By David Christianson / Special to Healthcare Facilities Today

It’s a new day for IT in ambulatory care in part due to government healthcare quality initiatives and the trend from fee-for-service to value-based reimbursement contracts.  

Technology-driven healthcare innovations are emerging at a rapid pace to address quality initiatives and to support reimbursement models using EHR (electronic healthcare records).  

For instance, changes to provider reimbursement models require changes to EHR platforms, which can often necessitate IT changes – network infrastructure optimization, hosting and datacenter modifications, and new devices – mobile or otherwise – at the edge.  The complexity of these changes and new requirements can often appear overwhelming from an IT perspective. The need to consider workflow and clinical outcomes at every step of the way further complicates IT planning in the ambulatory environment.

The tension between quality care and efficiency

Providers are faced with the unenviable and seemingly impossible task of balancing care for their patients with maintaining efficient and cost-effective operations within individual practices. The overwhelming requirements of reimbursement systems, payer rules and federal, state, and professional compliance have created an environment that can increase the time required to simply run the practice. Providers are increasingly frustrated by the burdens these requirements place on their time.  That frustration is often magnified by the fact that EHR platforms and associated technology does not perform effectually, reducing time spent with patients, and more time devoted to ancillary data and business tasks.

Healthcare IT: Effective, efficient steady state operations

The ultimate goal of any good IT operation is achieving and maintaining steady state operations. All too often, IT organizations get caught up in the challenge and rush of change. Granted, change is a constant in IT; however good IT managers understand the need to define what a “steady state’ looks like for their users and consider what must be done operationally to insulate those users – those clients – from the pain and pitfalls of change.

Striking a balance between managing the patient care and business sides of any medical practice includes equalizing technology use and technology support. The benefits of any number of technologies can be achieved through good planning and effective professional implementation. What is often lost in the planning equation is emphasizing the considerable cost and operational burden of effective IT administration and support.  The ambulatory environment presents unique challenges for many internal healthcare IT organizations. The highly variable size and distributed nature of medical practices — whether owned or affiliated — requires very specific approaches to end user support, network administration and data center operations.

Central help desk/contact centers — whether owned or outsourced — can most effectively accept and triage IT issues. That single point of contact approach to all IT support provides a fundamental ease-of-use benefit for providers who are striving every day to ensure their “face time” with their patients. Having a single point of contact to help facilitate issue resolution of not only IT, but also EHR issues, can save precious time for providers and practice managers.  As in medicine, the rapid triage of IT issues ensures that problems are prioritized and assigned with maximum efficiency. The goal is always to resolve a high percentage of problems remotely, but any support organization has to provide for on-site support when required.  Quick dispatch of those onsite resources is another fundamental requirement for optimal healthcare IT support

Customized solutions for Health IT

Utilizing an outsourced healthcare data center to support an aggregated network of physician practices often proves to be both efficient and cost effective.  EHR platforms are effective only when they are available and performing well. Core IT operations principles apply here: high availability, reliability, security, redundancy and extensibility.    

A quick, secure, and easily scalable healthcare data center solution can really ensure healthcare practices are well supported. For instance, with healthcare's strict data retention policies and increasing demands for high capacity data storage capabilities, having a scalable storage and outsourced data center is good practice. In environments where the central IT organization is hosting EHR, outsourced backup and disaster recovery can provide the necessary capability and flexibility to ensure business continuity and compliance.

Gone are the days of one-size fits all. Ambulatory practices are seeing very quickly a growing need to utilize a variety of healthcare IT services to increase efficiency in the office setting and improve patient satisfaction and outcomes as well as achieve their business objectives in order to thrive. In the event of a possible hardware malfunction, site failure, or event error, maintaining uninterrupted data accessibility is essential. 

IT Resources for an ambulatory setting

With HIE (Health Information Exchange), personal health records need s to be shareable between healthcare providers; such as private practice physicians, home health agencies, hospitals and nursing care facilities.  

This is where a healthcare IT services company can really make a difference. For instance, since EHRs have been widely implemented, medical practices have successfully gone paperless; access to patient data is amazingly convenient when it is working and amazingly inconvenient when it is not.  Unfortunately, IT can become a barrier in an ambulatory setting with patient care.

Providers need to be assured that their computers will work properly.  Providers want to avoid entering an exam room, trying to log in and find that they can’t because the Wi-Fi cuts out.  

They end up spending too much time trying to get what they need on their screens. Mobility in particular presents a whole range of IT challenges that need to be met before applications are implemented or upgraded.  If core IT infrastructure is inadequate, then the best applications in the world have no hope of being effective. No one likes to hear the four words, "The system is down!" This is usually accompanied by some angry four-letter words that, although may be liberating at the time, unfortunately do very little to solve the problem.  

Struggling with administrative responsibilities diverts a lot of time away from patient care and then there is the insurmountable amount of data entry that needs to happen to get reimbursement for healthcare services.  Doctors are overworked and we now all too often hear the term “pajama time.” Providers are spending too much time after hours – after the patients have left the practice – to complete the administrative tasks associated with EHR, payment requirements, etc.   

In conclusion

With the rapid evolution in healthcare technology, healthcare organizations are stressed in trying to stay on top of the constant progression of technology.  Utilizing a healthcare IT services firm provides flexibility, efficiency and effectiveness, particularly in the ambulatory environment. It allows you to choose the services you need to complement, supplement, or supplant what your organization’s IT staff does.  

The concentrated focus that an experienced and expert IT solution provider can bring to the table can help healthcare IT organizations meet the technology and business challenges in ambulatory care, provide superior support to providers and contribute to a higher quality of patient care.

David Christianson is the Senior Vice President for Versatile Healthcare Solutions.