IT feature: Communication breakdown

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As more operators develop information management networks, technology problems are also on the rise for more facilities.

In the 27 years she's been at the Parkview Care Center, Betty Jo Banks has seen her share of changes. But few have had an impact anything like the arrival of information technology.
Thanks to new data tools, she can better manage resident care, finances and overall operations at the 67-bed facility she runs in Osborne, KS.
"Technology is great -- when it works," she said. And therein lies the rub: Sometimes it doesn't.
At times, problems stem from machines or software not working or integrating properly. Sometimes IT efforts and business goals are out of whack. Other times, it's something extremely unusual.
And when technology doesn't work as expected, frazzled nerves are usually close behind.
To better understand how such disconnects affect long-term care and in other fields, Bain & Co. launched a survey last summer.
The survey polled executives at 359 companies. Fully 60% said that IT implementation at their companies has inhibited growth. What's more, at those companies where IT is viewed as an inhibitor, spending on technology averages considerably less -- 4.7% of revenue versus 7.4% at places where it's seen as a helper.
"That's a significant difference," said David Shpilberg, a Bain spokesman. "People who are frustrated with their technology stop spending," he said.
Nursing homes have traditionally characterized themselves as high-touch rather than high-tech operations. But that's changing. Increasingly, providers need immediate access to critical information in order to make sound clinical and business decisions. This is especially the case when reimbursement is involved. For many operators, data is being seen less as a cost center than a reimbursement generator.
"The management and analysis of data pays for itself in two fundamental ways," said Peter Hallett, vice president of marketing and business development for Insightful, an analytic technology provider.
 "First, data management and analysis can assist operators in avoiding risk or needless expense. Second, an effective data management strategy can generate more revenue."
So why do problems persist? Raj Tewari, a spokesman for Unisys, notes a scenario many operators find themselves in. They have numerous systems running multiple applications -- and all of them are incompatible with each other. "This incompatibility extends far below the surface," Tewari said. "It includes incompatibility of file formats, data base schemas, systems and platforms."

Great expectations
According to a recent survey by, managing business-side expectations is also a major challenge for information managers. Respondents said their effectiveness is most often compromised by "unrealistic or unknown expectations from the business." Other hurdles included inadequate budgets, proving IT's value, and aligning business goals with IT efforts, according to the survey.
When data-management efforts are misaligned, data managers can be reduced to little more than order-takers for the business. Brad Brown, a partner in the Business Technology Office at McKinsey & Co., said the expectations gap is a result of the classic business/IT disconnect.
"These people live in very different worlds," he said. "But enlightened data managers are quite adept at bridging the gap, and putting the IT world in the language of the business."
Managing business expectations is, of course, easier said than done. The goal often demands a tremendous effort by both sides. The challenge is compounded in long-term care, where data management skills have not historically been in high demand.
"Generally speaking, long-term care professionals are not trained to manage computer systems, file servers, network connections and proper handling of backup," noted Todd Spence, CEO of MDI Technologies Inc., a St. Louis-based software firm.
"However, they are wholly dependent on technology to communicate their business processes to the various government authorities that provide reimbursement," he added.
This disconnect often occurs when facil