Lessons from the Healthcare.gov Project Meltdown

Posted on January 21, 2014 by American Sentinel University - Business

In the fall of 2013, the meltdown of Healthcare.gov, the consumer website for the Affordable Care Act, otherwise known as Obamacare, suggested that what the government needed was an IT doctor. Running late, missing features, and simply not working for millions of people, the launch was embarrassing, left people unsure of what to do, and caused huge political problems.

In any large-scale project using project management skills is the best first step.

If you work in health care management, this should be a warning. Information technology is rocketing in toward health care providers. Many organizations will need to quickly come to speed with electronic medical records, mass data integration, news software packages, automation, and tricky project management. These days, an MBA in health administration should include a grounding in managing technology adoption. The website rollout was a disaster because it “violated every principle of sound project management.”
That includes the following: 1. unrealistic project goals of automating an entire complex insurance and government regulatory interaction; 2. ridiculous complexity involving dozens of contractors and hundreds of insurers in 36 different states; 3. fragmented decision making and authority; 4. inadequate testing in the face of aggressive roll-out goals.

Even more of a problem, people at the bottom didn’t talk and people at the top didn’t listen. There were early signs that the project faced problems, only people did not want to address them, as the New York Times noted:

Some people intimately involved in the project seriously doubted that the agency had the in-house capability to handle such a mammoth technical task of software engineering while simultaneously supervising 55 contractors. An internal government progress report in September 2011 identified a lack of employees “to manage the multiple activities and contractors happening concurrently” as a “major risk” to the whole project.

Outside of the Department of Defense, most government branches don’t have the deep experience monitoring, coordinating, and integrating all the separate aspects of a project to have something that works at the end. No one rolled out the project in pieces; it was all supposed to work fine on day one. Months before the opening day crash, people inside and outside of government were warning about the rapidly approaching brick wall.
Many companies and government bodies will also have to implement large-scale projects. The biggest single piece of advice, if you are part of such an effort, is to prepare the necessary software project management skills:

No matter what the pressure, set design and implementation goals that are realistic for the organization. Over-promising and under-delivering can lead to disaster.

Have experienced project managers run things.

Test results early and often.

Roll out systems in phases and avoid an all-or-nothing strategy.

If you must outsource, have someone in charge who knows how to integrate work of multiple teams.

Communicate goals, progress, and problems clearly.

Ensure that communications runs from bottom to top as well as top to bottom, so that the observations of people on the front line receive adequate attention.

Chances are that whatever health care project your organization takes on will be only fractionally as large or complicated as the healthcare.gov website. But don’t let relative safety lull you into complacency. The minute you think things are safe is about the time that they will blow up.

About American Sentinel University - Business

American Sentinel University delivers the competitive advantages of accredited Associate, Bachelor's and Master's online degree programs focused on the needs of high-growth sectors, including business administration and business intelligence degrees. It also offers health care programs, such as health care management, MBA-Healthcare and DNP-Executive Leadership, and online IT degree programs, including business informatics. The university is accredited by the Distance Education and Training Council (DETC), which is listed by the U.S. Department of Education as a nationally recognized accrediting agency and is a recognized member of the Council for Higher Education Accreditation.

Provost Feature: How to bring data analytics to health care

Posted on January 21, 2014 by American Sentinel University - IT

To meet federal health care reform mandates, IT and health care have joined forces. Job opportunities are increasing at rapid rates. What does this mean for professionals working in IT? In health care? Where does higher education play a role?

RnR Market Research estimates that health care analytics will grow 23 percent from 2012-2017.

In recent coverage on the IT shift into health care Bytes explored the field of health information and health care informatics. Kurt Linberg, Ph.D., provost at American Sentinel spoke with Health IT Analytics stating that the demand for nurses is just as high as for IT professionals. To address this,  the university has specifically developed the MSISM online degree program to meet market demands.

“We’re realizing that, in working with our different healthcare partners, it’s more than just a nursing shortage.  They’re dealing with these very tough system integration issues,” says Dr. Linberg. “They need more technologists.  They need more information system managers and more executives with an understanding of healthcare challenges.”

Read the full article here: Trainee informaticists must face myriad EHRs, analytics tools

About American Sentinel University - IT

American Sentinel University delivers the competitive advantages of accredited Associate, Bachelor's and Master's online degree programs focused on the needs of high-growth sectors, including information technology, computer science, GIS, computer information systems and business intelligence degrees. It also offers online health systems management and health informatics programs. The university is accredited by the Distance Education and Training Council (DETC), which is listed by the U.S. Department of Education as a nationally recognized accrediting agency and is a recognized member of the Council for Higher Education Accreditation.

