By Michele Hayunga
With the U.S. economy slipping into recession, most providers are hesitant to pour money into information technology. But, done right, IT can strengthen an organization and provide a solid return on investment, experts emphasize.
The key, they say, is approaching IT strategically.
Establishing a technology baseline should be the first step for an organization, explains Dan Cavolo, president of The Loyola Group, an IT management and consulting firm. 
“What technology defines your IT infrastructure? How many different systems are in place?” he asks. It’s critical to have accurate answers to these questions before considering new investments, he notes.
Along with this assessment, providers should review or establish policies regarding access to and use of information.
“If marketing wants a list of rehab admissions and the director of nursing refuses, the IT department shouldn’t be making the judgment call,” Cavolo says.
Another high point providers should be aware of is getting a realistic picture of how IT employees spend their time. This is essential for strategic planning.
Often, people approaching IT don’t differentiate between routine support and special projects. “‘Can you fix my e-mail?’ is not in the same category as ‘Find an emergency call system,’” Cavolo says. “The average full-time IT employee has only seven hours a week to devote to new initiatives.”
Cavolo believes every organization should have a system for tracking IT requests. Small providers can accomplish this with a simple spreadsheet, while larger ones can purchase ticket-tracking software for between $1,500 and $3,500.
IT projects should be managed with the same professionalism as other business initiatives. 
Cavolo suggests creating a brief outline for each project that addresses the key questions: Who are the project leaders? How will they get buy-in from everyone affected? What type of system is needed? Where will it live? Are upgrades required? and, What is the time frame and budget? 
Experts also maintain it is a good idea to review all IT projects at a monthly meeting that includes representatives from every department. This provides an opportunity to coordinate among departments, centralize new infrastructure costs and set realistic timelines. 
Leadership prevails
“Leadership and the leader’s personal involvement in a project is the  number one predictor of success,” says John Ederer, president of American Data, which makes the ECS Electronic Chart System and Financial System. The ideal project leader has management’s support, respect from staff and time to focus on the project, he adds. 
Getting stakeholders involved from the outset is critical to gaining support. 
“How will a new system impact admissions, nursing, wound care, dietary, therapy, activities and physicians?” asks James E. Shearon, clinical operations consultant with Vocollect Healthcare Systems, which makes the AccuNurse voice-activated documentation system. “Even if it’s only one or two touch points per functional area, it’s worth asking so everyone feels they took part.” 
“Don’t underestimate the positive impact of a team approach to implementation,” adds Doron Gutkind, chief software architect for LINTECH, maker of COMET’s clinical and financial solutions. “Getting everyone on board from the point of vendor selection all the way through the process—planning, training, going live and post-implementation support—is essential.”
Project leaders must clearly define an initiative’s goals and evaluate potential solutions accordingly. 
“It’s important to match an IT solution’s features to the organization’s ability to take advantage of those features,” explains Ayman Fadel, owner of RUG Tools, which offers software to support MDS coordinators. “It’s better to have a fully functioning Escort than a non-functioning Cadillac.”
Also, consider whether a system allows for an incremental approach, adds David Finkelstein, CEO of 6N Systems, which provides electronic medical records and financial software. For example, with EMRs, facilities should be able to start with a smaller project like automating the clinical chart. Later, they can add efficiencies in the medication ordering process, and ultimately embed workflow and decision-support rules.
“This way, they can get a start on the EMR and realize improved documentation, fewer medication errors, and reduced rehospitalizations over time, instead of having to invest all their IT dollars at once,” Finkelstein says.
References and experience are also very important, adds Joshua Shupp, vice president of marketing and administration for //SOS/Corporation’s integrated software solutions.
“You want to make sure the vendor has installed the solution in a site very similar to yours,” he says. “It’s never good to be a guinea pig.”
Let them click
Offering resident-oriented IT services can help offset new infrastructure costs, suggests Dennis Stufft, president of Prelude Services, an IT services company. Many of his clients are getting into the business of providing Internet-based telephone service (VoIP) as a means of paying for a campus-wide wireless network. VoIP is typically cheaper for residents than traditional phone service.
“The same wireless infrastructure also allows communities to offer residents Internet access, which creates another potential revenue stream,” Stufft says. He hopes in the next two years it will become cost-effective to add cable to the package as well. 
Some of Stufft’s clients are actually making a profit on the telephone/Internet packages, while others are simply offsetting their wireless costs. But the real payoff is that a wireless network allows communities to implement a variety of care delivery and resident-service solutions. 
IT can be an important tool in meeting business goals such as diversifying service. 
Many seniors are putting off a move into a retirement community with the hope that the housing market will rebound.
“With the current economy, there is a real opportunity to grow community-based services,” says Majd Alwan, director of the Center for Aging Services Technologies (CAST). “To do this well, providers need to have IT infrastructure in place that improves the efficiency of caregiving staff.”
Alwan points to the increasing sophistication of telehealth monitoring technologies that can reduce the number of unnecessary visits. Other technologies, like point-of-care documentation and electronic health record systems (EHRs), can improve coordination of care.  
It’s important to consider the bigger picture when evaluating potential return on investment.
“Many companies look at cost alone and do not realize the amount of money spent on such things as local technicians’ monthly bills or the lack of productivity for their staff that is created when an unstable system is ‘down’ over the course of the day,” explains Claire Chitwood, vice president of business development for Enformix Technology Services. “An increase of expense in the foundational IT infrastructure of the company often leads to a decrease in expenses in other departments that often appear unrelated to IT.”
Several experts recommend looking for vendors that offer flexible financing such as monthly rental/subscription payments or pay-as-your-receive ROI options. Vendors also should be able to help an organization estimate how long it will take for the technology to become self-funding. 
A good start
Implementation is only the beginning, experts stress.
“All too often, providers implement a new system, utilize 10 to 20 percent of the system’s functionality to relieve initial pain points, and forget to go back six months to a year later to look at what additional benefits the system can provide,” Finkelstein says. 
It’s important to take full advantage of the current system before jumping into any upgrades, he adds.  
Another common pitfall is that organizations start out with fully-trained personnel, but when they leave the organization or are pulled away to other duties, replacement personnel are not adequately trained.
Organizations should take care not to fall into the trap of over-customization, Cavolo warns.
“The more you customize, the more IT staff you need to maintain a system,” he says. Organizations may also face a tough transition if a staff person leaves or they need to switch vendors.
Above all, experts stress, doing nothing is not an option. While it takes work to implement IT in a strategic manner, they agree that the outcome is well worth the effort.
Residents are already beginning to demand wireless Internet, electronic health records, and one-card solutions. 
“You can’t throw technology aside,” Cavolo says. “When this economy turns around, you can’t afford to be behind.”