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Case Study – Intermountain Health Care

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1. What is the history of information technology/automated systems use at Intermountain Healthcare?

The history of automated systems/information systems in Intermountain health Care dates back in the 1970’s. This is when the heath care institution came up with HELP, a clinical information system that would act as a diagnostic tool. Later, the automated system developed to be a clinical decision support. Pharmacists could use the system to enter prescriptions and to help them in drug interactions. During the same period, information systems were used in the electronic medical record area as EMR was later introduced in the company. With the information systems that developed for a long period of time into perfection, it would be possible for health care professionals to go through a patient’s medical history and also provide the correct drug prescriptions. A patient’s medical history would be obtained in a second and by the 21st century many patients’ history had been included in the company’s electronic data.

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2. Provide an overview of what Intermountain’s Clinical Integration program is. What do doctors like about it? What do doctors dislike about it? How is technology involved?

One of Intermountain’s approaches to quality care, which is Clinical Integration is celebrated and at the same time disliked by some health care professionals inside and outside the institution. Those who celebrate clinical integration argue that standardized care that is based on evidence leads to better outcomes. In addition, health care professionals can quickly access past data to aid them in present decision making processes. This is especially so when a patient’s medical symptoms are similar to past medical symptoms of another patient who had been successfully treated in the facility. Those who love using clinical integration in delivering quality care argue that it is easy and it helps in doing what is right. They also praise the interdependence that clinical integration brings among the institution’s health care professionals as this maximizes on the quality of clinical care.

However, critics use patient’s uniqueness to refute the method claiming that the fact that patients are unique means that one method cannot be used to successfully provide quality care. Others who still refute the system argue that the systems is a threat to independence, autonomy and power especially of those who love work autonomy.

Clinical intergration uses technology to integrate all professional data in the organization into a single system that can be accessed by all professionals inside the institution. Clinical data for both outpatients and inpatients have been safely recorded for a long time now. By using the system, the health care management at this institution belief that current’s decisions about a patient can be supported by past data from similar cases. Although some critics hates the integration, the health care institution is still working hard to bring more clinical integration in the system and to provide quality care to more people in the country.

3. Who is Dr. Brent James and what is his role at Intermountain? What challenges does he face in this case?

At Intermountain Health Care facility, Brent James is the executive director. He is also a biostatistician and a surgeon at the same facility. Brent is among the individuals in the health care facility who believes in what the institution is doing and its approaches to quality. For example, he believes in the organization’s data systems as he argues that it is the best in the country (Bohmer, 2013).

However, he is faced with the inability of the clinical integration’s inability to move to a desired level, which is self-governance of the involved staff members in order to reduce costs and improve on the quality of health care. In fact, the first attempt to make the plan materialize failed and the second attempt is still proving to be hard for him. Building an effective clinical management system is becoming hectic for James who overly believes in quality and efficiency (Bohmer, 2013).

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4. In class we have discussed the “silo effect” – where has this effect been seen at Intermountain? What are the repercussions and what is the organization trying to do about it?

The silo effect is a problem that involves organization’s department where some do not want to share their information with others. As a result, the organization in question suffers from inefficiency and other things such as employees’ morale and cooperation is reduced. When allowed to take its effect to higher degrees, silo effect can lead to the fall of an entire organization (Mills, 2007 pg. 116). In Intermountain, obtaining interdependence among the existing professionals is quite hard especially when using the clinical integration system developed earlier. Even after trying to make clinical integration work for a long time, James has realized that it is hard to integrate this idea into the organizational culture. Getting all its components running is a huge problem since not all physicians are willing to subscribe to this high quality concept. For years, James has been trying to hold the debate concerning standardized care and it is almost impossible for physicians to adopt the practices, which are deemed as good by the executive, on their own.

Despite the negative effects associated with the silo effect, James has been trying to integrate the idea into the organization’s culture. He has in many times come up with debates concerning standardization of care. He has written memo’s encouraging clinical integration in the institution. James has also presented the organization with the results of the positive effects of the clinical integration program hoping that employees’ morale would be boosted as a result.

The institution has also come up with strategies aimed at boosting integration in the company. For example, one of the strategies aimed at integrating all the key players in order to share the benefits and the costs of the system. Revenues as well as costs would be shared among the key players, who had been selected from the institution’s employees.

5. Where did redundant systems and/or redundant data entry exist at Intermountain?
What was the organization trying to do about it?

Redundant systems at Intermountain existed in clinical charting and billing area. In order to avoid redundant data at the two areas,  the organization was trying to create a single data system, which would generate data for both areas. The institution was also trying to use technology in order to curb the problems associated with redundant data. A financial tracking system was also developed in order to solve the problem. 

6. What cultural change was trying to be accomplished at Intermountain? What change management/implementation practices were being used to support the goal? How was the organization attempting to get physician buy in?

As seen earlier, Intermountain is trying to embed the idea of clinical integration and standardization in its organizational culture.
Some of the practices being used to support the goal include what James terms as “best practice.” In this case, standardization of care has to be adopted by physicians by their own will and it has to be integrate with accountability and measurement systems. Eventually, this would help in increasing quality and decreasing costs. 

In order to support this culture change, the managers and the executives within the organization believes that some early adopters have to be used in order to transmit the culture to others within the organization.

7. What is the time frame of this project? Do you believe the time frame makes sense and why?

Based on the information presented on the case study, the project does not appear to have any time frame. Instead, it is a continuous project, which began in the 1960s and it is still on going. However, based on the delay of adoption of some important aspects of the project, time frame in this case would have been important. This is because scheduling helps in the success of a project. In addition, scheduling helps in curtailing a project’s costs, which in this case, is one of the problems being faced by the institution? Therefore, the current time frame does not make sense based on its inability to cater for the important aspects of the projects such as costs and success.

8. Provide your impressions of Intermountain Healthcare based on viewing the first
YouTube video (the Transformation Lab) – what do you think of this healthcare organization is doing differently from other healthcare organizations if anything?

The intermountain Healthcare Institution provided in the YouTube video is awesome and at the same time perfect. Unlike other facilities, the health care facility is applying the idea of data standardization, which is yet to be adopted in the health care sector. As a result, such things as quality, efficiency and timeliness are being realized (Intermountain Healthcare, n.d ). Given the high level of efficiency provided in this health care facility, I think that all health care facilities should be out to try the facility like the one exhibited by Intermountain.

9. Discuss the Intermountain data standardization video – what points does it attempt to make about the medical supply chain? Summarize issues surrounding this topic – what issues surround this topic?

Based on the data standardization video, it is clear that standardization helps in regulating waste, increases revenues and cuts costs. In addition, standardization leads to patients’ satisfaction and improves the overall efficiency of a health care institution (Intermountain Healthcare, n.d ).

Despite this, standardization is still to gain acceptance in the health care sector. Unlike other sectors, this sector, which would greatly benefit from standardization, is lagging behind.

However, with proper innovations and transformation from institutions like Intermountain, standardization can be accepted in the healthcare sector.

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