By David Rosenbaum
In the midst of the furious debate in the United States over the government’s role in healthcare, an equally critical and no less passionate examination of clinical practices is underway. This intense scrutiny is driven in part by the healthcare provisions of the American Recovery and Reinvestment Act of 2009 (ARRA), known as the stimulus bill in the U.S., which to a great extent promotes the power of digitization to increase access, lower costs, and improve quality of care.
As Paul Keckley, executive director of the Deloitte Center for Health Solutions, notes, the stimulus bill set aside US$19 billion for medical technology—but not without some requirements. Keckley points out that Medicare, an existing U.S. government health program, will reduce payments to providers that don’t deploy electronic health records (EHRs) by 2015. This is both a carrot and a stick to lower costs by reducing paper-based manual processes, drive change, and ensure that IT is broadly deployed to reduce medical errors, keep patients healthier, and improve medical outcomes.
For those unwilling to wait five years for examples of forward-thinking healthcare IT, the University of Texas M.D. Anderson Cancer Center in Houston, Texas, is already serving as a model. M.D. Anderson has consistently ranked among the nation’s top cancer hospitals— U.S. News & World Report’s “America’s Best Hospitals” has placed the center at the top of its list of the best cancer hospitals for four of the past six years. Not coincidentally, over the past decade M.D. Anderson executives have been transforming the IT infrastructure that supports clinical and business processes. The goal, explains M.D. Anderson Senior Vice President for Business Affairs Dan Fontaine, is nothing less than to eradicate cancer in Texas, the nation, and the world. “That’s the reason we live and breathe,” Fontaine says.
|University of Texas M.D. Anderson Cancer Center
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A Prescription for the Future
M.D. Anderson’s IT strategy hasn’t always been so strategic. As is the case with many healthcare institutions, the center’s infrastructure evolved, as Fontaine puts it, “as a bunch of kiosks” for managing enterprise resources—with financials on one platform, human resources on another, and scheduling and billing on still another. According to Fontaine, M.D. Anderson followed this spot-solution approach until it became obvious that the money spent on infrastructure support and interface development was probably unsustainable.
Recognizing the need for a more structured, orchestrated approach to IT strategy—and a better way to manage resources—M.D. Anderson developed a customer-oriented but centralized governance structure for making ground-up IT decisions. “This centralized governance,” Fontaine explains, “started moving us down the road to an ERP [enterprise resource planning] system.”
According to Fontaine, M.D. Anderson approached three companies in its search for a partner to assist in rationalizing its IT infrastructure. Although technological expertise was important, it wasn’t the only thing the center was looking for. “We said, ‘We don’t want to discuss system installation or software; we’re not interested in building the world’s best ERP system for its own sake; we need to be able to visit with your top healthcare people and learn what your strategic initiatives are,’” Fontaine recalls.
Fontaine learned that M.D. Anderson’s goals for primary business applications were aligned with Oracle’s. Healthcare is a strategic imperative for the software maker, and an area of critical importance to the worldwide economy. Fontaine was convinced that Oracle was willing—either through acquisition or new software development—to meet the long-term business application needs of healthcare enterprises. These needs reflected major changes in the way these enterprises operate. Business applications for healthcare enterprises mirrored the same need for data-driven decision support that is seen on the clinical application side of healthcare (see “Genomics and the Digitization of Cancer Care”).
“What we heard from Oracle was a passion for being in this space,” says Fontaine, “And we heard a level of sophistication about what was going on in healthcare in the world.”
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