The Future Dictates the Present

Future Healthcare StrategyLess than a decade ago, technology promised to form the future. In today's rapidly changing, collaborative setting, the future dictates today's technology.

Technology of the present must be built to anticipate and accommodate changes of the future. Regardless of how the version of standards regulating the electronic handling of health care transactions change, systems must possess the characteristics, foundation, and structural underpinning necessary to allow for tweaks in a day-to-day environment as well as leaps for future requirements.

This means the technology company's organizational infrastructure has to be in lockstep with the practice plans, while both are anticipating and overall industry future trends. Your technology vendors should be able to articulate where they see the industry going and how their research and development (R&D) investment is ensuring they will be leaders in the game not only next year, but five and ten years from now. For example, a decade ago we focused on the cost and complexity of interfaces and each time a new hospital was added to the billing system, it could involve a fairly substantial amount of time and money. Groups would often interface only to the largest hospital served and work smaller entities from paper. As time went on and interfaces became standardized (and cheaper), it became practical to add even relatively small sites via electronic interface. So what did we focus on instead? Further automating traditionally manual billing process—from charge reconciliation to claims submission to coding to claims follow-up. Obviously this means your partners in technology should be a vital part of practice initiatives to maximize employee productivity and reduce costs.

Where else should we be looking? Storage space is inexpensive, scanned documentation has become the norm and the ability to expand capacity is not optional but, based on current trends, it is sooner or later a requirement. If a network is 3-5 years old, then it is probably outdated—even though that is not a message most managers like to carry to their physicians. On the other hand, as software improves, significant savings are eventually realized in terms of staffing reductions. Operating systems, computing methods, storage space, and performance requirements have changed rapidly over the last few years, improving clean claims quality, charge verification, the speed and accuracy of file submission and cash flow. Bottom line: the network infrastructure is the backbone for continued and compliant operations and the wrong place to cut a corner. Investments in improved billing/image transmission technology can easily be undercut unless the framework to support that functionality is in place.

Furthermore, the unacceptable alternative to a highly functional system could range from the interruption of production (nuisance) to complete data loss (disaster). If it's not in the current budget to overhaul the entire support system, make a plan with a definite completion date and then start with updates of the oldest components. This is a definite area where your vendors can provide guidance and direction, beginning with an outline of recommended specifications for their current offerings as well as what they anticipate will be needed in the next few years.

Current hot topics like meaningful use, 5010, and ICD-10 are "must haves" and thereby a required standard offering, rather than an episodic Y2K-like opportunity. This means "Me too" products and components may offer little stand-alone longevity so flexibility, adaptability and the ongoing investment in innovation should be a foundational expectation of primary vendors. Otherwise, it would be equivalent to buying power windows and antilock brakes without the car. RIS systems should obviously have the ability for the Stage 1 Meaningful Use opportunity--and RIS and PACS leaders should already be studying and implementing Stage 2 items. Medicine has long shown lessons learned from the past may be provide a point of reference, retaining only the best from previous experience while strictly looking at future results and acting accordingly in the present. Systems that serve healthcare organizations must model this behavior by adopting trends and creating stateless platforms. This means that the delivery methods and buzz words like cloud computing, virtual environments, and mobile access that drive the product planning debate become secondary and cross-method readiness becomes the standard so that planning is include "it all". In other words a good system will accommodate the end user's preferences and requirements by creating (or taking advantage of) infrastructure and delivery technologies.

In terms of strategic planning, it is important to recognize end users (patients and referring physicians) are more educated and tech savvy than ever before thanks to the internet and specifically, social media sites. By the same token the speed at which information is created and shared can easily result in overload and confusion. We have seen if used properly, the available avenues can become very powerful branding and revenue generating tools. The newness of internet or social media has come and gone to the degree it has become a fact of our lives. If ignored or underestimated, it will likely impede our ability to formulate objectives and talk about the future with any degree of precision. It is unthinkable that any technology can remain competitive while overlooking the aggressive pace of digital revolution. Ultimately all systems created and services performed in the healthcare space are aimed at serving patients. These patients are social media site users and will increasingly demand functionality accessible from their mobile devices. How is your practice and how are your vendors planning for these changes?

Much like social media, healthcare platforms (now and in the future) have to be enabled by scalable communication techniques. Forward thinking technology and delivery systems have to embrace the concept of "frictionless medicine" and create a universe of possibilities into each core competency. This means that regardless of vendor, all aspects from the patient admission over the clinical components to billing and analytics have to work together seamlessly as core functions. The expanded functionality of the systems should then have all of the extensions to encompass a much broader purpose – in particular patient acquisition, revenue generation, quality of service, and reputation.

When choosing a system it is exceedingly important to listen to the vendor's thoughts on future trends, the vision for its products, and the implementation timeline of "readiness" for those trends. Declarations for the extended future should be bold. There is no magic in small vision. There has to be a plan to incorporate the obvious movements like social media and an offering that reaches beyond the immediate product you are looking for. When building systems, developers have choices – so do you. Find out what the R&D budget is and how heavily the vendor invests in its product planning and development. If the vision and the core competencies of the product suite are clear and have a strong focus and commitment, then all extended purpose should become a simple plug in. Innovation and anticipation should be second nature (measured based on past performance and not just the sales pitch) and you should expect "going the extra mile" to be part of your future vendor's demonstrated business philosophy --rather than a simple marketing slogan.

Once you can assume the product you own (or are looking at) has a future, make sure to check off your present day questionnaire list. Ask for the full cost. That's everything--inclusive. Ask if there is any provision related to the long-term cost of ownership you should know about prior to making your selection. (Some contracts require a re-purchase that could virtually equal the initial investment—and others don't). Ask this with longevity in mind. Check for best practices in terms of the type of technology and development method used. Make note of update availability, how issues are managed, support capability, ease of application use, and quantity/quality of training as well as supporting materials. Ask what the application or vendor doesn't do well and listen for an honest answer. Since you can't run your business on an opinion, make sure what you are buying is not a negative selling technique but real features, functionality, and future. A potential vendor has to propose capability and positive differentiators of its own offering. If all they have is sour grapes, excuses and a questionable past performance, then they have nothing to offer you.

The future dictates the present. If a particular technology/system is not designed to go with the times, demonstrate scalability, and anticipate the future or the company behind the product lacks vision, then there is only one place it can take you – the past. You can't afford to be there because the future is all about better performance for the dollar spent. If you want to move ahead, make sure that all vital systems are aligned as forward thinking drivers of your business, offering new ideas, innovative process changes, flexibility and adaptability.

By SAM F. KHASHMAN - Printed in July-August 2012 RBMA BULLETIN | Published by Radiology Business Management Association |

Also view on the U.S. Chamber of Commerce Foundation website - The Future Must Drive the Present, published May 8 2012

Sam Khashman

Sam F Khashman is president and chief executive officer of Technology Partners, Inc. DBA Imagine Software located in Charlotte, North Carolina. He founded TPI with a vision of developing workflow-centric computer systems and, utilizing his experience working with high volume transactions in the financial and insurance industries, he developed the IMAGINE practice management system. IMAGINE is widely recognized as an innovative leader in the field of medical billing/collections.

You can find Sam on LinkedIn, Twitter and Google+.