iHT2: Use creative IT for Lean initiatives

Health IT can help organizations apply the Lean process-improvement strategy, but it might take some creativity, according to a new report from the Institute for Health Technology Transformation (iHT2).

EHRs don't provide most of the necessary tools, and there are few off-the-shelf applications available to support Lean, says the report. Most organizations have to devise workarounds--but it doesn't have to be expensive. In some cases, cloud computing can step in to support your Lean initiatives--it can be a great way to do ICD-10 testing, for instance.

The report is chock-full of ways organizations have used Lean to improve processes to boost the efficiency and quality of care. One suggestion is to start by identifying who your customers are and how the processes you use add value. That might not be as simple as it sounds, the report points out. At a hospital, doctors might be important customers because they bring in business. Nurses, might be, too, because they provide most of the care. Improving processes that make these workers' lives easier, however, could benefit the end customer--the patient--in myriad ways.

A key to making Lean improvements is to allow--even to make it "safe"--for front-line workers to chime in suggested improvements.

"If you work on creating value for everyone in the system, the end customer generally benefits from that," says John Toussaint, M.D., CEO of Thedacare Center for Healthcare Value, in the report.

Among the examples:

  • Measuring time spent on handoff between processes can speed up a former black hole. Some EHRs have "time stamp" capability that can document when a patient checked in and checked out, so team can focus on ways to make that more efficient.
  • Sumter Family Health Center built a feature into the EHR so that front-office staff could check patients' insurance eligibility while on the phone to make appointments. By making calls to pre-register patients, check-in time to see a doctor dropped from 30 minutes to 10 minutes.
  • Thedacare adopted a peer-to-peer system that can create patient-centric views of data in native applications without aggregating it in a central repository. The organization's data analysts then began to build reporting tools that the front-line managers can use like apps on an iPhone.

Toussaint said it reworked the systems it had, rather than using a rip-and-replace strategy, and has found getting data to front-line managers in as near to real time as possible has been less expensive than hiring more analysts.

FierceHealthcare reported previously that by applying Lean principles, Thedacare saw costs drop 20 percent and the number of "excellent" patient satisfaction ratings jump from 68 percent 95 percent.

Relationship-building is a key skill for leaders involved in Lean efforts, especially with doctors. For them, make it all about improving care rather than cost-cutting, experts suggest.

To learn more:
- find the report (registration required)


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