Building a Business Case for Hospital IT Projects

Do you have a Health IT project in mind for your hospital, department or clinic? Do you need help justifying it and getting it approved?

Here’s my quick tip: Use IRACIS.

I’ve been working in Health IT for more than 12 years and most of my experience involves working with hospitals. It can be daunting to justify a hospital IT project to management. What helped me was a concept I came across in a book–it’s called IRACIS.

IRACIS is an acronym that stands for:

  • IR: Increase Revenues
  • AC: Avoid Costs
  • IS: Improve Services

When using each item in IRACIS, be as concrete and as tangible as possible. Use actual numbers and figures, if at all possible.

Increase Revenues

Let’s accept it–all projects in the hospital should contribute to financial viability. That’s why this part of IRACIS is important. Possible areas you can look into:

  • Turn-around time: Streamlining queue-based processes and reducing waiting times help patient throughput.
  • Additional services: IT projects can introduce new hospital services, e.g. Telemedicine.
  • Value-added service: Basic services, e.g. laboratory, can be ‘converted’ to premium services once enabled by IT services.

Avoid Costs

Hospitals are pressured to manage costs. IT projects are often set in place to help avoid cost and reduce overhead in the long run. Possible ideas include:

  • Eliminate paper: IT projects can eliminate many paper-based requests and processes, e.g. logbooks, request slips.
  • Reduce manpower requirements: This may be a sensitive issue but some IT projects–not all–might eliminate several job functions.
  • Lesser redundant services: IT systems can catch redundant orders and tests. They also help manage inventory and supply chain.

Improve Services

This IRACIS component is often the most difficult to quantify. However, hospitals looking for opportunities to differentiate and expand their market cannot ignore this component. Some potential areas include:

  • Reduced waiting times and queue management: Hospitals can learn from innovative restaurants and banks about how to handle queueing, registrations and order-taking.
  • Patient engagement: Emails, SMS and Websites can increase range of patient engagement activities.
  • Customer service: Keeping databases on patient details and preferences can make the hospital visit feel more personal and tailor-fit.

The IRACIS approach is a quick-and-dirty but extremely useful tool when proposing and justifying IT projects to management. When building your business case, remember to be as concrete and tangible as possible in each specific component.

Good luck!

Question: Do you have tips, advice and recommendations for proposing and justifying hospital IT projects? What worked for you to get them approved?

Note: This post was inspired by a question asked after my Health IT talk at the Emergency Medicine Postgraduate Course on Aug-20-2014.

2014 HIT-PH Conference Invitation

Dear Friends and Colleagues,

I’d like to invite you to attend the 2014 Health IT Philippines Conference on May 22-23, 2014 at the Crowne Plaza Manila Galleria. It aims to bring together all the stakeholders in the Health IT industry in the Philippines. The goal is to make it easy for hospitals and healthcare groups to access locally-available and cost-effective IT solutions.

I’m really excited for this conference. As of this writing, these are the confirmed topics from various speakers.

  • Hospital IT Leaders Panel Discussion: Information Technology as Strategic Investments for Hospitals
  • Clinician IT Leaders Panel Discussion: Engaging Doctors and Clinicians in Health IT Projects
  • Philippines eHealth Strategic Framework and Plan 2013-2017
  • #HealthXPh: Tweetchat on Emerging Technologies and Social Media in Healthcare
  • Transforming Healthcare by Using Cost-Effective Telemedicine Solutions
  • Lessons Learned from Hospital IT Implementations: Philippine Heart Center
  • Building the IT and EMR Roadmap: Strategic IT Planning for Hospitals
  • Emergency Department Information System (EDIS): A Demonstration of Workflows, Interoperability and Patient Use Cases
  • Strategies for Capacity-Building in Healthcare
  • e-Prescription: The Benefits and Challenges for Philippine Healthcare
  • Telemedicine in Hospitals: The Tele-Ophthalmology Project of The Medical City
  • HL7 Philippines: Going Beyond Interoperability and Messaging Standards
  • mHealth for Hospitals: How Mobile Technologies Enable Process Improvements
  • Nursing Informatics: The Evolving Role of Nurses in Hospital IT Implementations

This event is a rare opportunity to learn from various experts on Health IT. Three of the topics (Telemedicine, mHealth and EDIS) will have speakers coming in from the US to share their experiences. Other topics will have implementation leaders and managers speaking about lessons learned and challenges encountered.

