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Health IT Projects – High Value, High Risk


Health IT is a category of technology that is evolving and growing at an exponential pace. Allowing organizations developing Health IT solutions to positively benefit our lives and their bottom lines. There are not too many areas of technology that can potentially extend, enhance and empower our lives, the way Health IT can. With amazing opportunity comes many risks as these solutions collect, store, process, analyze and deliver output leveraging very personal data. These risks highlight the need for organizations and project managers leading Health IT projects to ensure they foster an environment that balances security and privacy of often personal data, without stifling innovation as they deliver groundbreaking solutions and advancements.


Health IT

What is Health IT?

Health IT or Health Information Technology is a classification or category of technology focused on the delivery of solutions that leverage, process and yield health related information. The usage, products and services are very diverse and often interconnected. The goals and outcomes of Health IT can include better cost control, lower insurance costs, error reduction, more efficient service delivery, streamlined communication, trend identification, surveillance, new treatments and self-management.

Health IT is all around us and its many individual technologies often converge, influence and have a direct relationship to one another. A few highlighted focus areas of Health IT include:

  • Technology Infrastructure

  • Personal Medical Devices

  • Cost Efficiency

  • Research

  • Treatment and Prevention

Technology Infrastructure

The driver of many Health IT projects is the underlying Technology infrastructure. Technology Infrastructure related projects can and do touch and influence almost all other areas of Health IT, including personal medical devices, cost efficiency, research, treatment, service delivery and wellness strategies. Technology Infrastructure comprises the systems, technology and processes that drive Health IT solutions or in health terms the heart, brain, nerves and blood vessels that allow us to function and live as we do.

Technology Infrastructure innovation is often driven by a combination of database technology, hardware performance, interoperability and communication between systems and devices.

Drilling further down into many Health IT solutions we find the Electronic Health Record (EHR), an electronic record of patient health information generated by care and service providers. It often contains very personal and private information including age, weight, race, progress notes, behaviors, complaints, medications, pictures, medical history, immunizations, tests, laboratory data, radiology reports, diagnosis, treatments and outcomes. In addition to EHR's there are related records including financial, claims, credit, insurance, payment history, employment, Personal Health Records (PHR), which is a patient’s own self maintained record and input from a myriad of personal devices.

This interrelated and highly personal information can be very useful as technology and data sources come together and are linked up and collect, store, feed and communicate with each other. This convergence creates amazing new opportunity along with risks due to the many exposure points.

Big Data is becoming a big player in Health IT, as the valuable medical data gathered from EHRs, PHRs and other sources are consolidated. Big Data is the term applied to data collections that are so large they require new, advanced and evolving data processing tools, applications and consideration to find, collect, store, secure, clean, manipulate, query, interpret, extract, share or access data (1). The insights gleaned from leveraging Big Data technologies and electronic heath records can generate significant savings for organizations. It has been reported that Kaiser Permanente’s, HealthConnect system, designed to promote the use of electronic health records across all medical facilities, has improved outcomes in cardiovascular disease and saved an estimated $1 billion (2).

Another triumph in part attributed to Technology Infrastructure is the speed and efficiency we have in sequencing the human genome. The first sequencing of the human genome was completed in about 13 years and cost several billions of dollars. A decade later that time was reduced to about 26 hours at a cost of approximately the cost of a few thousand dollars. This important innovation has created major advancements in the treatment and identification of many diseases and medical conditions including lifesaving improvements for the identification and treatment for critically ill infants with undiagnosed illnesses (3) (4) (5).

Personal Medical Devices

Personal Medical Devices are all around us these days providing us with portable or mobile access to immediate information and tools to manage and monitor many health related functions. These devices include wearables, where by glancing at a watch or phone we can monitor any number of vital statistics including heart rate, heart rhythm, breathing, temperature, glucose level, blood pressure, activity and sleep. There are also specialized wearable devices and sensors that can automate the monitoring and delivery of medications. The engraining of Internet of Things (IoT) into our daily lives is also helping speed the impact of Personal Medical Devices as communication and information sharing become common or even expected. The Internet of Things is in its simplest form the connectivity of a sensor or device to other devices via the internet.

