men” characters help us tell the “why,” and with this new website, we plan to bring our clients and friends specific strategies and tactics to help execute on the change and close the gap between the two canoes.

Rethinking Return on Investment

Rethinking Return on Investment: The Challenge of Accountable Meaningful Use

by Pam Arlotto

Contributors: Susan Irby, Lori Bishop, Marla Crockett, Bryant Hoyal, Kevin Martin, Vicki Miller

Rethinking Return on Investment offers a timely exploration of the value achieved through the Meaningful Use of electronic health records and other components of the HITECH legislation. The authors provide a look back at how ROI of health IT has typically been measured and explore how Meaningful Use regulations are driving healthcare organizations to adopt a value-based purchasing model — thus challenging readers to rethink how they define the ROI of health IT. The authors examine Meaningful Use within a three-stage Value Management Framework: value identification, value realization and value optimization. To assist organizations in evaluating how to drive value out of an investment in people, processes and technology, the book includes numerous value maps for measuring a project’s benefits, such as quality improvement, care management and cost reduction. The authors conclude by setting the stage for how the current impact of Accountable Meaningful Use will contine to transform the healthcare delivery system for years to come.

Available through HIMSS, order here.

Don’t miss the forerunner — Beyond Return on Investment: Expanding the Value of Healthcare Information Technology — which provides lessons learned from healthcare IT adoption on how to drive value realization, look at healthcare IT as a strategic asset, achieve value from clinical systems, manage healthcare IT as an investment, analyze ROI to make the case for investment, and governing transformation toward integrated decision making