LEARNING FROM THE DAVIES AWARDS

The Texas Department of State Health Services was fortunate to win one of this year's prestigious Davies Awards for Public Health bestowed by the Healthcare Information and Management Systems Society (HIMSS). The entire process, from deciding to apply, to vetting numerous drafts of the application, to the on-site visit once selected as a semi-finalist, to the HIMSS annual meeting where we received the award, was a tremendous learning experience. Organizations that have deployed an innovative and proven health information technology product are invited to apply, and any organization that meets the threshold criteria should seriously consider it.

Even if an organization isn't fully convinced it is ready to apply, the process of outlining the application's content could help all areas of an organization get on the same page about how the IT product supports the organization's goals. We found the application process to be very enlightening. An organization that has developed and implemented an innovative IT product rarely has the time or inclination to reflect on how the technology has improved the way it does business.

The application does not require pages of tech-speak. Rather, it focuses on how the product helps the organization provide more effective and efficient services. The application asks for details about:

• management, the organizational aspects of electronic health record (EHR) implementation, strategy, planning, project management, and governance;

• the functionality delivered by the EHR to meet organizational objectives and the needs of patients and end-users;

• the technology-technical design and architecture that enable the EHR to deliver the required functionality and performance; and

• the return on investment and intrinsic value derived from the EHR's implementation.

To do a reasonable job of covering these areas requires someone who can write well, a cross-functional approach, and multiple drafts. It might take more than one application cycle to get it right, as was the case for us and the other behavioral health organization that won this year.

Describing what the technology does, from the standpoint of how it works (in non-tech-speak), can be daunting. We were used to “preaching to the choir,” describing our EHR to interested parties that had some familiarity with it. Describing the EHR so that someone with no exposure to it understands it is harder than we thought it would be.

Being selected as a semi-finalist was humbling for everyone involved in the application process. While people who have an emotional attachment to a product might think it is good, there is nothing like external confirmation. Of course, that feeling turned to nervous anticipation ahead of the site visit, which proved to be as instructive as the application process.

A three person review team, including a senior official at the Centers for Disease Control and Prevention, a university professor, and the HIMSS staff member in charge of the Davies Awards, visited us to hear not only from key staff involved with the application but also from the product's end-users, which in our case were contracted substance abuse provider organizations. It's one thing for an organization to have end-users who are its employees, in which there is at least an illusion of control. It's quite another to have people that use the system day after day and who have no investment in the site visit's outcome be asked about the product's strengths and weaknesses.

Winners are asked to do a presentation about their product at the HIMSS annual conference. This can be intimidating particularly for a behavioral health organization, given the extensive use of technology in medical settings and conference participants' depth of knowledge. Attending the HIMSS conference was truly an eye-opening experience. I had never attended a conference with more than 20,000 participants, nor had I ever seen so many vendors (more than 900) in one exhibit hall.

At the HIMSS conference I gained an appreciation of how much we will need to change to accommodate this new and inevitable way of doing business, and the trip convinced me that behavioral health belongs at the table in the rapidly evolving healthcare IT field. We behavioral healthcare administrators and providers have an obligation to be informed about how technology is evolving in order to provide a voice for those impacted by these systems.

With the inexorable progression of integrating physical and behavioral healthcare, state substance abuse and mental health authorities, other units of government, and provider organizations need to be better informed about how technology is affecting the effectiveness and efficiency of medical care and consider how it might translate to behavioral healthcare. Organizations, both public and private, with an understanding of the rapidly transforming technology landscape will be positioned to make sound strategic decisions about the future. Using the Davies Awards application process to assess technology the organization is using or developing is an excellent first step.