Hexoskin, a wearable biometric shirt has sensors woven into the fabric for measuring your heart rate, pace, breathing rate and volume, steps taken, calories burned and sleep. This data then can be saved and transmitted to a mobile app or viewed through an online dashboard. The Computer Electronic Show in Las Vegas highlights many new and innovative Health IT devices (6) and ApplySci, an organization that educates, promotes and nurtures companies developing new wearable and digital health technology, sponsors conferences and collaboration worldwide focused on this category of Health IT (7).

Cost Efficiency

Individual healthcare practitioners, hospitals, insurance companies, government and consumers all have a desire to deliver and receive health related services in an efficient and cost effective manner. Healthcare is a big business. Aetna reports that total health care spending in the United States is expected to reach $4.8 trillion in 2021, up from $2.6 trillion in 2010 (8). Healthcare IT provides a vehicle to help contain and control costs without sacrificing patient care and service delivery.

IBM, recently purchased Truven Health Analytics in order to enhance the growth of its Watson Health business. IBM now will have data on the cost and treatment of more than 300 million patient’s lives. The plan is to leverage the patient data and Watson’s artificial intelligence software to assistant physicians and health providers to increase efficiency and decrease costs (9).

Many health care providers have found that electronic health records (EHRs) help improve medical practice management by increasing practice efficiencies and cost savings.

HealthIT.gov published the following statistics related to Health IT (10):

  • 79% of providers report that with an EHR, their practice functions more efficiently

  • 82% report that sending prescriptions electronically (e-prescribing) saves time

  • 68% of providers see their EHR as an asset with recruiting physicians

  • 75% receive lab results faster

  • 70% report enhances in data confidentiality

Research

Health related research drives new identification of treatment, prevention and cures. Heath IT plays a significant role as data and technology allow researchers the access and ability to analyze and test hypotheses with new methods, thereby increasing accuracy and speed with which research is peer reviewed and shared.

Funded in part by the Bill & Melinda Gates Foundation and the National Institutes of Health, the researchers at the University of Pittsburgh Graduate School of Public Health developed a database of reportable disease surveillance reports dating back to 1888. Project Tycho, as it is called, is a comprehensive database provided at no charge to researchers all over the world to study and understand, hopefully prevent or mitigate public health outbreaks. (11) (12).

Treatment and Prevention

Vast amounts of data can now be studied and analyzed in ways with efficiency and speed never imagined a decade earlier. This has led to the treatment and prevention of many diseases and medical conditions. Health IT plays an integral part in this equation.

St. Mark’s Family Medicine, an independent practice and residency clinic in Salt Lake City, Utah uses technology to monitor changes in patients’ clinical markers. It stores and analyzes hemoglobin A1C, blood pressure, and cholesterol measures for their diabetes patients, looking for changes that need to be addressed. Leveraging a data driven analytics tool, not only alerts care givers to any changes in monitored markers, but also provides preventive care reminders for all related services, including those for routine eye exams and laboratory testing. The system has helped St. Mark’s significantly improve patient outcomes for patients with diabetes (13).

Project Management Is Not Optional

If you are an organization executing Health IT projects or a Health IT project manager this is a great time to be a part of a transformative industry that can play a positive role in the lives of many. Organizational governance, control and support coupled with sound project management practices can help mitigate risks and help deliver new and life changing Health IT solutions.

There are also a few additional important suggestions, specifically for Health IT projects that may help you reach your project goals.

Plan for Risk

With great opportunity comes high levels of risk. At the top of the list is ensuring that security and privacy are fully accounted and planned for. Health IT projects are oftendata heavy with very personal and private data.

Security and privacy on Health IT projects aren't optional. In addition to organizational controls and procedures, it is often mandated by rules, regulation and guidelines. In the United States, HIPAA or The Health Insurance Portability and Accountability Act of 1996 (HIPAA) provides regulations protecting the privacy and security of certain health information (14). Closely related is the Health Information Technology for Economic and Clinical Health Act (HITECH) which establishes programs to increase and improve health care quality, safety, and efficiency through the advancement of Health IT. It also covers privacy and security related to the electronic transmission of health information, bolstering the civil and criminal enforcement of HIPAA rules (15).

Understand what rules, regulations and guidelines are required for your Health IT project. Communicate and confirm that all team members understand the policies and procedures regarding security and privacy. Actively manage security and privacy throughout a project and develop a plan to respond to any breaches or violation.

