• Hard Versus Soft Savings from IT Investments

    Aug 20, 2014

    The experience of Baylor Scott & White Health shows that soft savings contribute to long-term value.

    pg62_column_branzellFor as long as I’ve been directing IT in healthcare organizations, I have faced the value question. What will be the return on this investment?

    Admittedly, it’s not an easy question to answer. IT executives have appeared evasive as we struggle to quantify the kinds of savings that organizations can expect from their IT spending.

    This is especially true when it comes to clinical information systems. Hospitals across the country have committed millions in purchasing them, installing them, training users, and adapting workflows. Incentive funding from the federal government defrays only a portion of the expense, so organizations are right to wonder how they’ll recoup what they’ve spent.

    There are some hard savings for most organizations. However, increasingly, meaningful savings from clinical records systems will come in areas where costs are avoided and serious patient issues are prevented or treated at an early stage, as opposed to late in the game where costs are high and patient viability might be at risk.

    Learning from Leaders

    A recent CHIME case study (available at chime.org) shares the experience of Baylor Scott & White Health, a large integrated delivery system in central Texas.

    In late 2010, Scott & White developed a five-year roadmap for rolling out a single vendor solution throughout its hospitals and ambulatory clinics. The effort grew in complexity with the late 2013 combination with Baylor Health Care System, but the goals remain the same—to develop a single patient record that can be accessed anywhere in the system.

    By investing heavily in upfront education and IT support, the system has had a successful, and fast, implementation. Its largest hospital, in Temple, Texas, achieved Stage 7 of the HIMSS Analytics EMR Adoption Model, a seven-stage measuring stick for gauging progress to a fully paperless environment, only six months after going live on the new system.

    Savings have been achieved in a variety of ways at Baylor Scott & White. The workflows used by clinicians and other staff have been streamlined, standardizing care delivery to increase efficacy and cut unproductive steps. Assets used to supply transcription and coding services have been redeployed. And the new system supplies data used by managers throughout the organization to drive continuous quality improvement efforts.

    Even as the rollout of the integrated records system continues, Baylor Scott & White executives are already pegging savings of millions of dollars while they make progress toward achieving their strategic vision for molding the system into one of the nation’s leading healthcare providers.

    I know that some of these last achievements are sliding toward the “soft” side of the scale, but they are meaningful to the folks at Baylor Scott & White. The Texas health system places a premium on improved customer service, using data, and automation to help improve performance. For example, achieving demonstrable improvements in patient satisfaction factors into bonuses for staff and managers, and its physicians are incented to complete documentation within specified time frames—and to respond quickly, when possible, to telephone inquiries from patients and families.

    Investing for the Future

    The value of digital systems will become more difficult to measure and assess, especially as the nation’s healthcare system reforms to an approach that rewards providers that can better manage care, improve patient health, and cost-effectively take care of large populations. This is the painful, adolescent period for these reforms—some are being tested, but providers still are anticipating future maturity and wrestling with a reimbursement system that rewards per-unit volume of care.

    Still, it’s clear where healthcare reimbursement is heading, and providers understand they eventually will be more highly rewarded for improved patient service and for avoiding unnecessary and expensive patient events.

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