Effective sharing of patient information depends on getting different and often disparate systems to exchange data and, at the highest level, process those data.

This requires sturdy bridges between systems, interpretive and compatible algorithms, and integrated strategies for how different systems will be used and will work together.

CHALLENGE: Developing An Enterprise Strategy

Many of the multiple and disparate information technologies that now handle patient data in consolidated health systems were initially implemented to serve distinctly different purposes. IHNs/IDNs "stuck" with these systems need a strategy that allows for an integrated but heterogeneous IT landscape, one that promotes patient welfare as it improves short- and long-term clinical performance.   This can be a tall order.  

Recognizing the continuing trend toward consolidation, a thoughtful IT strategy should be considered even if hospitals or other facilities have not been directly impacted by a merger or acquisition.  Healthcare providers might consider choices in IT systems that will minimize disruption if and when they are acquired; make them more attractive as prospective acquisitions; or provide options in a future where joint ventures, affiliations, and collaborations are alternatives to traditional M&A. 

Developing a strategy that pulls the several (or many) different IT tools together depends on dealing with the shortcomings of interoperability. Critically important is reducing complexity and inefficiency.  Not doing so runs the risk of becoming overwhelmed by the integration and management of  myriad systems. This risk is particularly high if IT tools are not well-suited to the tasks that must be performed.   


The simplification that comes from integration and consolidation of IT systems can save  money by making processes more efficient and IT systems easier to maintain. It is a transformative process.



CHALLENGE: Managing Human Factors

Human performance determines how well machines work.  This goes for any industry in which people work closely with machines and particularly advanced technology. In health IT,  a good working relationship between human and technology can translate into improved quality of care, increased efficiency and, ultimately, fewer errors. 

But optimizing the relationship between people and their machines is seldom easy or simple. Relatively small processes, if not compatible with the way people work, can lead to big problems.  For example, entering data on a medication order form in the opposite order as would be written on a paper prescription can lead to errors if the physician defaults to old habits.  

Human activities and the way these are done directly relate to workflow and ultimately translate into efficiency, efficacy, and patient care management.  IT developers must understand how caregivers work and synchronize the design of their technologies to complement these processes.  


So much boils down to understanding and resolving workflow problems. Because small problems can become big ones -- often in ways not anticipated – the vendor must communicate regularly and well with the customer’s various stakeholders. 



SOLUTION: Consolidating Healthcare IT Systems

The goal is to make the best use of IT, one that optimizes the delivery of effective patient care. When consolidating several PACS, for example, the most direct way is to offer a comprehensive radiology PACS that allows collaboration between the clinician and the radiologist who can view images at the same time. Ideally such a PACS would bring together data from multiple sources as in the case of several EMR systems, each of which may have created separate patient identities.  The same goes for workflow, bringing together the different ways the different specialties work.

Consolidating PACS may involve the expansion of a system to take the place of others, for example, expanding a radiology PACS to takeover for the mini-PACS dedicated to pediatric cases (a legacy system tucked away under a radiologist's desk).  Such expansion would require data migration, just as increasing efficiency to handle the increased data load may require upgrading the PACS.

So-called "single-stack" solutions are the easiest to deploy, for example, a single EMR system that handles the records of all patients in an enterprise, one that integrates data and function. 

The opportunity to do so, however, seldom exists after healthcare systems consolidate.  But there are ways to bring data together by implementing a centralized system. 

In radiology the PACS provides the core diagnostic capability to radiologists. The Conserus platform extends this capability by adding tools that provide the ability to do a peer review of critical results, as well as to orchestrate and augment workflow. Conserus workflow orchestration tool is a rules-based engine that monitors and orchestrates different workflows throughout the enterprise.

Unifying data flow is Imaging Fellow, which connects data from multiple sources that may exist throughout the enterprise. It extracts specific bits of information, consolidates and aggregates them; then presents them to the radiologist in a way that is easy to understand and use. 



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