Improving community hospital IT through affiliation: Cure-All or fantasy?

Community hospitals in the U.S. are increasingly opting for alignment with larger health care systems.

According to an August 2015 study, researchers at Johns Hopkins University report that one fifth of U.S. hospitals are seeking affiliations within the next five years, and 193 mergers were reported in 2013 and 2014.

While IT issues are not typically the sole basis for a community hospital's decision to affiliate with a large health care system, they're often a significant part of the equation. Larger health systems can bring larger budgets and more IT staff, but aligning with a bigger health care network is almost never a quick fix to a community hospital's IT woes.

The reality is more complicated. If you're contemplating affiliating with a larger system, it's helpful to have realistic expectations about what the effect on IT will be. You must be able to think clearly about the strategic business value of affiliating – without the distraction of too much focus on IT.

IT Should Never Be THE Reason To Affiliate

Many community hospital executives often see IT as a drain on resources. It seems to them that no matter how much money they allocate to IT, clinicians still get frustrated by the technology, patient satisfaction remains low and the organization as a whole fights to get systems running effectively and elicit proper use from end users.

But, simply joining a large health system won't magically solve these IT problems. An affiliation involves more than just adopting new IT systems: You're also choosing to align your strategic and organizational approaches, as well as your policy and care protocols, which could significantly change how care is conducted in your community.

Understanding The IT Effect Of The Health Care "Mothership"

Bigger and more expensive IT isn't necessarily better, and getting access to the "right" software doesn't magically make every problem go away. Certainly, having the proper technology in place is a piece of the puzzle, but you don't have to affiliate with a larger health system to implement a software solution that delivers real value to your hospital. Conversely, affiliating with a larger health system doesn't ensure that their software is a good match for your organization, clinicians and patients.

Many community hospitals that ultimately align with a larger health entity in part to access the "right" IT do so because they have been struggling with IT thus far – which might actually be the result of factors that don't have anything to do with the technology itself. They mistakenly assume that seeking solace under the wing of a "mothership" can alleviate their problems.

However, community hospitals can improve their physicians' happiness and deliver top-notch patient care without seeking an affiliation. Whether or not they choose to join a larger health system, they must first focus on aligning their hospital IT with business strategy for smarter spending and more effective outcomes.

In fact, a large health system may not fully understand or align with your complete IT needs, which could introduce new complications and challenges for your community hospital and IT team. Your workflows, volumes and overall requirements are different from theirs, and there could be a gap in understanding when your small hospital calls the larger system for support. As a result, IT support response times may significantly degrade, and the communication gap between your clinicians and IT support staff could actually widen. Affiliating with a large health system won't automatically strengthen your IT support system – and it could weaken it.

Tips For Fixing Your IT

You don't have to look to a bigger health care entity just to fix your IT problems. There are plenty of IT resources specifically for community health care providers.

Of course, proper training, change management and implementation are essential elements to any major shift in hospital IT, but when managed properly, community hospitals are able to put an end to their IT woes.

RECOGNIZE THE HUMAN ELEMENT: Far too often, human factors – rather than business drivers – perpetuate community hospitals' perceived need to join a large health care conglomerate. People get frustrated with an EMR system's speed or the user experience, and when enough people feel a certain way, there's a rallying cry for change. These reactions are understandable but shouldn't be the sole drivers for a business change – especially one as fundamental as affiliating with a large health system. These human factors are usually best addressed by a renewed focus on IT strategy.

REFOCUS YOUR HEALTH CARE IT GOALS: Your IT goals should drive business value and be measured in terms of three things:

1. VALUE TO THE PATIENT (leading to market share improvements)

2. VALUE TO CLINICIANS (giving doctors and nurses more time to spend caring for patients rather than documenting)

3. VALUE TO THE BOTTOM LINE (improved cash, improved data analytics to drive new markets, new services, etc., and efficiencies that help you preserve and improve your financial health)

Once these goals are properly defined, be sure to align your IT Plan accordingly.

EMBRACE CONTINUOUS IMPROVEMENT: Too many facilities fail to realize the benefits of technology investments because they stop working once the new system is "live." Don't fall into this rut. Study your system usage and impacts, understand the gaps (and your process) and refine them to get the results you're after. View go-live not as the end of a project, but rather as one important milestone in an ongoing effort.

DON'T BE TOO QUICK TO REPLACE YOUR EMR: Keep in mind that EMR vendors are now past the huge strain of Meaningful Use, which should translate to a greater development focus on usability, productivity and information-sharing. So, before you decide that you need a replacement, consider the benefit of optimizing what you have. Along the way, your current solution is likely to advance.

When you have the right vision, a solid plan of action and the right IT operational structure, it's possible to dramatically reduce your community hospital's struggles with IT and enable your clinicians to provide better care with less hassle. With IT under control, you can evaluate the decision to affiliate or not with a clearer lens and focus squarely on business factors instead of being clouded by frustration with IT.

Phil Stravers, Partner | Phil Stravers has been an advocate for community healthcare since joining ICE in 1995. Prior to joining ICE, he started and oversaw a national helpdesk supporting technology systems for engineering and architectural design. Since acquiring ICE with Keith in 2003, Phil has guided the development of a services portfolio tailored specifically for community healthcare providers' distinct IT needs. Phil was instrumental in the development of ICE's focus on community healthcare. Phil routinely presents and educates through various healthcare associations, such as the Healthcare Information Management Systems Society (HIMSS), Healthcare Financial Management Association (HFMA) and National Rural Health Association (NRHA).

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