Know Your Team

Health IT projects often involve many non-technology focused people who may have little experience working on a technology project. They also may have other job obligations outside of the project they need to balance.

Early in the project lifecycle, identify and learn the goals, knowledge, experience and commitment for all team members, stakeholders and sponsors. Incorporate what you learn into your plans and management strategy and address any areas that may come into conflict. Holding a team project kick off meeting to cover project details, processes and procedures and set expectations is an important part of project onboarding.

Plan for Change

Health IT projects are often breaking new ground. Expect requirements, assumptions and staff to change. Developing sound plans at the start of the project on how the organization and project will assess, review and react to change, will make it easier to adjust and manage when change does occur.

Quality

While quality is important in every project, Heath IT projects can impact the care, treatment and lives of the end user. To manage quality, it is important to have a clear understanding of the project goals, scope and requirements and a detailed plan to manage quality.

Health IT projects may require specific testing, certification and documentation that other project types do not. During the planning of a Health IT project ensure that all quality and testing plans are in compliance with any applicable rules, regulations and certifications, that the right experts will be validating or certifying results and there are checks and balances to ensure compliance as the project progresses and at project completion.

Conclusion

Health IT is an exciting and important new segment of the healthcare and technology landscape. Innovation continues to evolve at a rapid pace with each technological advance. Organizations and Project Managers are challenged with balancing this growth while ensuring the security of highly personal medical information. Leveraging solid project and data management practices will allow organizations and project managers to meet this challenge.

References and Citations:

  1. Rock Pine Partners Website and LinkedIn Pulse, Managing Big Data Projects For Success, Gregory J Valyou, 1/22/2015, http://www.rockpinepartners.com/#!Managing-Big-Data-Projects-for-Success/crei/56a691e00cf2cede5a4eb5f5

  2. McKinsey and Company, The big-data revolution in US health care: Accelerating value and innovation, Basel Kayyali, David Knott, and Steve Van Kuiken, 4/2013, http://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/the-big-data-revolution-in-us-health-care

  3. Popular science, We Can Now Sequence A Whole Human Genome In 26 Hours, Claire Maldarelli, 9/30/2015, http://www.popsci.com/scientists-can-now-sequence-whole-genome-in-26-hours

  4. National Human Genome Research Institute Website, 2/22/2016, https://www.genome.gov/10001177

  5. Live Science Website, Human Genome Project Marks 10th Anniversary, Tanya Lewis, 4/14/2013, http://www.livescience.com/28708-human-genome-project-anniversary.html

  6. Information Week, 10 Healthcare Wearables, Devices Dominating CES, Kelly Sheridan, 1/7/2016, http://www.informationweek.com/healthcare/mobile-and-wireless/10-healthcare-wearables-devices-dominating-ces/d/d-id/1323787?image_number=6

  7. Wearable and Digital Health Conference, San Francisco, California Website, 2/22/2016 http://digitalhealthsf.com/

  8. Aetna Website, 2/22/2016, http://www.aetna.com/health-reform-connection/aetnas-vision/facts-about-costs.html

  9. Bloomberg, IBM Buying Truven for $2.6 Billion to Amass More Health Data, Jig Cao, 2/18/2016, http://www.bloomberg.com/news/articles/2016-02-18/ibm-to-acquire-truven-health-analytics-for-2-6-billion

  10. HealthIT.gov website, 2/22/2016, https://www.healthit.gov/providers-professionals/medical-practice-efficiencies-cost-savings

  11. Becker’s Health IT & CIO Review, University of Pittsburgh Researchers Digitize Public Health Records to Improve Public Health, Helen Gregg, 12/3/2013, http://www.beckershospitalreview.com/healthcare-information-technology/university-of-pittsburgh-researchers-digitize-public-health-records-to-improve-public-health.html

  12. University of Pittsburgh, Project Tycho Website, 2/22/2016, http://www.tycho.pitt.edu/

  13. HealthIT.gov website, 2/22/2016, https://www.healthit.gov/providers-professionals/dr-berneike%E2%80%99s-clinic-meets-diabetes-treatment-goals-health-it

  14. U.S. Department of Health & Human Services -HIPAA Website, 2/22/2016, http://www.hhs.gov/hipaa/

  15. HealthIT.gov website, 2/22/2016, https://www.healthit.gov/policy-researchers-implementers/health-it-legislation-and-regulations

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