Much of the focus of healthcare reform has not been on the core operations of organizations; however, the ability to reduce costs and drive efficiency while continually improving clinical quality and patient satisfaction is foundational to healthcare reform – and successful healthcare organizations. Nimesh Shah, president of McKesson’s Enterprise Information Solutions (EIS), has extensive experience in solutions for efficiently and effectively managing core operations. In his role as McKesson’s EIS president, he has leadership responsibility for Paragon® EHR, revenue cycle management, supply chain management, document management, ancillary solutions, professional and managed services.
With so much focus on analytics, interoperability and value-based care, is our industry in jeopardy of taking our eye off of the importance of core operations?
From a provider perspective, analytics, interoperability and value-based care are critically important, especially in relation to population management, care plans for patients and reduced readmissions. That said, providers also need to pay attention to their daily operations – labor, supplies, workflow, IT infrastructure and the health of their revenue cycle, to name a few. Simply put, you can’t get to clinical and financial health if you ignore operational health. Everything is contingent upon a strong foundation.
And to have a strong foundation, it’s critical to elevate the role of IT. Rather than a cost center, you should consider health IT as a strategic lever and then spend time with your vendor to understand what’s required in order to drive value from your IT investments. Are your processes optimized? Have users adopted the systems? Are they using all the functionality available to them? Are you getting the data needed to put analytics to work and drive business decisions? Bottom line, with the appropriate focus, your health IT infrastructure has the potential to be a powerful enabler for organizational success.
What absolutely needs to be in the sights of every healthcare executive in terms of operational health?
Healthcare executives have a lot on their plate, ranging from physician alignment and patient engagement to ongoing regulatory change and resulting new requirements. But let’s keep sight of why we’re in this business: high-quality, safe care and ultimately, better health for patients. To accomplish that mission, executives must focus on the critical jobs to be done in building any sustainable, healthy business. These include reducing costs where possible, identifying savings in supply costs while supporting the ability to better manage and predict supply spend, optimizing the revenue cycle, managing your workforce and reducing variability to improve quality.
Here’s a real-life example of the impact operational health can have. A provider was experiencing 80 percent of their admissions through the ED, resulting in extended wait times, patient dissatisfaction and medication-labeling errors. By modifying their operational workflow to better leverage their EHR solution, they’ve improved patient throughput, patient care and patient satisfaction. Scores supporting patient satisfaction have jumped from the 65th percentile to the 91st percentile. Not to mention medication-labeling errors went down to less than one per month. Improving core operations resulted in drastic improvements in patient care.
What can organizations do to streamline and simplify the complex processes specific to managing today’s mix of reimbursement models?
Focusing on interoperability and making sure your vendors are committed to open systems and uninterrupted movement of patient data across all care settings will ultimately result in faster reimbursement through easier and faster access to patient information.
We’re also going to begin seeing more providers outsource revenue cycle management. Rather than spending the time, resources or the money figuring out the complexity of reimbursement, providers can work with well-skilled partners who can put the right metrics and processes in place. It’s a win-win scenario for the patient and the provider.
After an organization puts new tools and processes in place to support the value-based model, what strategies encourage the cultural change and engagement needed for adoption?
Communication is a key factor in changing old practices as you take on risk and evolve toward payment models that are value-based. Have you prepared physicians and other staff before making changes that affect their workflow? Are you clearly communicating expectations and actively seeking buy-in? Have processes been updated to effectively integrate new technology and achieve the outcomes you expect?
Relying on experienced resources can also be a key driver to successful adoption, as best practices can save both time and money. We’ve found that our customers want to know how to best affect change, drive adoption and transform their organizations to achieve desired outcomes – across settings of care and functional areas. Professional services can help mentor an organization through that process to achieve faster results, such as improved adoption of technology, less resistance to standardization and better compliance with organizational protocols.
But organizations can’t afford to operate at a loss, so they are watching every penny. Can they afford to outsource in today’s climate?
For any organization, for-profit or not-for-profit, the question is always: Can this be done cheaper if we partner with somebody, or can we do it cheaper ourselves? That’s a fair and essential question, but other considerations are also important. It may look cheaper to do it yourself, but it may take you longer. Or, you may not get the full range of benefits available to you. In my mind, it’s a question of competency and efficiency. Can we find and retain the right talent? If providers don’t have strong IT competency in place, they may not have the right efficiency measures in place. It also raises the question of where to spend time and limited resources. Is it fundamental to your mission? If it’s not, then you’re better off partnering. Services like IT Outsourcing or Remote Hosting enable an organization to focus on strategic initiatives and deliver quality patient care, while vendors specializing in providing IT services take on the tactical elements of the IT infrastructure and productivity demands of the modern workplace. Bottom line: it makes sense to partner with an expert when the value of the partnership exceeds the total cost of doing it yourself and leads to better business and patient outcomes.
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About McKesson and McKesson Technology Solutions
As a division of America’s oldest and largest healthcare services company, McKesson Technology Solutions (MTS) plays an integral role by helping organizations across healthcare – hospitals, physicians, pharmacies and health plans – confidently manage their businesses today while focusing on the capabilities required for better clinical and financial health.
