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Health Care Is Ready For Lean Integration

In my last post I wrote about how 2010 will be The Year of the ICC. For the health care industry, 2010 could be the Year of Lean Health Information Integration. Integration Competency Centers have been in existence in health care for over a decade – they are called Health Information Exchanges or HIEs. One of the first (if not the first) was the Indiana HIE which began in 1994.  There are now over 150 HIEs across the U.S. as per the eHealth Initiative website.

This is not just a U.S. phenomenon since there are Health Information Exchanges in Canada, Australia, U.K. and Europe. In the past few years, I have come across more and more people talking about how to apply Lean principles to health care. For example, in my home town of Minneapolis, Park Nicollet Health Services has been applying Lean practices for over 10 years to everything from outpatient services to operating rooms to emergency services. For further evidence, the first annual Lean Healthcare Transformation Summit is coming up in a few months. And now with my and David Lyle’s book on Lean Integration about to hit the bookstores, the stage is set for the health care industry to combine established HIEs with the impetus for lean practices to start the Lean Health Information Integration wave.

In fact, any company planning to implement an ICC could take a lesson from HIEs.  The eHealth Initiative describes 7 stages of HIE maturity as follows:

  1. Stage 1 Recognition of the need for information exchange among multiple stakeholders in a state, region or community. (Public declaration by a coalition or influential leader)
  2. Stage 2 Getting organized; defining shared vision, goals, and objectives; identifying funding sources, setting up legal and governance structures.
  3. Stage 3 Transferring vision, goals and objectives to tactics and business plan; defining needs and requirements; securing funding.
  4. Stage 4 Well under way with implementation – technical, financial and legal. Pilot project or implementation with multiyear budget identified and tagged for a specific need.
  5. Stage 5 Fully operational information organization; transmitting data that is being used by stakeholders.
  6. Stage 6 Fully operational information organization; transmitting data that is being used by stakeholders and have a sustainable business model.
  7. Stage 7 Demonstration of expansion of organization to encompass a broader coalition of stakeholders than present in the initial operational model.

These steps lay out a sound foundation for a multi-year implementation roadmap for any large enterprise. What stage are you at?

By the way, the Lean Integration book is available for pre-order on Amazon. Check it out!

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3 Responses to Health Care Is Ready For Lean Integration

  1. Pingback: Twitter Trackbacks for Health Care Is Ready For Lean Integration | Informatica Perspectives [informatica.com] on Topsy.com

  2. Dr. Dominic Orsler says:

    Hi John

    Great to see major players in the information integration market like Informatica taking a genuine interest in what is probably the biggest and possibly most important integration challenge that has existed to date; that of Health information. Paradoxically, however, in contrast to other verticals that achieved impressive integration some time ago (e.g. Finance and Banking!), nowhere near as many dollars flow across Health integration enterprises and the whole issue is many orders of magnitude more complex and sometimes sensitive with regards to legislation and privacy than others. Moving basic numbers around a tightly controlled, private financial enterprise is just a teensy weensy bit easier than moving MRI results between independent health organisations and correlating them with a vast panoply of related information, including lab test results, pharmaceutical information, chronic disease management histories, discharge summaries, referrals, encounters, etc, etc, etc! The challenge is vast, but not insurmountable. It becomes a realistic proposition with a very solid ICC in place, but many historic approaches have failed horribly and continue to do so.

    I would not go so far as to say an HIE is an ICC, but rather a technical tool around which an ICC should be built. I found your book inspirational, and look forward to the next one, but from what I understood, one of the paradigms upon which it was based was the notion that integration is primarily a business process-based, discrete discipline. HIE’s, not being ICCs, have been implemented all over the world without this approach in mind, and have suffered accordingly. In the worst case hypothetical scenario, integration becomes ad hoc, siloed, disjointed and sometimes just plain dangerous. Changes are made unilaterally and not communicated at various stages along the integration pathway, sometimes manifesting themselves at the physicians’ desks, at which point it is retrospectively hoped they have had no major impact on patient safety and they get fixed, at best resulting in exasperated and worried physicians, at worst with harm done to patients.

    At Alberta Health Services we have a relatively mature HIE and we aim, with Informatica’s help, to focus henceforth a lot more on the driving business processes required to make the technical tools like our HIE work for the enterprise, from a service-oriented perspective, to ensure patient safety continues to come first. HIE’s badly need ICC’s to centrally manage and coordinate integration to ensure patient safety is never compromised by unilateral, mis-communicated changes.

    I believe that no-where is it more important to apply the lessons outlined in your book than in HIE’s; patient safety, not just dollars, is at stake!

    Dr. Dominic Orsler

  3. John Schmidt says:

    Dominic, thank you for your thoughtful comments. Very well said. I have no rsponse at the moment, but I intend to write more articles about Lean Integration in healthcare – so I appreciate your input.

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