Marty Howard, CIO at Amedisys, described creating a lean IT organization in his company to optimize at-home patient care.
In his keynote presentation at the 2016 Chief Information Officer Forum held on February 24 in Dallas, Howard began by explaining that the primary goal of Amedisys, a home health and hospice company, is to create outstanding outcomes for its patients in their homes by providing its care centers and clinical teams with the right tools and simplifying operations to facilitate a focus on patient care. Amedisys has a relatively new management team, most of whom started with the company in 2015.
Amedisys’ services and capabilities act as a “wall” to help keep patients where they want to be: in their homes. The company’s aim is to prevent unnecessary and costly hospital admissions and readmissions. Amedisys’ “new game” is to become an aging-in-place company that avoids the need for hospitalization by eliminating such patient issues as medication errors, dehydration, and dietary problems that result in long and expensive hospital stays. Payers will support this, Howard said, and almost all patients prefer to be in their homes.
Amedisys’ “new game” is to become an aging-in-place company that avoids the need for hospitalization by eliminating such patient issues as medication errors, dehydration, and dietary problems that result in long and expensive hospital stays.
People with chronic conditions who are living at home need monitoring, and much of this monitoring is already being done using devices in the home that relay information to a central, off-site location. High-acuity patients are best served by technologies such as biometric monitoring, immediate-response capabilities, and two-way video. Medium-acuity patients require technology that engages with them to teach self-management and wean them to lower-tech devices. These patients also require devices for safety and caregiver support. For lower-acuity patients, the focus is on wellness technologies, use of wearables, interactive voice response (IVR), and self-reporting. “None of this technology needs to be invented,” Howard pointed out. “All of it is established and proven in other environments; what’s necessary is putting it all together.”
The new game depends on information. Amedisys’ mission is to get medical personnel the information they need to take care of their patients better and do their jobs better. “We call this strategy Enterprise Information Management, and we eventually want to call it Intelligence,” stated Howard.
“Amedisys has outsourced everything that’s not part of healthcare,” said Howard. This includes classic IT as well as operational support to run the electronic health record (EHR), which was outsourced to a vendor that specializes in this area. As a result of this outsourcing and other restructuring efforts, the company has gone from 300 IT employees in April 2015 to 56 today. The company’s IT expenditures have declined from 5% of revenue to 2.5%.
“Amedisys has outsourced everything that’s not part of healthcare. As a result of this outsourcing and other restructuring efforts, the company has gone from 300 IT employees in April 2015 to 56 today.”
Howard’s theory of IT is to provide a high-performing, scalable, secure, flexible, cost-effective platform that delivers information to support and drive improvement in ongoing operations and longer-term objectives. During his visits to more than 1,000 companies, he discovered the following:
• Fewer than 10% of IT departments enable or drive improvement.
• Good IT costs less and requires fewer people.
• More than 25% of IT work is “self-inflicted.” IT delivers a system or device and has to redo it because end-user needs and desires weren’t researched.
• Top performers across industries spend far less than the industry average.
• New technology and ubiquitous use of technology provide endless opportunities for CIOs.
Howard sees IT departments getting smaller and transferring into strategic partnerships that serve as information experts on how to drive sales and how to improve products, customer satisfaction, and operational performance “because we know how information works across the board.”
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