Feature articles by: Christina Beach Thielst, FACHE, and Denny Angelle and Clare L. Rose, FACHE
Healthcare delivery in the United States is on the path to transformation
through information. In our new world, we’ll have access to data that we can use to
make decisions that improve the quality of the care we deliver, address the health of
our society from a population health perspective, reduce medical errors, and analyze
and drive waste and overuse out of the system. This exciting time brings with it the
promise of transformation at the very heart of healthcare delivery.
Transformation is exciting, but that does not mean our healthcare system is without
its strengths. Healthcare workers can perform amazing feats and mend broken
bodies. However, the system has a critical weak link at the core of its infrastructure. We
need information—clinical information that is centered on the patient—and we need
to be able to analyze, understand, share, and use that information wherever the patient
enters the system.
The process of transformation is, and will continue to be, a difficult path. The
good news is that we are traveling confidently down that road. As David Bernd and
Peter Fine say in their feature, “there is no turning back the clock.” A recent report
from the Office of the National Coordinator for Health Information Technology (HHS
2011) reveals that 80 percent of hospitals and 41 percent of office-based physicians plan
to implement an EHR and take advantage of the meaningful use incentive program.
The investment that has been needed for so long is finally being made.
Skilled leadership is vital to the success of that investment. The path to transformation
is riddled with roadblocks, one of which is end users’ reluctance or refusal to
adopt new technology. Bernd and Fine note that “innovation requires that leaders push
highly educated people into new processes that change their habits. This disruption
can result in resistance—sometimes aggressive resistance—to innovative solutions
such as EMR and can derail implementation efforts.” EHR adoption requires all the
vision, determination, and charisma that the CEO and other leaders can bring to the
undertaking. It may also require tough love. EHR implementation and adoption cannot
be allowed to fail because of the foot-dragging of those who would rather stay behind.
Not only do we have the opportunity to transform care delivery, we also soon will
have the information tools to improve population health. Without taking our eyes off
the demands of the individual episode or the single chronic condition, we will better understand the factors that affect population health and how to improve the health of
entire population segments. Chronic conditions account for about 80 percent of our
healthcare costs (Health PAC 2011). M. Michelle Hood outlines the opportunity to improve
population health: “Including preventive and early intervention protocols in our
care transformation models, again enabled through IT -dependent disease registries
and other IT -dependent population health tools, will further strengthen the likelihood
of better patient outcomes.” The EHR, however, is not an end unto itself. It is one element
of infrastructure needed to achieve a vision in which healthcare delivery is truly
patient centered, in which clinical information flows readily to patients and providers
no matter the venue of care, where preventable medical errors are prevented, and where
patients have access to information to fully participate in their healthcare. If we are to
realize the full potential of the time, money, and opportunity investments being made
in EHRs, we need, more than ever, visionary, wise, firm, and inspiring leaders.