Defining the HIT Triple Aim

Can we take the concept of the Healthcare Triple Aim (Berwickian) and apply the same concepts to the design, spread, and utilization of EHR tools and other HIT? Here's what this HIT Triple Aims might look like:

1) Improved "health" of a "population" of HIT tools

a) Tools are developed, tested,  and demonstrated to improve the healthcare triple aims. If we spend large amount of resources implementing EHR-based early warning systems for rapid responds teams, we better demonstrate clinical value

b) Tools are more flexible technically. How do we build clinical decisions support tools for populations (transgendered patients, for example) when we can't even define the population within the systems?

c) Proven tools are rapidly adopted. This requires help from our colleagues in education, social media, psychology, graphic design, usability testing, and gaming. And we must create healthcare systems which are learning organizations.

d) How do we increase HIT a science to build tools with high quality and high reliability?

2) Improved HIT User experience

a) We must recognize that users include more than the physicians, but also clinic population health managers, behavioral health providers, dentists, social workers, home health nurses - ideally working in one seamless system. 

b) Patients must be considered as primary consumers (and thus system drivers) of the EHR and other HIT tools. Check out www.MyOpenNotes.org . Would you prescribe a new therapy or medication with negligible side-effect if it led to a 30% improvement in certain clinical outcomes? (NNT = 3; you bet we would endorse it.) It's coming. Get on board.

c) Are we demonstrating value (quality/cost), or improved healthcare Triple Aims with our HIT tools?

3) Decreased total cost of HIT deployment

a) Consider the annual budget of your organozations's IS Department, divided by the number of unique patients or encounters or hospital beds or providers.

b) Consider the annual budget for vendors such as Epic or Cerner (etc) - divided by some numerator as above.

c) Consider the annual Federal budget for HIT (Meaningful Use, etc)...

d) Are we able to innovate and improve at lower cost? How can we do that? Can healthcare IS Departments lower costs and improve the tools by leveraging the Model for Improvement, or Lean, or Six Sigma, or ITIL? Or are we lost in tools and it getting better at how we do business?

I welcome your thoughts!

Tim