MAR 12, 2012 10:23am ET

EHR Beyond Meaningful Use: Productivity -- Part 1


The Bipartisan Policy Center Task Force on Delivery System Reform and Health IT's January 2012 report, “Transforming Health Care: The Role of Health IT” has one glaring and stupefying omission -- nowhere in the report does it address productivity.

As we see in most government and academic edicts on health care information technology, this document focuses on effectiveness, touches on efficiency, but completely ignores productivity. This is despite the fact our health care system has pretty much tapped out all potential sources of additional financial resources (personal or governmental).

This is quite an astounding omission for those of us that have I.T. experience in other industries, where the major reason for, and chief benefit of, the spending on I.T. is increased worker, and capital, productivity. 

Sure, some information technology, like CAD/CAM, PLM, market research analytic packages,, improve the products and the consumers’ ability to access new and improved products, but the major reason most organizations spend money on I.T. is to improve productivity by buying and implementing systems that reduce costs, and improve revenue and profits.

Yet we see nothing in the task force report that deals with actual measurable productivity -- not better outcomes, which are theoretically covered, but getting better utilization of the resources currently expended in health care.

Let's lay down a few working definitions:

Effectiveness describes how well any activity achieves its desired output. In health care, I would define a relatively effective health care system as one where the doctors come up with the correct diagnosis and apply the correct treatment nearly all the time.

Efficiency describes how well any activity achieves is desired output based on the effort applied. A health care encounter is more efficient if on the very first visit the correct diagnosis is arrived at and the correct treatment is applied. If a health care system requires a lot of visits, and considerable trial and error, to diagnose and treat the patient correctly for relatively common ailments, it’s inefficient.  High hospital readmission rates are a good indicator of an inefficient system.

Productivity encompasses effectiveness and efficiency, but also goes further taking into consideration financial and economic issues.  Productivity measures the amount of output produced by a system for a given level of capital and labor.

Nowhere in the report, available here, do we see any material discussion on how to use available information technology to drive productivity. Nowhere in the report do we see any mention of borrowing proven best practices from other industries to drive similarly needed productivity improvements in Healthcare.

I suppose this is not too shocking given the lack of efficiency and productivity experts from industries renowned for improved productivity on the panel.  Adding people like Steve Chase, Mark Hurd, Scott Davis, Randy Mott, or Larry Ellison would make all the difference in the world.

In Part 2, I will go over some specific suggestion on how a slight shift in the mindset of health care can easily drive massive increased productivity by deploying proven best I.T. practices.



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