Clinical technology: are you getting your money's worth? - several factors should be considered when investing in clinical information technology

Healthcare Financial Management, Feb, 2003 by Barry P. Chaiken

With the number of hospital beds decreasing and demand for the remaining beds rising, hospitals that capture the increasing demand for services with existing infrastructure obtain a significant financial advantage over competitors.

Examples of clinical IT systems that help reduce length of stay include computerized physician order entry (CPOE)/clinical decision-support systems and physician portals. These systems facilitate putting patients on treatment regimens that are more likely to get them well quickly With physician portals, physicians use web technology to access accurate, up-to-date patient information. This capability allows physicians located offsite to respond quickly to changing clinical data.

Although identifying changes in length of stay due to clinical IT solutions, such as a physician portal, is not without its methodology challenges, healthcare providers can statistically adjust for the intervention and supplement that information with survey data obtained from physicians.

Staffing efficiencies. Properly deployed clinical IT systems provide staffing efficiencies that allow a fixed number of staff members to treat a greater number of patients. Efficiencies occur through improved communication of treatment plans, reductions in time spent clarifying orders, and the elimination of unnecessary efforts. For example, GPOE/clinical decision-support systems deliver to each staff member the exact assignments that require completion for each patient. Each staff member can then organize the workload to maximize efficiency In addition, treatment errors that result from such things as the inability to read someone's handwriting are eliminated.

Improved adherence to medication protocols. Changes in practice patterns, particularly in drug use, can decrease the cost of treatment. Some organizations successfully reduced antibiotic and anticoagulation drug costs by deploying a CPOE/clinical decision-support system that uses evidence-based medicine guidelines when providers enter orders at the point of care. These systems not only increase compliance with the hospital formulary, but they also direct physicians to the appropriate, least expensive medication that can deliver the desired outcome. As an added benefit, reviewing and limiting antibiotic use in this way also reduces the potential for antibiotic-resistant pathogens.

Eased regulatory reporting. Clinical IT systems can assist in regulatory and accreditation reporting to CMS and the Joint Commission on Accreditation of Healthcare Organizations. These systems provide much of the required information through analysis of existing patient data sets. Having this information available reduces the time staff spend pulling records and compiling disparate data elements. It is likely that as more clinical IT systems are deployed, regulatory and accreditation standards will adjust and take advantage of the available reporting capability

Physician referrals. Lastly properly chosen and deployed clinical IT systems help to improve medical staff relations by facilitating physician workflow and satisfying the information needs of the practicing clinician. As the environment becomes more functional, physicians are more likely to refer patients to the institution. These increases in referrals lead to higher occupancy rates and better utilization of fixed assets, culminating in improved hospital cash flow and net revenue. To help measure these benefits, one organization that deployed a physician portal tracks changes in referrals through utilization statistics supplemented by regular surveys of its medical staff administered through the portal.