Business Process Redesign in the Perioperative Process: A Case Perspective for Digital Transformation

This case study investigates business process redesign within the perioperative process as a method to achieve digital transformation. Specific perioperative sub-processes are targeted for re-design and digitalization, which yield improvement. Based on a 184-month longitudinal study of a large 1,157 registered-bed academic medical center, the observed effects are viewed through a lens of information technology (IT) impact on core capabilities and core strategy to yield a digital transformation framework that supports patient-centric improvement across perioperative sub-processes. This research identifies existing limitations, potential capabilities, and subsequent contextual understanding to minimize perioperative process complexity, target opportunity for improvement, and ultimately yield improved capabilities. Dynamic technological activities of analysis, evaluation, and synthesis applied to specific perioperative patient-centric data collected within integrated hospital information systems yield the organizational resource for process management and control. Conclusions include theoretical and practical implications as well as study limitations

A Patient-Centered Framework for Evaluating Digital Maturity of Health Services: A Systematic Review

© Kelsey Flott, Ryan Callahan, Ara Darzi, Erik Mayer.Background: Digital maturity is the extent to which digital technologies are used as enablers to deliver a high-quality health service. Extensive literature exists about how to assess the components of digital maturity, but it has not been used to design a comprehensive framework for evaluation. Consequently, the measurement systems that do exist are limited to evaluating digital programs within one service or care setting, meaning that digital maturity evaluation is not accounting for the needs of patients across their care pathways. Objective: The objective of our study was to identify the best methods and metrics for evaluating digital maturity and to create a novel, evidence-based tool for evaluating digital maturity across patient care pathways. Methods: We systematically reviewed the literature to find the best methods and metrics for evaluating digital maturity. We searched the PubMed database for all papers relevant to digital maturity evaluation. Papers were selected if they provided insight into how to appraise digital systems within the health service and if they indicated the factors that constitute or facilitate digital maturity. Papers were analyzed to identify methodology for evaluating digital maturity and indicators of digitally mature systems. We then used the resulting information about methodology to design an evaluation framework. Following that, the indicators of digital maturity were extracted and grouped into increasing levels of maturity and operationalized as metrics within the evaluation framework. Results: We identified 28 papers as relevant to evaluating digital maturity, from which we derived 5 themes. The first theme concerned general evaluation methodology for constructing the framework (7 papers). The following 4 themes were the increasing levels of digital maturity: resources and ability (6 papers), usage (7 papers), interoperability (3 papers), and impact (5 papers). The framework includes metrics for each of these levels at each stage of the typical patient care pathway. Conclusions: The framework uses a patient-centric model that departs from traditional service-specific measurements and allows for novel insights into how digital programs benefit patients across the health system

The chaotic nature of healthcare information systems: The need for transdisciplinary collaboration

Copyright @ 2013 EMCIS.This paper demonstrates one of the challenges of the healthcare information systems development, namely the chaotic nature of healthcare systems. Although the reliable evidence demonstrating the positive effects of health information systems on safety and quality remains inconclusive (a growing body of research revealing the unintended consequences and potentially error producing effects of health information systems’ implementation. Different arguments from the literature concerning the chaotic nature of healthcare, including but not limited to the nature of patients and disease have been presented. The requirements of new ways of systems design and the need for transdisciplinary dynamic teams within the requirements engineering phase as a start has been discussed. These arguments have been investigated in the context of an exploratory case addressing one of the advanced oncology centres in the US. This paper concludes that there is an important need to rethink healthcare information systems development method, which has to be in a dynamic ongoing manner for some major issues

Modelling and Analysis of E-Health Ecosystems: A Case Study of the United States

The United States (US), a world leader in medical technology, ironically also happens to be home to one of the least efficient healthcare systems in the world. The country’s mammoth, unsustainable spending on healthcare has triggered several key healthcare reforms to put the country’s healthcare system on the path for a major overhaul. One such reform was the HITECH Act of 2009 which made provision for incentives for adoption of Electronic Health Records by physicians and hospitals. The ultimate goal of this reform was to forge connectivity across the country’s fragmented healthcare system in the hope that it would lead to efficiency and consequently, a drop in the country’s healthcare expenditure. Although the reform no doubt spurred EHR adoption, its intended goal of connectivity has not been fully realized. A set of critical success factors has been proposed to overcome these issues and make the ecosystem both patient-centric and sustainable

