Sue Schade, MBA, LCHIME, FCHIME, FHIMSS, is a nationally recognized health IT leader and founding advisor at Next Wave Health Advisors, providing consulting, coaching and interim management services. Sue is currently serving as the interim chief information officer (CIO) at University Hospitals in Cleveland, Ohio.
Sue spoke with NurseNavigation.com about the opportunities for healthcare providers to leverage technology to improve patient engagement and outcomes.
Q: What do you think are patients’ expectations concerning technology and their care?
Sue Schade: This is an important topic, and one I’ve written about on my blog, Health IT Connect (www.sueschade.com), in a post titled “Great techspectations for the inpatient experience.” My angle was the fact that in all parts of our day-to-day life, we are reliant on technology. Whether it’s determining directions, making airline reservations, ordering dinner or using online banking, technology has become an integral part of our lives.
Then you get inside the hospital and all of that essentially comes to a screeching halt.
One thing you hear all of the time with patients is they don’t want to repeat the same information at the point of registration and scheduling. They feel like the hospital doesn’t “know them” like other consumer services. Once you register with online companies, they store all of the data you provide. Patients expect their health information to all be in one place, accessible to them, whether they have to see multiple specialists or go to multiple facilities within a single, integrated delivery network. You at least should expect that your information be available in one place to you regardless of who you saw within that network.
Patients are looking for an easier healthcare experience, from scheduling appointments; finding a physician or specialist; completing transactions, such as renewing a prescription; and receiving education. It’s really about access and the ability to obtain all of the information and take care of everything they need in one place.
Q: What role do you think technology needs to play in supporting better clinical outcomes for patients?
SS: If you look at the continuum of care, there’s a front-end piece: the patient needs to find you and come into your system, identify the specialist they want or need to see, get scheduled for an appointment and tests, and take care of everything else that needs to happen before care is provided.
Then there’s the care piece itself, whether that’s an inpatient visit or stay, or a series of ambulatory visits. That’s where you get into care delivery, quality of care, key metrics and outcomes.
Then there’s the post-discharge experience. Following a stay, the patient goes home or to another facility. The patient needs medication reconciliation completed. The patient needs discharge instructions and any education for their caregiver to follow, if they are going home, or for staff at a step-down care facility. The patient also needs to know if he or she is going to come back in for post-discharge visits or have a home nurse visit them which would require all of those arrangements to be made.
Ideally what you want is for everything described to be a smooth and seamless experience for the patient. Optimally, all of that information tied to the patient and his or her care should be available to anybody who needs it. But what we all know is that this information is very fragmented. There’s a tremendous amount of opportunity for technology and integrated systems to make that a much more smooth and seamless process.
One of the things going on in the industry is that core solutions are not able to keep up and provide all the functionality organizations want and need, so what you have is many “one-off” solutions available to meet various needs. But those one-off solutions, while helpful in filling gaps, are not necessarily integrated with the core, which leads to inefficiencies.
Q: What are organizations doing to try to overcome these shortcomings?
SS: They are first looking to their primary integrated EHR vendor to do as much as possible along the continuum. When the EHR vendor can’t deliver, then they are going to third-party niche products and trying to integrate them. When organizations find themselves far ahead of the industry and market and require a solution that no one is providing, then they will sometimes develop it themselves. It’s essentially three concentric circles — you have your core, your niche players, if you need to add something in, or you develop a solution yourself.
Q: What are healthcare providers doing better with technology?
SS: Let’s think of inpatient care in terms of those three pieces in the continuum I described earlier. There’s the front-end access, which is scheduling and everything we think of in IT as the revenue cycle piece. Then there’s the care delivery and interaction with your clinicians. Then there’s the post-care component.
I think there’s been a big focus in the last several years, due to meaningful use, on replacing and putting in new EHRs, so you’re really focusing on that core care delivery piece. What people are looking much more for IT to do is improve upon that front-end piece relative to access, and the back-end piece in terms of post-care delivery and the integration of all of the other ongoing ambulatory, non-acute services.
We’ve made good progress in the care delivery component. I think consumers are now looking for the other pieces. That’s where you see a lot of emphasis on developing mobile apps, portal strategies and web strategies. Virtual health and telehealth are other big areas that tie into this. These are all areas where there’s a tremendous opportunity for advancement, which consumers will certainly welcome.