Many health centers, in one way or another, use computers. In the most basic cases, they are used for standard (routine) administrative tasks; e-mail, website, communication. Some implement them more extensively in their daily tasks and patient care, but without adopting them completely.
Most medical equipment manufactured in the last 20 years incorporates or is based on computers. To offer an appropriate approach, this post describes the economic benefits of using standard computers and specialized software in a wide variety of activities carried out in document processes or by people.
Health IT consists of a variety of systems such as
- Hospital administration: such as billing, word processing, web portal and email.
- Clinical administration: Systems that provide appointment scheduling, reminders, patient admissions, insurance information, institutional and medical equipment management systems.
- Direct clinical support: Prescriptions, medication administration, image storage and retrieval, and laboratory tests.
- More ‘advanced’ systems: Electronic medical records, semi-automated drug administration, real-time location systems, decision support systems, provider point-of-care access and multiple system interoperability.
Everyone works to support patient care; sometimes in the most cost-effective way.
In general, the most cost-effective benefits of IT systems are indirect. There is no direct increase in reimbursements, except in the reduction of billing errors. Most of these come from decreased costs per patient. Some of these decreases are immediate, while most are cumulative over time.
Additionally, there are more benefits in systems that serve chronic patients. Some examples in the United States are the Veterans Administration (VA) health care system and Kaiser Permanente.
Both track patients for decades, so the investment has a better chance of cost recovery. In the private sector, especially in large urban areas, patients have many hospitals to choose from.
This benefits them, as they can choose a hospital that is excellent in a particular specialty, such as Cardiology or Orthopaedics. However, these institutions may only treat the individual for a particular procedure and never see them again.
In these health centers without effective mechanisms to share information when they need it, there is no efficiency seen. In addition, the immediate benefits may not be apparent, especially after a large investment to introduce IT. They also depend on the mission of the hospital. If they are part of a large system, hospitals gain economic benefits much sooner.
In a study by the United States Congressional Budget Office, a large number of integrated health systems have seen improvements in efficiency and quality of care. However, the study also mentions that independent hospitals are unlikely to see immediate benefits.
It is not that there are no immediate benefits, but that they are more evident in the long term than in the short term, usually appearing two or three years later. The activity of independent doctors may also show no economic benefit due to the high cost of purchasing and implementing the systems.
In the short term: Better communication of patient information, allowing care providers and specialists to immediately obtain all relevant patient information. This minimizes delays in decision making and clinical inaccuracies. Other gains include reductions in duplicate high-cost exams (X-rays, MRIs, etc.), medication errors, billing difficulties, and transcription expenses; as well as avoiding unnecessary testing costs.
In the long term: Reduced admissions (important for hospitals with annual funding), reduced costs of treating immuno-preventable diseases through early detection, and reduced costs of treating immuno-preventable diseases; as well as improved inefficiencies through better information.
Real-time Locating Systems (SLTR)
Over the past decade, SLTR systems have been implemented in numerous hospitals. Although they are expensive (average US$9.00 per square meter), they have shown immediate return on investment in a few areas. Two of these are the use of equipment and the reduction of waste of clinical consumables.
The Texoma Medical Center in Denison, Texas, USA, struggled to find portable medical equipment such as sequential compression devices, PCA Pumps, feeding pumps, and wound vacuum pumps. Frequently, staff spent 20-30 minutes to find only one piece of equipment. Additionally, some of these had been accidentally thrown away and lost. They decided to install an SLTR to help solve this problem.
The SLTR is a combination of passive tracking, such as that used in grocery stores to reduce theft, and active tracking, which constantly updates the location of items on a central computer.
The medical center saw immediate benefits. The recovery time for the equipment was reduced to five minutes per device, saving many staff costs and increasing worker productivity. A personal observation: this probably also greatly increased worker satisfaction.
I’ve spent time tracking down lost equipment; it’s a little more frustrating than trying to figure out where the item is, especially when you don’t want to. A direct economic benefit was the decrease in costs for the purchase and rental of equipment. The hospital eliminated $88,000 in PCA pump purchases, as well as $3,000 per month in equipment rentals.