Clinical transformation initiative starts with a total vision

Healthcare as an industry has been slow to apply information technology solutions in an effort to transform its clinical systems. But that seems to be changing.

These solutions are transforming the way healthcare is delivered. Clinical transformation initiatives offer healthcare organizations improvements in patient care and financial performance, and greater physician and patient satisfaction.

Technology alone, however, won't get an organization to that point. In fact, technology is not even the starting point when healthcare organizations decide to automate their clinical systems.

"In terms of clinical quality and clinical delivery, healthcare organizations need to know where they are at the beginning of the process, and they need to know where they want to be after the technology is implemented," says Mitch Morris, MD, executive vice president of First Consulting Group, a Long Beach, Calif.-based healthcare professional services company. "If they can articulate where they want their clinical delivery systems to be in three, five or 10 years, they can begin to work on a strategy and tactical plan to get there."

Any attempt by an organization to implement an IT system before working through its clinical vision only invites trouble. "It is not just about technology," says Dr. Manuel Lowenhaupt, vice president of Capgemini, which helps companies address their business and IT issues through consulting, technology and outsourcing services. "Organizations don't understand that, and they stumble along the journey. Technology is the vehicle; the road that it travels is redesigning processes."

And since a technological solution will cost millions of dollars, take years to implement and will impact practically every member of an organization's staff, it's important to get it right the first time.

In fact, because these projects are so huge and time-consuming, there might not be a second chance.Technology will become more expensive, and the ability to earn personnel buy-in will be much more difficult.

IT'S A PERSONNEL ISSUEThere has to be a commitment from a healthcare organization's entire staff-from leadership to physicians and nurses-to change workflow designs and processes in every department.

The road to establishing a clinical vision has to start in the chief executive's office, but in no way can it end there.

"Leadership has to define the solution and a common set of principles to work under, then the end users [employees] have to take control," Dr. Lowenhaupt says. "You want your employees to assume ownership of the project. You can't go into a command-and-control mode."

Dr. Morris says leadership has to "sell" the concept to employees. "The communication plan is tremendously important," he cautions. "You have to spin the message [to indicate] that this will make their jobs easier, and it will help them improve patient care."

First Consulting Group advised Legacy Health System, a four-hospital, 900-bed hospital system in Portland, Ore., when it undertook its clinical transformation initiative in 1999.

From the beginning, employees were-and continue to be-heavily involved in each step of the project, says Carol Edwards, vice president of information systems and quality for Legacy.