Next generation assisting clinical applications by using semantic-aware electronic health records

The health care sector is no longer imaginable without electronic health records. However; since the original idea of electronic health records was focused on data storage and not on data processing, a lot of current implementations do not take full advantage of the opportunities provided by computerization. This paper introduces the Patient Summary Ontology for the representation of electronic health records and demonstrates the possibility to create next generation assisting clinical applications based on these semantic-aware electronic health records. Also, an architecture to interoperate with electronic health records formatted using other standards is presented

Implementation of Bedside Technology May Influence Satisfaction with Nurse-Patient Communication

Health care consumers expect high quality care and outcomes that are cost effective, while hospitals focus on improving patient engagement and satisfaction and optimizing reimbursement. The nurse-patient communication process is a critical component of care for hospitalized patients. Use of technology applications to communicate patient needs may increase patient engagement in their own care while improving patient satisfaction. An expanded use of the electronic record capability has been implementation of a new patient-centric application embedded in the electronic record technology known as MyChart Bedside©. The objective of this study was to determine if there was an association between hospitalized patients using the MyChart Bedside© application and Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS) nurse-patient communication scores. This was a retrospective cohort study. The setting was an acute care hospital with 415 beds and the application was studied on three medical-surgical nursing units. There were 1520 patients who responded to HCAHPS surveys over a three-year time period, of which 290 patients (14%) activated the bedside application. The measurements were patient satisfaction scores for three questions related to the Communication with Nurses domain on the survey. The results of the study demonstrated a statistically significant association between the patients who activated the MyChart Bedside© application and satisfaction with nurse-patient communication compared to the satisfaction scores for those who did not activate the application during hospitalization. The activators had.26 higher satisfaction scores than non-activators (p value \u3c.005). There was no significant association with the bedside application and satisfaction scores with age, race, or gender. In conclusion, the activation of MyChart Bedside© application, as an interactive application for patients, was associated with improved patient satisfaction and may be considered a strategy to enhance patient engagement in their own healthcare, improve satisfaction with nurse-patient communication, and support hospital reimbursement through meeting Value-Based Purchasing (VBP) initiatives

Evaluation Report: NH Multi-Stakeholder Medical Home Pilot

The New Hampshire Multi-Stakeholder Medical Home Pilot was initiated in 2008 by the New Hampshire Citizens Health Initiative as a collaborative effort of its Medical Home workgroup, the Center for Medical Home Improvement and the four private New Hampshire Health Plans: Harvard Pilgrim Health Care, CIGNA, Anthem, and MVP Healthcare, as well as NH Medicaid. The goal of the pilot was to value, prescribe, and reward medical care that is tightly coordinated and of superior quality and efficiency

Transforming healthcare: policy discourses of ICT and patient-centred care

Information Technology (IT) is increasingly seen in policy and academic literature as key to the modernization of healthcare provision and to making healthcare patient-centred. However, the concept of Patient-Centred Care (PCC) and the role of IT in the transformation of healthcare are not straightforward. Their meanings need unpacking in order to reveal assumptions behind different visions and their implications for IT-enabled healthcare transformation. To this end, this paper analyses England’s health policy between 1989 and 2013 and reviews literature on PCC and IT. English policy has set out to transform healthcare from organization-centric to patient-centred and has placed IT as central to this process. This policy vision is based on contested conceptualizations of PCC. IT implementation is problematic and this is at least partly due to the underpinning goals and visions of healthcare policy. If this misalignment is not addressed then producing technologically superior systems, or better IT implementation strategies, is unlikely to result in widespread and substantial changes to the way healthcare is delivered and experienced. For IT to support a healthcare service that is truly patient-centred, patients’ needs and wants should be identified and designed into IT-enabled services rather than simply added on afterwards

Intelligent doctor patient matching: how José Mello saude experiments towards data-driven and patient-centric decision making

While data-driven decision-making is generally accepted as a fundamental capability of a competitive firm, many firms are facing difficulties in developing this capability. This case demonstrates how a private healthcare organization, José de Mello Saúde, engages in collaboration with a global university-led program for such capability building, in a pilot project of intelligent doctor-patient matching. The case walks the reader through the entire data science pipeline, from project scoping to data curation, modelling, prototype testing, until implementation. It enables discussions on how to overcome managerial challenges and build the needed capabilities to successfully integrate advanced analytics into the organization’s operations