One of the ways the healthcare industry is working to lower costs is by transforming the payment/incentive model for providers. This is the shift from the traditional Fee for Service payment model to the Pay for Performance model.

You may have noticed that most healthcare organizations are going through a significant shift in care management and you've probably also seen news stories around the provision of preemptive and proactive care.

All eyes are on IHI's Triple-AIM framework, which is centered on three core principles:

  1. Improving the patient experience of care (including quality and satisfaction);
  2. Improving the health of populations; and
  3. Reducing the per capita cost of healthcare.

Healthcare executives already realize that if this transition is mishandled, it could be disastrous, which is why everyone from the CEO down is putting in place strategies to figure out the path to value-based care. The question is, are representatives from IT being invited to help set the strategy? And if they are, what are their contributions?

There are quite a few contributing factors as to why IT may not be included in these strategy sessions and just as many reasons why they should be, including the fact that IT staff often:

  • Have limited exposure to the larger, more complex issues
  • Are more product/vendor focused or biased
  • Are siloed into disparate groups

Many of these disconnects stem back to when IT was seen as more of a back-office services organization, rather than the tactical or strategic contributor it is today. There is no time like the present for IT team members to take it upon themselves to change the perception of their group and re-frame the narrative to break the “IT exclusion cycle”.” A few things that IT could do to make this happen:

  • Educate themselves on their organization's current strategies, such as the move from fee for service to value-based care;
  • Engage in discussions regarding how their current projects are facilitating the business goals of the organization;
  • Strategize internally on projects that could affect the bottom line and ease the shift in ideology; and
  • Research new technologies and their impacts on enabling these transitions.

It is in the best interest of IT and the organization as a whole to have “all hands on deck” with respect to these overarching business drivers. If IT takes the initiative to educate themselves and bring attention to their role in the payment model transition, they will be positioned as valuable team players and will be more likely to be included in setting strategy early on. There are numerous benefits to be realized by including IT:

  • Empowerment, inclusion and team unity. An empowered employee is a productive employee;
  • Gaining valuable insight from their expertise. Seeing problems from multiple angles leads to better solutions;
  • Aligning vision of the organization with the IT group. Teams perform better when they know the end goal;
  • Instilling forward thinking in the IT organization. This mentality trickles down to all work resulting in better long-term solutions;
  • Course-correction in terms of poor technology choices. There is a team of technology experts at your disposal, lean on them for their insight; and
  • Cost savings with innovative technologies. Some of these insights may result in time and cost savings.

It isn't realistic to bring everyone into these early stage conversations, but by bringing in key players to disseminate ideas, all these benefits can be realized. Working in a top-down fashion in terms of discussion and debate allows an organization to find a bottom-up solution. This ensures that the best ideas rise and become incorporated in strategy, all while increasing team unity through a shared-vision.

How has your organization tackled the IT Inclusion paradox? Is your IT team actively working to change the status-quo? And in what ways would you go about breaking the exclusion cycle?