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A new, more powerful information system may be your ticket to compiling the reports and data necessary to prove how indispensable and efficient your women’s health center is, say women’s health center managers who have plunged into the computer age.
"Most [women’s health center] managers have a clinical background, but they need to learn to include an information system component into any plan they make," observes Meredith Pence, RNC, MBA, CNAA, director of women’s and children’s services at John Muir Medical Center in Walnut Creek, CA.
"When dealing with an employer-based market for your services, you must realize that they have [high-powered computer capability] in their corporations. They’re used to it. When they call on Tuesday and want information for that quarter for a Wednesday lunch meeting, you better be able to produce it."
To assist readers, Women’s Health Center Management talked to two women’s health providers to determine how providers can use information systems to improve their status against competitors.
Pence says her tertiary care center is "computerized beyond belief."
"Nurses don’t spend any time writing freehand," she says. "Every bit of information is entered into the computer."
The system at John Muir was purchased from Cygmet in San Jose, CA, but was modified to meet Muir’s needs. The Muir database allows Pence and her colleagues to perform outcomes research and determine best practices. This helps them to internally monitor performance, says Pence.
It also helps them to make a stronger case to those funding health care that they are doing the most efficient job possible, she says. In addition, the impeccable data and clean records help in defending malpractice cases in court, says Pence.
Pence and her colleagues are now laying the groundwork for hooking outlying hospitals to Muir’s computers, so information on patients can be instantaneously exchanged. This will allow Muir’s physicians, for example, to look at the chart of a woman in labor at a primary care center and to advise the physicians there whether the woman should be transferred to Muir’s tertiary care facility.
Marilyn Stockman, RNC, director of women’s services for Health Midwest, a network of 14 hospitals and 28 physician services in Kansas City, MO, has five OB/GYN hospital units that use the same information system.
The data collected by these five units have, in some cases, modified the kind of care they were offering. For example, Stockman and her staff were able to track the progress of infants in the neonatal intensive care unit (NICU) and to compare the outcomes of those who were breast-fed vs. those bottle-fed.
"We were able to show that babies who were breast-fed left the unit three to five days sooner than bottle-fed babies," she says. This information helped persuade her neonatologists to be more supportive of breast-feeding, says Stockman.
It also allowed Health Midwest to demonstrate that it was getting better results in its NICU than its competitors, which "helped our system to win some contracts," says Stockman, whose hospital system uses a custom-written program.
The old use of computers for merely billing is outdated, says Vinson Hudson, MSEE and Medical Electronics, president of Jewson Enterprises in Menlo Park, CA. Hudson specializes in physician’s office management/medical information systems for ambulatory or outpatient care settings.
"Now we’re in the world of capitation and clinical care," says Hudson. "Information systems have to be used for outcomes measurement, cost control, and cost accounting."
The right information system can help identify and standardize the best treatment protocols, look over medical records in a longitudinal way (alerting you to a woman who, for example, needs a Pap smear or is at higher risk for osteoporosis), and spot where financial losses are occurring.
Deciding what computer system to use is a major job, one probably assigned to a chief information officer (CIO). But each manager has a role to play in seeing that the new system meets the needs of his or her group.
"First, you define your needs," says Hudson. "What the heck do you want and why? You look at the operation you have now. How do you handle a client who walks up to the check-in counter? How do you get bills out the door? How do you get the right forms to the caregiver? You diagram the process you follow for each task."
"Then you take your diagrams to your CIO or to a consultant and you say, This is what I need help with.’" Hudson urges managers to take the initiative in stating their computer needs, instead of waiting for a new information system to appear in their offices. The more the experts understand, the more likely you will get an information system that you like.
But be prepared for continual change. Just as health care management is in flux, so is the computer business, with vendors of hospital information systems consolidating as rapidly as hospitals are. At the moment, no one vendor has all the answers, says Hudson, who edits an annual directory, Healthcare Computing Publications’ Directory of Medical Software, that lists more than 1,000 vendors. (For ordering information, see resource box, p. 25.)