The early bird rate of Php2000 is only until May 1, 2014. Please visit our site (http://hit-ph.com) for more information.

I look forward to seeing you all there!

Thank you,

Dr. Mike Muin
Chairman
2014 Health IT Philippines Conference

2014 Health IT Philippines Conference

I am happy to share with you that the 2014 Health IT Philippines Conference will be on May 22-23, 2014 (Thursday and Friday). If I had a ‘dream Health IT conference’ for the Philippines, this would be it.

The 2014 Health IT Philippines Conference brings together Health IT leaders, clinician stakeholders and project implementers to address issues and challenges in hospital IT implementations, share lessons learned from successful projects, and propose strategies to redesign clinical workflows.

More information can be found at the website: http://hit-ph.com.

Confirmed Speakers include:

  • Usec. Dr. Ted Herbosa, Department of Health
  • Dr. James K. Gude, OffSiteCare
  • Dan Smith, EHR International
  • Dr. Annabelle Borromeo, St. Luke’s Medical Center
  • Don Rabanal, The Medical City
  • Dr. Lyndon Dayrit, Healthway Medical
  • Edison Dungo, Makati Medical Center
  • Dr. Iris Thiele Isip Tan, UP College of Medicine
  • Dr. Gerry Manzo, Philippine Heart Center
  • Dr. Cesar Dimayuga, The Medical City
  • Dr. Angelo Juan O. Ramos, Molave Foundation
  • Dr. Alfonso U. Bengzon, The Medical City
  • Dr. Mike Muin, HL7 Philippines

The organizers are still working on getting more speakers and technology partners to join. If you are interested to be a speaker or a sponsor, please let me know.

Please check out the site and this group page for more details.

Thanks!

HL7 Philippines is here!

HL7 Philippines is now in official HL7 International page.

HL7 Philippines is now in official HL7 International page.

I’m happy to share that HL7 Philippines is now official!

Thanks to the efforts of Dr. Alvin Marcelo, Dr. Gerry Manzo, Dr. Vic Caguioa, Dr. Myra Macalalag-Cruz, Louie Cruz and Doods Ventura.

The easy part is over. The journey towards making HIT standards work in the Philippines is just beginning.

I’ll keep everyone posted.

Thanks!

Health CIOs share insights on 10 years of Health IT

From: CIOs gauge decade of health IT headway | Healthcare IT News.

Several prominent Healthcare CIOs shared their insights about the past 10 years of pushing for Health IT.

Here’s just a short rundown of the insights:

  • Interoperability headaches push some hospitals to abandon best-of-breed systems in exchange for enterprise systems.
  • Government-backed incentive programs helps push for Health IT projects and investments in enterprises and clinical practices.
  • IT in healthcare is now moving from just being an operations enabler to becoming more strategic for the business.
  • Collaboration and interoperability are still important challenges for enterprises.

More insights are in the article. HIT people should read it.

Doctors and Scribes

Doctors always have a hard time multi-tasking: typing at the computer, thinking of the case, and working with the patient. This makes EMR adoption very challenging. And this is a common situation I encounter–and try to address!–with our EMR efforts. Having someone type for doctors actually might make sense and might actually improve EMR adoption.

Without much fanfare or planning, scribes have entered the scene in hundreds of clinics and emergency rooms. Physicians who use them say they feel liberated from the constant note-taking that modern electronic health records systems demand. Indeed, many of those doctors say that scribes have helped restore joy in the practice of medicine, which has been transformed — for good and for bad — by digital record-keeping.

via A Busy Doctor’s Right Hand, Ever Ready to Type – NYTimes.com.

What do you think?

