Previous page: Accountability versus quality improvement
The need for new technology
More hospitals are looking at implementing advanced business intelligence (BI) tools to address these challenges within the health care sector. Business intelligence refers to a group of tools that collect and analyze internal and external data to generate knowledge and value for an organization.
Used effectively, these tools can help people to make better business decisions. A BI system is designed to interpret data in a way that will help, for example, to integrate initiatives, align organizational units and resources, and improve performance.
The ability to improve patient care in Canada is closely tied to the availability of sophisticated tools that help to improve the dissemination of information across the user interfaces that health care employees use every day.
Effective BI tools also offer the potential to improve efficiency by reducing the costs associated with errors, data re-entry and document processing and storage. In turn, BI tools promise to improve management by providing feedback and promoting planning, prioritisation and cross-institutional learning.
Strengthening accountability has been a key theme of most proposed health care reforms. However, it could be argued that the emphasis of performance measurement reforms should increasingly be placed on internal quality management rather than external accountability.
Investment is required in human resources and information technology that is aimed at assisting quality improvement efforts. Recent research suggests, for example, that Canadian hospitals spend approximately two per cent of their budgets on IT, compared to 5.5 per cent in the U.S.
Furthermore, performance measurement is often considered within the purview of those in the quality management section of a hospital's organizational chart. The quality program, if indeed it exists, is often located within a clinical portfolio and is frequently under-resourced, in terms of expertise in quality improvement processes. Rarely are the clinicians and quality improvement workers meaningfully associated with the core analytical expertise of the hospital.
It is important to look at middle managers and frontline staff within hospitals and to consider what challenges they are being faced with, the sort of information they would like, the format they prefer to receive it in and how this might actually result in an improvement of overall performance management.
Effective performance measurement needs to involve both senior leaders who understand the long-term goals and frontline personnel who appreciate the kinds of measures needed to support local decision making.
Data standardization
Unfortunately, given the fragmented nature of communications and the relative paucity of digitized clinical records in Ontario, gathering information, even something as simple as a patient file, can pose a challenge.
The Ontario Hospital Association and Ontario Buys, a program within the Ontario Ministry of Finance, are committed to ensuring the broad dissemination of information across the health care sector. This is a step in the right direction.
However, a similar commitment to technology that can help achieve quality improvement goals and improve patient care processes is less forthcoming. To help meet this commitment to technology, the health care sector needs to sharpen its focus on performance measurement and delivering the right information to the right person at the right time, emphasising how individual employee actions affect results.
Universal health care in Canada is a burgeoning and polemic area at a critical juncture in its history. Michael Moore`s recent film, Sicko, reflects the international gaze on the sector and perception studies continue to find that timely access to health care is one of the highest policy priorities for Canadians. Performance measurement and reporting in the sector have clearly made advances in the past decade, but more needs to be done to continue to move the sector forward.
By implementing IT systems based on a commitment to BI technology, accurate, standardized information is likely to be more readily accessible and understandable to health care professionals, offering the promise of improved patient care, efficiency and management.
Clinton Free is an assistant professor at the Queen's School of Business. Contact him at cfree@business.queensu.ca
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