Operational challenges in adopting new healthcare technology

Many healthcare practitioners agree that it is probably the best of times to adopt new technologies. At the 6th Annual Healthcare Innovation Summit Asia, healthcare practitioners have discussed in a panel discussion the many operational challenges of managing a healthcare institution today, which many agree is at an important crossroads. 

With most healthcare organisations grappling with the challenges of ageing societies, chronic diseases, increasing cost of medical care and the need to reduce medical errors and increase the level of care, IT is becoming an imperative, not just an enabler of operational efficiency.

Dr. Ow Chee Chung, CEO, Kwong Wai Shiu Hospital, Singapore, said that the nursing home scene is forecast to double capacity in the next five to six years and technology innovation would be a key factor.

“We have taken steps to go beyond just any system. Now we are using technology, we going paperless, not entirely for in-patient, but also for monitoring. Finally, we are moving to document management systems for hospital records,” he said.

However, he sees the main challenge is cost; IT being expensive for hospitals. Over the years, he said the hospital has moved from  1 percent to 3 percent of total operating expeditures.

“The major challenge is not the implementation, but ensuring that we can get five percent of total operating expenditures to support it,” he added.

In the Philippines, the major challenge is also cost, but the more important factor is change management. 

Richard Lirio, President, Healthcare Executives Society of the Philippines,  and Head of Operations, Fe Del Mundo Medical Center, said that with around 200 or more professionals working for their organisations, which include specialist and generalist doctors, nurses, accountants, IT staff, they need to ensure that everyone is on the same page and moving towards the same goals.

“All of them will have different priorities and goals. We are a 57-year-old hospital. This (IT) is something new. We have to be up to par with the group of hospitals we are in. That includes having a good hospital information system, having good medical devices and equipment that are modern. But change brings fear to people, fear of the unknown,” he said.

In Taiwan, the health insurance system provides for universal health coverage and almost 99.9 percent of citizens are covered. However, Phoenix Ho, Technical Specialist, National Health Insurance Administration, Ministry of Health and Welfare, said that the main challenge is implementing policies into more than 20,000 hospitals and clinics.

“The difficulty is very big. We have to bring all the stakeholders together. The first step is to persuade the leaders in the adoption of the technology,” she said. “Incentives are key to implementation.”

Speaking from a vendor perspective, Sandeep Makhijani, Regional Director Asia Pacific, Truven Health Analytics, Singapore, agrees that change management is important to get the staff and all end users to embrace the technology.

“They have to be trained, they have to be assured that these systems will make their jobs easier and they will have more work-life balance,” he said.

Facilitating information between vendor and internal IT personnel is one thing, but increasing health technology returns with effective change management is another. The gap must be closed to ensure optimal use of resources.

“We need to find a way of optimally use this (IT) resource. Technology is the only enabler for optimally using resources,” he stressed.

Ho agrees that when users understand the benefits of technology adoption, they take advantage of it. “I think technology is not just a tool for the physician to enhance their performance, it must be a smart one like iPhone; everybody must like it,” she said.

Dr. Steven Wong, Consultant Radiologist, Singapore General Hospital, said that for any technology to be adopted, end users must be convinced that the products works well and doesn’t cause too much disruption to the workflow, and in the long run will benefit the patients.

“I work in a public hospital, so it is not a matter of incentives, but Im sure if it improves my workflow in the day, I can do my work faster,(I can see the benefits),” he said, adding that it would be much desirable if the user interface is simple, returning minimum amount of clicks on the interactive screen.
The panel members agree that there should also be a form of incentive to organizations to adopt IT at the institutional level.
Dr. Ow said that in Singapore, the government is working towards creating a system to help those who, on their own,  are too slow down to move forward, or totally upscale to pick it up. he said there are also foundations who actually support IT initiatives.
In Taiwan, Ho shared that Phoenix Ho that the Ministry of Health and Welfare also provides organizations to set up the information system and help them adopt to new technologies. 

“We ask our hospital leaders to set up rewards systems in their hospitals. Our hospital accredditation mechanism is also part of the incentives,” she said.

In the Philippines, where there are government and private hospitals providing healthcare services, Lirio said it is   market forces that drives everyone to improve. However, the  national health insurance makes it a  point that healthcare providers given the level service appropriate for its members or the Filipino people, and they have devised ways of incentivising or improving quality of care by giving better payouts or benefits for those who can reach a certain level of excellence or quality standards.

“This forces health organizations to look into new technologies, new systems so that they can improve the service they can provide,” he said.

Similarly, in Singapore, Dr. Wong said there is a need for hospitals to look at how they are practicing medicine and how they can do better. 

“All Singapore hospitals have JCI accreditations. It consolidates a lot of best practices in the hospitals,” he said. “But  at the end of the day, once you communicate the need for  new technology to be adopted, and stakeholders are invited to come and participate in the new process, there should be no problem.”
Makhijani said he doesn’t agree that the less resources available contradicts or works against the goal of being the best or adopting best practices.

“Demand for healthcare services will continue to grow,” he stressed. “Technology can make you more efficient and efficiency by definition is doing more with less. You adopt technology to optimally use your resources.”

Lirio said that when it comes to implementing new technologies, the owners what it the be the lowest possible cost or to yield maximum returns. End users want quality of the output and ease of use. Patients want the best medical outcome from the technology.

“If all of these are satisfied, there wouldn’t be a disconnect,” he said.
Asked to summarize their experiences in healthcare IT adoption, the panel members said it is challenging, there is a need for better communication, but it is actually the best of times to explore it. Above all, it must be functional.

“One of our end users describe it best this way: ‘I want to increase the quality of my care through reasonable cost-effective program to decrease the medical dispute and to bring more profit,’” said Ho. “That is what they want. Through functional IT, we can lower cost.”