• Personal health records (PHRs) are quickly becoming an important method of ensuring that an individual has easy and comprehensive access to all of his/her healthcare information.  I feel like, if used correctly,  PHRs can help transform the healthcare industry by providing people with the information they need to know to help prevent and/or manage diseases throughout their lifetime.  If you have any questions about the potential of PHRs for your organization and your patients, you will find this study (click here) from the Robert Wood Johnson Foundation to be very informative.

• This website (click here) from AHRQ will be very helpful for any organization that is involved in health information technology (HIT) projects.  It has articles on a full range of IT topics, and can help you from the evaluation of projects to ensuring a successful adoption of IT systems in your organizations.

Successful Information Technology must ADAPT to people’s needs

All healthcare professionals know that technology is evolving at a lightning-fast pace.  Why, then, do so many healthcare organizations find it difficult to implement the latest and greatest in healthcare Information Technology?  The reason is simple – technology advances only as quickly as people in an organization will allow.  If those people see no personal benefit from the innovation, the technology will not advance.

In organizations where technology has advanced, it happened because it followed a step-by-step path where technology slowly built upon itself, adding value to users and addressing opportunities created by the previous step.  An interesting observation is that the same predictable, repeatable path has been followed by many organizations from all industries.  Understanding this common evolutionary path, and where your organization currently fits in it, is a critical aspect of building a technology strategy to support your business.

The ADAPT Model

The ADAPT model of technology evolution describes five distinct stages that organizations experience while adopting new technology. The stages are:

• Adhoc
• Data Silos
• Analysis/Decisioning
• Partnerships
• Transformation

This model was created by the authors to help organizational leaders understand the important connection between staff motivation and technology evolution. If taken into account while prioritizing and planning IT initiatives, the model can greatly improve an organization’s success when adopting new technology.

Adhoc

The Adhoc phase of healthcare technology is where many organizations find themselves today.  At this stage, individual staff are starting to realize that they can use technology to be more efficient. They utilize existing office productivity tools to build anything that can help them. Staff begin using Word documents, spreadsheets, and even Word spreadsheets to capture information about consumers, appointments, medications, and anything else they need to remember.

At this stage, there is no clear path for adoption of technology and no concerted effort to build systems to support the business.  This is a necessary phase for an organization as the experience will lead them down a path of creating a technology plan while recognizing the value in pulling data together in a more accessible, stable, less error-prone manner.

Data Silos

The next phase in the evolution of healthcare information technology is the creation of systems to aggregate data that is being collected in each department.  Information is shared within the department so that it is entered only once, users with appropriate permissions can see the same view of the data, work can be backed up for easy recovery, and the tools match the department’s individualized workflow.

This step is key in developing a culture that thinks of leveraging economies of scale by eliminating redundancy within departments. People begin to see technology as a way to work more efficiently and collaboratively.  They get a sense of the tremendous insight that can be gained by looking more closely at the data and begin to expect more visibility into IT systems.

Analysis/Decisioning

After data has been aggregated into silos and is collected for some time, there is a realization that key performance indicators can be compiled via dashboards, reports, and additional system enhancements. This can be a daunting and overwhelming experience, especially for staff that have a long history in the organization and have certain mental models about how the data should “look”. Reporting solutions and business intelligence services are critical to presenting the data to all staff in accurate, meaningful ways.

There is a high degree of ambiguity in this phase, and it is important to have experienced “data mining” staff who can analyze volumes of data and extract information on which to make decisions.

The analysis phase is often a dramatic turning point in an organization’s relationship with technology.  People are empowered with an understanding of key performance metrics.  They are able to immediately see the impact of organizational, procedural, and personnel changes by running reports.  Data is “scrubbed” so that it is as accurate as possible.  Internal workflows become nearly optimal and people begin to realize opportunities to improve the entire system of care by streamlining interactions with other departments or external organizations.

Partnerships

Once an organization has analyzed and “scrubbed” its internal data and made attempts to improve its internal operations, it begins looking for ways to expand its improvements.  The organization recognizes inefficiencies when working with external parties, such as other healthcare providers, pharmacies, and labs as well as with consumers themselves.  Additionally, the organization has confidence in its own data, and wants to share what it knows with other organizations (all within the bounds of HIPAA, of course) so that third parties will provide the best care to consumers they have in common.  Individual partnerships, integrated health arrangements, health information exchanges, ePrescribing, Personal Health Records (PHR), and other forms of electronic order entry become possibilities.

At this phase, the organization is becoming quite comfortable with technology.  Policy issues become larger barriers to change than technology barriers when new ideas arise.  The organization is developing a comprehensive view of consumers and is looking for ways to further improve quality of life for the people it serves.

Transformation

At the final point in the evolution of healthcare technology, an organization has developed a comprehensive view of consumers.  Using the profiles gained during the previous steps in the evolution, an organization in the Transformation phase can implement revolutionary new approaches to healthcare.

Two of the most important tools that Transformation organizations currently have at their disposal are Clinical Decision Making tools and Prevention tools. While it is true that many clinical decision making models will be developed external to the organization by research teams and others, there will also certainly be a need for prediction models that fit the structure, strengths, and practices of individual  organizations.

Even more exciting than clinical decision making, organizations at the Transformation stage will also have the tools to create prevention models that can save time, money, and most importantly, improve recovery from mental illness and avoid physical illnesses like diabetes and heart disease.

Using the model

The most effective way to use the model is to integrate it into an organizational IT Strategy. Simply stated, an IT Strategy is a plan that aligns technology-focused initiatives to business goals. It is created by understanding the gap between the organization’s current use of technology and the long-term goals of the business. The ADAPT model is essential to creating a realistic IT Strategy because it aligns projects in an order that will have staff demanding the next project, rather than defeating it. What’s the point of developing an IT strategy if people aren’t ready to use what you build?

Conclusion

The ADAPT model outlines a repeatable path for technology evolution that is focused on people’s needs. Like any other evolutionary path, there are variations and outliers and the road isn’t always as clear and concise as outlined above.  The key is to remember that people must agree to use technology before it can do anything useful. Organizations can use the model to strategically prioritize and schedule IT projects to greatly increase staff adoption of new technology.

Regardless of where you start in the evolution, just remember that everyone goes through these same five phases as their technology is evolving…everyone.  If your organization isn’t where you want it to be, don’t worry.  Just set expectations that you will need to go through each of these phases so that people will know what’s coming. Establish a 3-5 year IT Roadmap that will guide your organization from step to step, and get going!

Chris Akerley and Jeremy Nelson, Afia Inc.

This site features interesting concepts and aggregates information about how Behavioral Health can stay connected in the HIT space and continue to evolve. This can be a good place to start collaborating and sharing ideas.

http://www.bhemr.com/