Why Low-Cost Apps Could Spark Healthcare Innovation
Healthcare organizations are finding it increasingly difficult to set aside money for innovation. A recent CSC Town Hall explored strategies for reducing the cost of the applications environment to allow organizations to focus on new business requirements. Dipankar Addy, a service delivery executive at CSC, says a number of IT trends are changing the way healthcare is delivered.
"Consumerization through trends like mobility and social media is changing the way patients and providers receive and share protected health information. And new mandates, many of which have overlapping timelines, are exerting pressure on healthcare providers. But so, too, are the risks associated with data security," Addy says.
Watch a short summary of the Town Hall discussion: The Digital Medical Home
The business environment has become more complex, Addy says. "Population health management puts pressure on organizations to develop complex networks of providers. This initiative is made difficult by a lack of interoperability standards. And a heightened demand for revenue replacement has providers looking for ways to do things better."
These trends are causing healthcare providers to move away from proprietary solutions to managed service and as-a-service models. "That means organizations must define application delivery objectives up front and work backwards," Addy says.
One step at a time
He also notes that an organization's transition to these new service models has to happen in planned increments.
"You can't expect to jump from an early service-delivery model directly to the most mature. You have to assess your application portfolio to identify opportunities to reduce complexity and eliminate misalignments and redundancies. You should consider how you can leverage your vendors more," Addy says. "And finally, change management within the IT and business organizations is required."
What an organization finds as it begins to assess its enterprise application portfolio may be surprising. Industry research reveals that many application portfolios aren't properly aligned with the strategy or operating model of the company they serve. This adds to the increasing total cost of ownership of application portfolios.
Addy says this results from the way many IT organizations have evolved. "Decisions were not made enterprise-wide, and solutions were more technology driven than business outcome driven," he says.
Accounting for four dimensions will help IT leaders avoid these issues when defining an IT strategy for an application portfolio:
- Know business expectations, such as changing regulatory requirements, changing business models and reporting requirements
- Understand IT expectations, for example, the need for rapid application development, 'build vs. buy' for infrastructure, standardization, customization and life-cycle management • Account for service delivery, which includes training for employees, vendors, testing, networks and security
- Provide for operational requirements, including SLAs and 24x7 application support.
The challenge to find resources for innovation is compounded by the fact that flat or shrinking IT budgets are increasingly consumed by the demands of legacy application portfolios.
Top CIO concerns
Josephine Molle, a service delivery executive with CSC, says, "CIOs are admitting that the level of application duplication is moderate to too much, and we often see in the field that many applications are underutilized."
"Keeping your application inventory current is one way to begin to address this, and it sounds easy, but it isn't. Especially if you work for a large organization. Regularly performed, that exercise can help you decommission applications that are no longer being used, which creates savings. Tracking software licenses is another important step, to ensure you are not under- or overusing the number of seats for software you license," Molle says. "It's also worth reevaluating whether you have the most appropriate license with vendors for a particular application. A different structure could save money."
Molle adds, "CIOs will also have to grapple with the fact that we're seeing a lot of changes in the EMR [electronic medical record] market. Industry research shows we have more than 1,000 EMR vendors. By the time we reach 2017 and the implementation of Meaningful Use Stage 3, more than half of these vendors will be out of business. Organizations using these vendors will have to potentially re-architect the entire IT estate."
Maintaining the privacy of patient information is another concern and cost for organizations, as the digitization and sharing of protected health information spreads beyond electronic health records. Addy says there are more ways to share data, and potentially lose control of it, than ever before.
"Patients are accessing their health information over a growing number of endpoints like smartphones and tablets. Clinical and healthcare employees use emails and social networks to communicate with colleagues and patients. There are more data points and transmission mediums than we've ever seen before," Addy says.
Tools for the toolbox
To address these vulnerabilities, Addy says organizations should take some definitive steps. "First, a senior executive should be appointed to be responsible for the security of protected health information in the organization. Policies should be established to safeguard patient data. The organization's security plan should also consider all the different endpoints that can access protected health information. Invest in technology that can mask sensitive information — things like encryption, virtualization and authentication."
Cloud computing and as-a-service models can be used to reduce costs. "CIOs want to pay for things such as email storage on an as-you-go basis, and they want a flexible model that can deliver services onsite or in the cloud. Everything as a Service, or XaaS, reduces costs because you're only paying for what you use, moving from a fixed-cost model to a variable-cost model," Molle says.
Molle cautions that without proper management, the as-a-service model can lead to misuse and the growth of shadow IT because these services are easy enough for departments and nontechnical managers to purchase and implement outside the supervision of the formal IT organization. A CIO can minimize these issues, Molle says, by establishing approved vendor lists and helping business units understand the performance vs. cost trade-offs of different providers.
"The best news for CIOs is that these services let technology professionals concentrate on what they do best and are an opportunity for the IT department to redirect the focus to more forward-thinking, strategic initiatives," Molle says.
Organizations aren't the only ones that stand to benefit from these improvements. Molle says patients will reap the benefits as well.
"Informed patients and their families can take a more active role in their care, such as when there are multiple treatment options. Ultimately, that helps level out the use of medical services, resolving underuse and overuse of medical procedures. When patients see multiple providers, for example, sharing their medical records will avoid repetitive procedures and tests," Molle says.
"This is what excites me about being in this field," she says. "This is a ripe area for bringing your own device, and smartphones and tablets are creating new opportunities for mobility in healthcare management. We'll be able to engage patients and families more, which is important in health outcomes. Well-informed patients are more likely to follow their provider's recommendations and can communicate information to their providers. That aids physicians in their diagnoses and care planning."