The best way to prevent wasteful spending and actually improve health care, according to Microsoft Corp.’s global e-health czar, is to think about technology as a way to streamline health processes.


“Health care organizations are getting so caught up, and in many ways distracted, by the (electronic health records) discussion and are not thinking about the ways in which technologies can be used to transform medical practice,” said Bill Crounse, a medical doctor who is Microsoft’s worldwide health senior director.


The advice comes just a few months after government leaders and health care organizations in Ontario made front page news for spending hundreds of millions hiring contractors and purchasing technology in a largely fruitless effort to build an EHR system.


Crounse, who was in Toronto on Dec. 1 for Microsoft Canada’s Connected Health conference, said public sector health leaders need to take a hard look at what they’re trying to improve.


“Instead of saying ‘what we need to do is get all health care digital and then we’ll figure out what we’re going to do with it,’ focus on what is going to be meaningful use,” he said. “What about the patient flow process, patient satisfaction, and patient safety do we want to improve, and how do we apply technology that will specifically get us to that place and time?”


The smartest health care and government organizations in the world, he said, are taking a commoditized approach to IT in health. This includes taking readily available, off-the-shelf or open source software, and applying technology to improve health processes.


“They are doing this rather than going out and spending $150 million on an electronic medical records system from some big vendor,” he added. Now that doesn’t mean EHR initiatives should not be undertaken, Crounse said, but rather government and health care leaders need to start thinking about how the digital data will help improve the process.


In Ontario, an October report from the province’s auditor general found that eHealth Ontario spent $1 billion on an EHR program that ranks last behind every other province in Canada in terms of progress.


“On a complex project like this, you’re going to need some outside expertise,” Auditor General Jim McCarter told ComputerWorld Canada in October.


But consulting on the EHR initiative was largely ad hoc. Without oversight and clearly defined, concrete deliverables, “things can get out of hand,” McCarter said.


McCarter said the program is salvageable, with improved strategic planning, time frames for deliverables, and tighter oversight. “You need an approved strategic plan,” McCarter said, which eHealth Ontario now has — seven years after SSHA began work on the initiative.


For Crounse, Canadian health and technology initiatives could actually be wise to follow the private sector in this regard. By that, he isn’t referring to moving away from our publically funded health care system, but rather moving toward the quality methodologies and workflow processes that private enterprises employ.


“Other countries have quite smartly looked at other industries and asked themselves ‘what can we learn from the way Ritz-Carleton provides customer service,’” he said. “‘What can we learn about ‘Microsoft about the way they do technology,’ or ‘what can Toyota teach us about production methods and workflow.’”


Crounse pointed to the work of the Virginia Mason Medical Center in Seattle, which actually sends their executives and physicians to Toyota to look at the way they manufacture cars. He said that by adopting Toyota’s workflow processes used in manufacturing cars, the health centre has streamlined the design of its own facilities, leading to better services and lowered costs.


“Toyota only manufactures fuel injectors for the exact number of cars that are being built on that particular day,” he said. “Likewise, Virginia Mason is using that technology to prepare for the patient visits and assembling whatever is going to be needed in that room, at exactly the time that it’s needed.”


This could also be the reason that the facility gives patients, staff, equipment and anybody visiting the medical centre radio-frequency identification (RFID) tags to track where patients are, what rooms are available and where equipment is stored, he said.


This approach, he said, especially makes sense for Canada considering the government’s role as both a payer and provider of health services.


– With files from Dave Webb, ComputerWorld Canada

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