2 TABLE OF CONTENTS CURRENT SCENARIO 2 NEED OF CARE PROVIDERS 3 IT Rx FOR IMPROVED PATIENT CARE FROM HCL 3 BENEFITS 5 CONCLUSION 6 AUTHOR 6 ABOUT HCL 7 Current Scenario Care provider organizations have been using Information Technology to capture patient information, with little success on putting them to effective use. Information Analytics and decision enabling capabilities of these existing systems are limited. This is evident from the reality that, despite all the technology solutions available, too many patients are being injured or killed by preventable medical errors and adverse events 1. We believe this can be brought down through creative IT solutions that can address the three V s of provider space 2, thereby achieving effective and predictable care delivery outcomes. With our provider IT experience along with practitioners analyzed the situation and found the immediate need to prevent medical errors and adverse events. 1 The Institute of Medicine has estimated that 45,000 to 98,000 deaths occur each year due to medical errors. Source URL: http://www.hhs.gov/news/press/2004pres/20040721.html accessed on March 20, 2010 2 Variability of patient population, Variations of patient conditions and Variances in practice
3 Need of Care Providers To improve care delivery effectiveness, hospitals need a solution that can identify a problem before it impacts patient health. Currently they face challenges of identifying problems (like adverse events, complications etc.) after it has already damaged the patient condition. They don t have a solution that delivers most needed information at the point of care the moment when real world variances in decision making that often require rapid, yet crucial collaborative sets of clinical information and actions to drive the outcomes call it as the undiscovered decision gap. The effectiveness of these decisions and actions often fixes problems before they become issues of patient care. Physicians need a solution that will enable care management in the NOW world, while patient is still in hospital We re-affirmed our belief that technology can help achieve a safer healthcare environment, if designed and adopted in the right context through our interactions with hospitals and other care providers. Our assessment reveals that care provider organizations will be able to considerably reduce preventable medical errors and adverse events by around 40 % through information delivery at the right time. This is further increased when appropriate clinical actions are undertaken, when directed by the solution. IT Rx for improved patient care from HCL With deep healthcare provider IT experience, we have designed an application product that can be plugged into the existing landscape to drive the organizations for better care delivery. Our solution improves the quality of care with adequate recognition of process variability, patient variations and practice variances that are in vogue. We have designed this product; with the issues faced by healthcare organizations, like confronting emerging trends and risks that threaten their reputation in the care delivery space. There is no point in having an Electronic Medical Record application, if it cannot be used to provide enhanced patient care outcomes, both qualitatively and quantitatively on a continuous basis
4 Our continuous care delivery enhancement product concept is as shown in the diagram below: Our product at a broad level will consist of the following: Gateway application component to extract/ abstract patient data, Clinical Rules engine for real-time monitoring of care delivery, Alert repositories engine for communicating with care givers about clinical events and triggers, and Data marts, data warehouse and dashboards. Clinical Gateway component is a sniffer application to abstract incremental patient data from all the applicable disparate clinical information systems landscape. Upon abstraction, the gateway will change the data to form understandable by the product and send it to the rule engine for further processing. This is a customizable component that can be tweaked to be plugged into existing landscape. Clinical Rules Engine consists of rules repository that works on patient data received to continuously monitor patients of interest. These clinical rules are designed by care providers and are completely configurable as per the organization objectives. Based on the care delivery algorithms, clinical rules engine analyzes the patient data, looks for exceptions and initiates necessary notifications, escalations to responsible care providers for suitable actions. Clinical Rule Engine performs the responsibility of notifying the care provider of possible medical errors, before the event and receives responses from them. As part of the response, it allows the care provider to edit the patient data on need basis. Notifications Repository stores all the notifications, initiated by the clinical rule engine. This works hand-in-glove with the clinical rules engine. This component facilitates improved clinical outcomes, through
5 unified communications with the end users, including secure health messages. Processed Data Repository stores edited data by the care providers, and comes with a viewer. Data marts store the complete information related to patients in the hospital for generation of reports and dashboards. The data is used for analyses of responses for refining the rules on an ongoing basis. Data Warehouse stores all patient data for predictive analytics to facilitate clinical rules revision Dashboards and Reports application component provides dashboards and reports suggested by Joint Commission, meaningful use of EMRs and any measures derived from them. It provides reports based on predictive analytics that can be used by care providers to refine the clinical rules. These dashboards and reports are configurable with features for additional dashboards through cubes The product line solution is uniquely architected for usage by care delivery organizations falling under the all the seven stages of EMR Adoption Model by HIMSS. The solution is designed to optimally manage and reduce excessive artificial variability in care delivery processes. Benefits The product solution is uniquely architected to address care delivery enhancement on an ongoing continuous basis. The benefits care providers gain is as shown below Continuous patient monitoring through incremental data abstraction Provides on-time notifications, escalations to responsible care providers to prevent medical errors, as needed by hospitals Enables action when the patient is still in the hospital At the Point of Care Facilitates needed care delivery management in the NOW world Allows care providers to input processes for enhanced compliance and performance Allows users to define measures and processes of their choice. Need based configurable data life cycle model, resulting in minimum overheads
6 Conclusion Healthcare providers need an IT solution to put patient data into meaningful and effective use to enhance patient outcomes. IT has been primarily for capturing data related to patients, and the effectiveness of converting data into information is minimal. Multifold enhancement of care delivery is possible with the right use of IT to deliver the right information to right care provider at right time. Shift in provider preferences is continuous based on changing patient demands and mandatory requirements. Most of the IT solutions available in the market are rigid and provide minimal flexibility to address the changing requirements of care delivery. HCL s product solution is carefully crafted to make it possible for any provider to be able to effectively manage their own performance compliance efforts. Author Aru Sudalaimuthu is consultant Healthcare Practice at HCL Technologies. Aru is a healthcare solution designer and has 20 years of experience. He is responsible for development of intellectual property and methodologies to support provider health care organizations. Aru is responsible for providing leadership and guidance to clients wanting to undertake changes in healthcare process and technology improvement.
7 About HCL HCL Technologies HCL Technologies is a leading global IT services company, working with clients in the areas that impact and redefine the core of their businesses. Since its inception into the global landscape after its IPO in 1999, HCL focuses on transformational outsourcing, underlined by innovation and value creation, and offers integrated portfolio of services including software-led IT solutions, remote infrastructure management, engineering and R&D services and BPO. HCL leverages its extensive global offshore infrastructure and network of offices in 26 countries to provide holistic, multiservice delivery in key industry verticals including Financial Services, Manufacturing, Consumer Services, Public Services and Healthcare. HCL takes pride in its philosophy of Employee First which empowers our 55,688 transformers to create a real value for the customers. HCL Technologies, along with its subsidiaries, had consolidated revenues of US$ 2.5 billion (Rs. 11,833 crores), as on 31st December 2009 (on LTM basis). For more information, please visit www.hcltech.com About HCL Enterprise HCL is a $5 billion leading global technology and IT enterprise comprising two companies listed in India - HCL Technologies and HCL Infosystems. Founded in 1976, HCL is one of India s original IT garage start-ups. A pioneer of modern computing, HCL is a global transformational enterprise today. Its range of offerings includes product engineering, custom & package applications, BPO, IT infrastructure services, IT hardware, systems integration, and distribution of information and communications technology (ICT) products across a wide range of focused industry verticals. The HCL team consists of over 62,000 professionals of diverse nationalities, who operate from 26 countries including over 500 points of presence in India. HCL has partnerships with several leading Global 1000 firms, including leading IT and Technology firms. For more information, please visit www.hcl.in