Health Modernization: Core IT Must Keep Up with Clinical Innovation

Government health services are evolving to provide a continuum of care, which means agencies such as the Veterans Health Administration and Defense Health Agency are rethinking how to deliver a broader range of capabilities. New tools and electronic health record systems promise to improve access to services, speed and quality of care for active-duty warfighters and veterans, but those advances depend on a core IT foundation that must be updated at the same pace as clinical technologies. To ensure that those new patient- and provider-facing capabilities can fulfill their potential, agencies must modernize those back-end platforms, which presents significant challenges as many core systems are built on embedded legacy components.

Bridging this gap can eliminate cost duplication and data sharing issues through IT consolidation and standardization across the military health care ecosystem. Yet it’s equally critical to empower patient-facing treatment facilities with the flexibility and innovation required to serve their unique patient populations most effectively. Perhaps most importantly, changes and upgrades should map to the end user’s journey; that is, ensuring every step provides an easier, smarter, more effective experience, all leading to improved patient outcomes.

Three Essential Stages to Health IT Transformation

The path to coordinating improvements for both clinical and core IT can be viewed as three, interdependent phases:

• Rationalization
• Accountability
• Performance

Each stage offers opportunities for transformative thinking: new approaches to the processes, platforms and skill sets that will drive better outcomes and greater flexibility down the road.

Rationalization: Audit Existing Inventory 

With so many technologies in place across the military health system—along with a range of cultures, capabilities and patient needs—a long-term solution has to start with knowing where things stand today. 

This phase begins by auditing existing and planned/in-process systems to attain a full understanding of the current environment, then mapping planned or desired clinical systems to the core IT back-end needed to support them. This gives decision-makers the proper context to prioritize technology upgrades and set milestones. It also identifies areas that may require a complete rethinking of how health care can be effectively delivered across all providers.

Accountability: Assign Centralized Ownership 

Ensuring that advances to clinical systems are built in tandem with the needed back-end capabilities requires authority and responsibility. While the ultimate authority may be someone at the senior leadership level, the process and the outcomes will likely be supported by teams of stakeholders. They’ll need both the responsibility and authority to effectively manage the potentially huge array of moving parts.

A key factor will be coordinating technology and services solutions providers to measure performance, avoid redundancy and maximize efficiency. The sheer number of potential suppliers also creates a risk, potentially resulting in dozens of point solutions that don’t integrate properly. A master systems integrator can oversee the work of all technology and service providers, keeping everyone coordinated and avoiding unintended consequences.

Performance: Execute Across People, Process & Tech 

Change is difficult. It’s unsettling. But it can also be empowering, setting people and organizations on paths that upend the status quo and stand up something better in its place. 

To support the patient journey effectively, three factors need to be considered, starting with process and policy; all changes need to maintain fidelity with the business need while moving toward a fully digital environment. This frequently means new workflows and revised governance consistent with transformation objectives. 

Second, technology, of course, plays a crucial role. Modernization goals must be met, security and privacy must be maintained, and data access and sharing, especially in support of the Defense Department Data Strategy, must be made simpler, faster and more comprehensive.

Finally, change management must be integral to the process from the outset. Because multiple agencies are involved, a collaborative approach is needed to determine how every organization and every system will interact. This will also be reflected in training to use and support new systems, and in the culture shifts that need to happen within and across organizations.

While advances in clinical tools can greatly improve care delivery, it’s vital that core IT systems are modernized to be able to deliver on the promise of that patient-facing innovation. Bridging the gap starts with understanding your environment and the need, in order to enable the future state. 

But modernization is more than just technological change; it’s a mindset that addresses systemic change. It’s essential to standardize and centralize IT systems for effectiveness and cost-efficiencies, while also recognizing and respecting local care delivery and the needs of patients.

The key to success is to always work backward from the ultimate mission goal: a higher quality of service to warfighters, veterans and citizens. For military health organizations, this helps all stakeholders understand roles and responsibilities while ensuring a seamless continuum of care.

Diana Ceban is a vice president of federal health at SAIC.