The Role of Information Technology in Healthcare Learning

St. James Medical System’s CEO, Stephanie, knows her organization faces many current and future challenges. Diminishing reimbursement, potential restructuring as an accountable care organization, increased regional competition, and greater difficulty in recruiting and retaining skilled professional staff, among other factors, will make the next decade a transition period requiring many innovative changes. She is not certain her organization is prepared to learn new ways to meet these challenges.

Stephanie recently read the Institute of Medicine’s nearly 400-page report Best Care at Lower Cost: The Path to Continuously Learning Health Care in America, which indicated that the US healthcare system has squandered billions of dollars per year on unnecessary care, unnecessary administrative costs, and preventable health conditions while failing to deliver high-quality care. She was impressed by the Institute’s ten recommendations:

Digital infrastructure. Increase the capability to capture clinical, care delivery process, and financial data to improve care and performance, and generate new knowledge.

Data utility. Simplify and revise research regulations to improve care, promote the capture of clinical data, and generate knowledge.

Clinical decision support. Accelerate integration of the best clinical knowledge into care decisions.

Patient-centered care. Involve patients and families in decisions regarding health and healthcare, tailored to fit their preferences.

Community links. Promote community–clinical partnerships and services aimed at managing and improving health at the community level.

Care continuity. Improve coordination and communication within and across organizations.

Optimized operations. Continuously improve healthcare operations to reduce waste, streamline care delivery, and focus on activities that improve patient health.

Financial incentives. Structure payment to reward continuous learning and improvement in the provision of higher-quality care at lower cost.

Performance transparency. Increase transparency on healthcare system performance.

Broad leadership. Expand commitment to the goals of a continuously learning healthcare system (Institute of Medicine 2013).

St. James has been working on many of these steps for years. The organization is constantly upgrading its information technology (IT) system, has developed clinical support decision systems, spent the past five years trying to shift to a patient-centered focus, and at the same time worked hard to lower its costs. Moving to a patient-centered care focus required a great deal of information gathering and learning, encapsulated in St. James’s four core concepts:

Respect and dignity. Healthcare practitioners listen to and honor patient and family perspectives and choices. Patient and family knowledge, values, beliefs, and cultural backgrounds are incorporated into the planning and delivery of care.

Information sharing. Healthcare practitioners communicate and share complete and unbiased information with patients and families in ways that are affirming and useful. Patients and families receive timely, complete, and accurate information in order to effectively participate in care and decision-making.

Participation. Patients and families are encouraged and supported in participating in care and decision-making at the level they choose.

Collaboration. Patients and families are also included on an institution-wide basis. Healthcare leaders collaborate with patients and families in policy and program development, implementation, and evaluation; in healthcare facility design; and in professional education, as well as in the delivery of care (adapted from MHA Keystone Center 2015).

Operating under these core concepts has been challenging, and Stephanie is worried about the organization’s ability to truly become patient-centered without adopting many major changes. Just improving the speed and data capacity of the health system’s IT infrastructure and electronic health record had been difficult; linking providers to streamline care continuity and providing financial incentives to reward continuous learning while running a transparent performance system seems especially challenging. She decides to make a few notes and discuss the difficulties with St. James’s executive team.

Case Studies:

The student will complete each case study scenario and answer questions from the case studies outlined in the assignment using the guide below. One reference (within the last four years). Address all five areas below.

1. Introduction
2. Present an overview of the key problems and issues in the case.
3. Provide a thesis statement that summarizes your analysis in one or two sentences.
4. Background, key facts, and issues
5. Provide background information, relevant facts, and the most important issues.
6. Tie to class materials, making sure to include how these issues impact the organization and individuals in the organization.
7. Alternatives
8. Outline two possible alternatives.
9. Discuss the critical constraints.
10. Explain the strengths and weaknesses of the alternatives.
11. Proposed solution
12. Recommend one solution.
13. Explain why this solution was chosen.
14. Support this solution with facts and class materials.
15. Provide personal experiences, if applicable.
16. Recommendations
17. Determine and discuss the specific strategies needed to accomplish the proposed solution.
18. If applicable, define what further information is needed.

Case study assignments count 20% towards the final grade and are evaluated based on the Case Study Grading Rubric