Meaningful Use Guidelines Can Enhance Discharge Planning – Here’s How!

Posted on January 22, 2014 by American Sentinel University - Health Care

During 2014, hospitals will continue to work toward meeting Meaningful Use guidelines. Nurse case managers may think of Meaningful Use mainly as an information technology (IT) initiative. Yet, some of the goals of Meaningful Use actually tie into the mission to reduce unnecessary readmissions through better discharge planning.

There are four key elements of discharge planning that may be supported or optimized by technology.

The current trend toward shorter hospital stays means that patients may go home sicker – making discharge planning more important than ever. Case managers have to formulate the best option for post-discharge care, after considering details about the patient’s illness and prognosis, level of health literacy, ability for self-care, and medical needs.

In the past, case managers have gathered, organized, and disseminated the information needed for a smooth discharge through manual processes. This is starting to change, as EMR vendors begin to include discharge planning modules in their software packages. By processing discharge data more efficiently, case managers can further specific Meaningful Use goals and help reduce fragmentation of care. There are four key elements of discharge planning that may be supported or optimized by technology, and each is discussed below.

1. Transition Planning. This basic function is necessary to ensure continuity of care and the right level of post-discharge services. When a patient will be discharged to another facility, it can be time-consuming to find an appropriate match and make inquiries about available beds and services. Software known as patient placement systems (PPS) – or, alternatively, as discharge referral systems (DRS) – can speed up the process by allowing case managers to electronically search facilities on a regional level and to make secure, paperless referral inquiries online rather than sending and waiting for faxes. These systems can also make it easier for case managers to track and monitor the status of multiple patients in real time.
2. Medication Reconciliation. Stage Two of Meaningful Use guidelines state that participating hospitals must electronically perform medication reconciliation for 65 percent of patients making a transition of care. It is hoped that an automated process will address this crucial step more accurately and efficiently than comparing the pre- and post-discharge medication lists by hand. Software designed for this purpose integrates with pharmacy systems and computerized provider order entry (CPOE) systems to help ensure that no medications or dosage changes have been missed.
3. Patient and Caregiver Instructions. An important requirement of Meaningful Use is that providers “use certified EMR technology to identify patient-specific education resources and provide those resources to the patient if appropriate.” Since clear, comprehensible discharge instructions can help a patient avoid complications at home, providers are looking for ways to easily create personalized discharge documents tailored not only to the patient’s medical needs, but to his level of health literacy as well. Technology vendors are responding to this need by providing document libraries that integrate with the EMR and make it fast and easy for providers to create individualized discharge instructions – without reinventing the wheel each time.
4. Discharge Summary. This document often serves as the primary means of communication between hospitalists and primary care providers – and research shows that when getting it to the patient’s primary care doctor quickly can decrease the chance of an unnecessary readmission, while increasing the likelihood the patient will receive
   
   timely follow-up care. Meaningful Use does not actually require an electronically generated discharge summary. Yet, some technology vendors are offering an optional module to improve the flow of key information. The discharging physician can complete a user-friendly template that standardizes the discharge summary with the most important information at the top – including the outcome of hospitalization, follow-up care needed, and plans for additional services (hospice, home health aides, patient monitoring devices, etc.) Where case managers are expected to make follow-up calls or set follow-up appointments, an automated work queue could help them manage tasks and track patient status.

1. Medication Reconciliation. Stage Two of Meaningful Use guidelines state that participating hospitals must electronically perform medication reconciliation for 65 percent of patients making a transition of care. It is hoped that an automated process will address this crucial step more accurately and efficiently than comparing the pre- and post-discharge medication lists by hand. Software designed for this purpose integrates with pharmacy systems and computerized provider order entry (CPOE) systems to help ensure that no medications or dosage changes have been missed.

About American Sentinel University - Health Care

American Sentinel University delivers the competitive advantages of accredited online degree programs in nursing, health informatics, case management, infection prevention and control, MBA Health Care, online DNP Executive Leadership, and DNP Educational Leadership. Its bachelor’s and master’s nursing degree programs are accredited by the Commission for the Collegiate Nursing Education (CCNE). Its online nursing degree programs suite is also a candidate for the National League for Nursing Accrediting Commission (NLNAC) accreditation. The university is accredited by the Distance Education and Training Council (DETC). The Accrediting Commission of DETC is listed by the U.S. Department of Education as a nationally recognized accrediting agency and is a recognized member of the Council for Higher Education Accreditation.