Government health services are evolving to provide a continuum of care, which means agencies such as the Veterans Health Administration and the Defense Health Agency are rethinking how to deliver a wider range of capabilities. New tools and electronic health record systems promise to improve access to services, speed and quality of care for active-duty combatants and veterans, but these advances depend on a basic computer base that must be updated at the same rate as clinical technologies. To ensure that these new capabilities for patients and providers can realize their potential, agencies need to modernize these back-end platforms, which presents significant challenges as many core systems are built on integrated legacy components.
Closing this gap can eliminate cost duplication and data sharing issues through IT consolidation and standardization across the military healthcare ecosystem. Equally essential, however, is equipping patient-contact treatment facilities with the flexibility and innovation necessary to more effectively serve their unique patient populations. Perhaps more importantly, changes and upgrades should match the end user journey; that is, each step provides a simpler, smarter and more efficient experience, all leading to better patient outcomes.
Three essential steps in healthcare IT transformation
The path to coordinating improvements for clinical and core IT can be viewed as three interrelated phases:
Each step offers opportunities for transformative thinking: new approaches to processes, platforms and skill sets that will lead to better results and greater flexibility in the future.
Rationalization: audit the existing inventory
With so many technologies in place throughout the military healthcare system – along with a range of cultures, abilities and patient needs – a long-term solution must begin with knowing where things stand today.
This phase begins with auditing existing and planned / ongoing systems to achieve a full understanding of the current environment, then mapping planned or desired clinical systems with the basic IT back-end needed to support them. . This gives decision makers the proper context to prioritize technology upgrades and set milestones. It also identifies areas that may require a complete overhaul of how healthcare can be delivered effectively to all providers.
Responsibility: assign centralized ownership
Ensuring that advancements in clinical systems are built in tandem with the necessary backbone capabilities requires authority and responsibility. While the ultimate authority may be someone at the senior management level, the process and results will likely be supported by teams of stakeholders. They will need both responsibility and authority to effectively manage the potentially huge range of moving parts.
A key factor will be the coordination of providers of technology solutions and services to measure performance, avoid redundancy and maximize efficiency. The large number of potential vendors also creates risk, which could lead to dozens of point solutions that don’t fit together properly. A master systems integrator can oversee the work of all technology and service providers, keeping everyone coordinated and avoiding unintended consequences.
Performance: Execute through people, processes and technology
Change is difficult. It’s troubling. But it can also empower, put people and organizations on paths that overturn the status quo and support something better in its place.
To effectively support the patient journey, three factors must be considered, starting with process and policy; all changes must remain true to the needs of the business while moving towards a fully digital environment. This often means new workflows and revised governance consistent with transformation goals.
Second, of course, technology plays a crucial role. Modernization goals must be met, security and privacy must be maintained, and data access and sharing, especially in support of the Ministry of Defense data strategy, must be simplified, faster and more complete.
Finally, change management must be an integral part of the process from the start. Since multiple agencies are involved, a collaborative approach is needed to determine how each organization and each system will interact. This will also be reflected in training in the use and support of new systems, and in the culture changes that must occur within and between organizations.
While advances in clinical tools can greatly improve the delivery of care, it is essential that core computer systems be modernized to be able to deliver on the promise of this patient-centric innovation. Bridging the gap begins with understanding your surroundings and the need in order to enable the future state.
But modernization is more than just technological change; it is a mindset that addresses systemic change. It is essential to standardize and centralize IT systems for efficiency and cost-effectiveness, while recognizing and respecting local care delivery and patient needs.
The key to success is to always work backwards from the ultimate goal of the mission: better quality of service for combatants, veterans and citizens. For military health organizations, this helps all stakeholders understand roles and responsibilities while ensuring a seamless continuum of care.
Diana Ceban is Vice President of Federal Health at SAIC.