AMIA: Clinical informatics has arrived | Healthcare IT News

This is great! I hope this is something we can emulate here in the Philippines.

The board certification is open to physicians of all specialties, encouraging interdisciplinary cooperation in the clinical informatics field. Physicians can currently become eligible for the exam by demonstrating practical informatics experience. However, after five years, candidates for the subspecialty will need to complete an accredited clinical informatics fellowship with the Council on Graduate Medical Education.

via AMIA: Clinical informatics has arrived | Healthcare IT News.

Disrupting The Status Quo

Health IT professionals are in the business of disrupting the status quo!

Tools like these help make sense and provide insights:

Lessons In Disrupting The Status Quo In Handy Visual Form | Co.Exist | ideas + impact.

Check out the graph, especially the context view.

  • Blue is for Principles
  • Orange is for Tactics
  • Red is for Theories
  • Green is for Case Studies
  • Purple is for Practitioners

Enjoy!

Yes, nurses should be involved!

I’m not sure why this is even an issue.

Why nurses must be involved in developing new health IT – FierceHealthIT.

Nurses are important stakeholders in the development, design and implementation of EMRs, especially in hospitals. I make it a point  to have the Nursing IT Advisory Committee involved in any project that affects nursing workflows, processes and workloads.

Here are some practical lessons why they should be involved.

  1. They welcome changes that would make documentation easier and help them focus on patient care.
  2. They can be early adopters of electronic clinical documentation.
  3. They are the workforce of the hospital and their data output is huge!
  4. Their data output (vital sings, flow sheets, medication administration records, intake/output) are great candidates for multiple data representation, e.g. data grid, chronological view, trending graphs.
  5. They can hold the keys to physician engagement for clinical documentation and CPOE.

At The Medical City, we are working together with the nurses to help implement nursing documentation for our hospital EMR.

  • How do you get nurses involved in your projects?
  • Are they open to changes that might come with EMRs?

HL7 Status in the Philippines

I got several emails (a few hours apart) asking the same series of questions about the state of HL7 in the Philippines. It’s for an assignment and they obviously found my blog for their research.

I am happy to share whatever I know so let me answer the questions in my blog.

 

What is the status of HL7 in the Philippines?

HL7 as a messaging protocol is being used by several Philippine hospitals. I am sure that St. Luke’s Medical Center (both QC and GC) and The Medical City use HL7 to integrate ancillary systems, e.g. Laboratory Information Systems, Radiology Information Systems, with Hospital Information Systems.

However, I’m sure there are other hospitals using HL7 for integration–though may not explicitly know about it. Some of the analyzer vendors I’ve worked with during integration projects were using HL7 in their interfaces but didn’t know anything about HL7 as a protocol, standard or organization. (That’s another story!)

There is also an ongoing multi-sectoral effort to get the Philippines affiliated with HL7.org. If this is successful, we’d have an official HL7 Philippines listed in this page: HL7 International Council. So far, the effort is doing well. We might have very positive news soon!

 

How will HL7 affect the healthcare industry in the future?

HL7 is the key to standards-driven healthcare interoperability. Interoperability and integration are the keys to improved IT-enabled clinical workflows.

What this all means is that if we plan to computerize clinical workflows, we need to integrate several health IT systems. These systems perform specific functions inside hospitals, e.g. ICU monitors, lab results, radiological images, and they should talk to each other. The way to talk to each other is via a messaging standard like HL7.

Better integration among systems can help improve adoption. Thus, if we do HL7 right, we might see more healthcare IT systems available in the market. This, in turn, will help lower costs of implementing clinical applications in hospitals.

 

What is the government’s stand on HL7?

The government is pro-HL7!

DOH is doing several multi-sectoral efforts to improve healthcare in the Philippines using Information and Communication Technologies. They are working on a national eHealth framework. Although implementation and technical details are still being developed with both public and private groups, HL7 will form part of the core standards to be implemented nationwide.

Check this links for more information about the DOH activities:

Thanks to everyone who emailed me. I hope this post helped.

Please email questions or post in the comments.