A Shared Information Technology-Business-Health Model: Lessons for Healthcare Leaders on Integrating Technology from Investment

Abstract

Objective: Technology is rapidly shifting our day-to-day existence, education, social relationships, health care and business.
Psychiatric leaders have slowly explored telepsychiatric services – but few have an approach to technology in general–due to
competing clinical, educational and research demands. Technology has typically been added on, rather than integrated, to institutional
functions.
Method: This narrative review used a literature search of Medline, PsycNET, PsycINFO, Embase, Cochrane, SpringerLink,
Scopus, ABI/Inform, Business Source Complete, and Web of Science, using subject headings and keywords along with a manual
search of reference lists of articles published by November 2020. The keywords explored four areas: 1) business; 2) service
delivery; 3) system change; and 4) technology. Articles were reviewed by title/abstract, full text review and review of references.
They were included if they discussed integration of technology into health care and compared literature from medicine/health,
psychiatry/behavioral health, business, technology, leadership and health care administration. The goal was to explore how
medicine/psychiatry has integrated technology compared to business, and apply business approaches to health care and training.
Results: From a total of 2,710 potential references, two authors found 327 eligible for full text review and found 69 papers
directly relevant to the concepts. Business and medicine/psychiatry have similarities/differences from both historical and contemporary
views. Many health care systems and companies lack a strategic plan for technology and focus only on short-term due
to administrative demands. Clinical informatics is a rapidly expanding area and would be central to this process. It has started to
facilitate patient-centered care as defined by quality, affordable, and timely health care. While in principle information systems
use integrative approaches, electronic health records, electronic means of communications with patients and staff, behavioral
health indicators and related digital advances are often added to existing systems rather than integrated. Effective businesses use
integrative approaches to share domain knowledge and streamline practices to link information technology (IT) with research
and development, production, financing and marketing management. A case example highlights the IT strategy and business
leaders’ comments in shifting to straight through processing (STP) from the banking industry for investments. It also exemplifies
a model of shared IT-business understanding, which improves performance via efficiency, quality of data/information processing/
integration and managerial teamwork.
Conclusion: When it is integrated into health care service delivery workflow, evaluated and quality improved, IT facilitates the
translation of strategic planning into organizational change. Incremental versus strategically innovative approaches to technological
integration for care, education and administration are considered. Successful implementation requires a needs and impact
assessment for patients, staff, clinicians and leaders across all levels of the organization. Benefits to the mission, limited disruptions
of core operational workflow and reasonable costs reduce the likelihood of failure.