Randy L. Thomas

"Convergence is the approach toward a definite value, a definite point, a common view or opinion, or toward a fixed or equilibrium state."
-Definition of convergence, Wikipedia, en.wikipedia.org/wiki/Convergence

"Everywhere you turn, technology is all about "convergence." Smartphones aren't just phones, but small, powerful computers with still and video cameras, MP3 players, calendars, contact lists, and other functions that can run an ever-increasing range of applications, from calorie counting to financial analysis. Mark Zuckerberg, CEO of Facebook, recently announced the availability of a new e-mail function, converging point-to-point traditional e-mail capability with instant messaging and chat capabilities, organized and preserved for all time within an individual's social media environment. And in an interview at the start of the 2010 Web 2.0 Summit in San Francisco, Tim O'Reilly, founder and CEO, O'Reilly Media, noted that innovation and convergence occur cyclically. After times of great innovation, he says, organizations incorporate innovations into their existing platforms, as we have seen Apple, Google, Amazon, and others do in combining mobile computing, search, communication, and electronic content ("Debating the Next Phase of the Web," NPR, Nov. 15, 2010, www.npr.org).

Healthcare IT is now entering a convergence stage. Although it could be argued that existing technology is hardly innovative (the basic concepts for the electronic health record [EHR] has been around since the late 1960s), the drive to comply with the meaningful use requirements of the Health Information Technology for Economic and Clinical Health (HITECH) Act have created a state of hyperactivity around EHR implementation never seen before in our industry. Within the next five years, we could see ubiquitous adoption of EHRs across the hospital and physician office landscape. Clinical decision support will provide guidance to clinicians on best practice care delivery decisions. Quality metrics based on the care documented in EHRs will be generated and submitted to state and federal agencies. The mantra that health care is "data rich and information poor" will be truer than ever!

Making Healthcare Data Actionable

In March 2008, IBM declared that analytics is the next "mega-trend" in healthcare IT ("IBM Sees Analytics as Next Megatrend," Healthcare IT News, March 13, 2008). Analytics is a means for healthcare organizations to make data "actionable." It assumes that an organization can combine all the data it is accumulating through its EHR implementations and other applications in one location and then look at the data using various business intelligence tools to identify ways to improve healthcare delivery.

Although this premise is valid, it says nothing about what an organization needs to do to take full advantage of the data and technology available. Analytics alone requires that an organization look for those improvement opportunities, that they know how to look for opportunities, and that they know an opportunity when they see it. But healthcare organizations will require more than just analytics. It will be the convergence of decision support capability, analytics, comparative benchmarks, best practice content, and collaboration that truly enables performance improvement in health care.

As time pressures continue to escalate, healthcare professionals shouldn't have to look for opportunities to improve care delivery in their organizations. The technology and data are available to "tell" them where those opportunities lie. If we know the target rate for a specific quality metric-for example, administering aspirin on arrival to suspected heart attack patients-and we have data regarding how these patients have been treated as well as analytic capabilities to determine the effects of treatment, we should be able to identify whether an opportunity exists to improve the overall rate of administration for these patients. We should be able to generate an alert that "pushes" that opportunity to someone's attention. These capabilities reflect the convergence of data, analytics, comparative benchmarks, and decision support applied to identifying opportunities for process improvements.

But exposing an opportunity is only part of making information actionable. The next step is to link that opportunity with information on how to make the improvements. Specific best practice examples should be connected to the opportunity so an organization can understand what it must do to realize the opportunity. For example, knowing that an organization needs to increase its rate of administering aspirin is good, but understanding how similar organizations actually achieved that goal brings the organization closer to knowing how to achieve compliance on its own.

Technology can help create these linkages.

Connecting with Peers for Improvement

The convergence of technology can also drive collaboration for improvement. If automatic identification of performance improvement opportunities is good and linking those opportunities to relevant best practice content is better, enabling connections among people who have either already addressed the issue or are in the midst of addressing it is best.

We learn by asking questions. Reviewing articles describing how others improved the rate of administering aspirin on arrival is, of course, instructive and useful. But an article or study can never include all the details. There will always be questions that remain after reading. The ability to collaborate online, in the moment, with the author of the article you are reading or others who have traveled the desired path toward performance adds richness and depth to your understanding of what your organization needs to do. It can also save time as you learn directly from the experiences of others.

Social media is not just the province of teenagers. The value of online collaboration in business-and health care in particular-is beginning to emerge. The ability to put a question out to a community of trusted peers and quickly receive multiple answers can speed the ability to drive performance improvement. No longer will each organization have to find the answers independently or limit its connections to its personal contact lists. Healthcare leaders can participate in multiple discussion threads and rapidly learn from others while contributing their own experiences and lessons learned in the process. Given the critical need to bend the cost curve in health care while improving quality outcomes, healthcare organizations need to leverage every time-saving tool possible in this quest. The targeted use of social media applied specifically to process improvement opportunities is one of those tools.

It is the convergence of these technologies-actionable information linked to best practices content and online collaboration-that shows great promise for accelerating our drive toward higher levels of performance. This next emerging "innovation" in healthcare IT is the ability to use the vast amount of data we already collect more broadly in the context of this convergence. The more we can connect the dots between identifying opportunities for improved performance and knowing how to implement the needed changes, the faster we can realize value from existing healthcare IT investments. More important, connecting the dots will speed the rate at which we can drive higher-value health care and improve the overall health of our communities.


Randy L. Thomas, FHIMSS, is a vice president, Premier healthcare alliance, Charlotte, N.C. (randy_thomas@premierinc.com).


 

Publication Date: Monday, January 03, 2011

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