Healthcare delivery remains somewhat "IT-challenged," relative to industries such as banking, retail and communications.
But with more than half of respondents saying they are fully or mostly integrated internally (53.9%) and externally (55%,
either with outside entities or among their own family of companies), the question becomes: Is the glass half full or half
empty?
While some may conclude that the integration glass is half full, organizations need to realize the need for integrating structured
information and unstructured information, experts say.
"The problem is that only about 20% of the business information that people and teams need to act on is the structured information
that's available in core systems, applications, and databases," says MHE Editorial Advisor Dennis Schmuland, MD, FAAFP, health
plan industry solutions director for Microsoft Corp. "This is the information that integration projects seek to unlock.
"The other 80% of information that people and teams need is unstructured—usually spread across the organization, hidden in
local hard drives, file shares, intranet sites, laptops, e-mail systems and in people's minds," he continues. "What's worrisome
is that unstructured data is growing much faster than structured, essentially doubling every three months. Yet most health
and care-delivery organizations actually believe that the structured-information glass is the only one that needs to be filled.
While the structured-information glass is half full, the unstructured information/expertise glass is empty." Mark Frisse, MD, director of the Regional Informatics programs at the Vanderbilt Center for Better Health, is also disappointed
with the overall results.
"Although I can understand the complexity of these systems—particularly with changing reimbursement rules and the slow path
of software integration—as a consumer, I would like to be reassured that plans with my funds are taking every effort to devote
as much of these funds as possible to improving the quality of healthcare delivery and not on compensating for administrative
inefficiencies," he says. "Employers and individuals should rightly ask, 'If you don't even have your own houses in order
and running efficiently, why should I allow you stewardship over my healthcare dollars?'"
Dr. Frisse believes organizations must at least achieve the essential integration of their medical systems with their pharmacy
systems. On the bright side, he does expect to see some integration improvement over the next five years or so, particularly
in internal consolidation, but the improvement will depend on the extent to which healthcare firms are merging.
"Also, I do not know if the external systems will be personal health records, regional health information organizations, or
other sources, but I do know that health plans' [data] will be only part of a broader set of information required to improve
healthcare and measure quality," he says. "That should result in a more focused set of relationships that allow individuals
and their families to be empowered to participate more actively [in their own health]."
Dr. Schmuland says in the next five to 10 years, the challenge will be less about integrating existing systems and more about
digitizing and improving the collaborative interactions among employees, consumers, providers, information, and processes
that can improve health while reducing the per-capita cost of healthcare.
"This won't be easy and will require a new generation of commodity, Internet-based technologies that make it easier and more
natural for people and teams to communicate, share insights, and work together across the workplace, the home, and multiple
company boundaries," he says. "And, of course, these new technologies will need to be integrated with existing core systems,
service channels, and partners."
Organizations that move beyond core system integration will be poised to take share by virtue of having flexibility to exploit
new opportunities and adapt to complex and changing business demands.
