Published on : June 22, 2010

Project Managers for the Future’s Healthcare

Project Managers for the Future’s Healthcare

Faced with aging populations, rising incidence of chronic pathologies, and shrinking budgets, national healthcare systems need to adapt to a radically changing framework of diagnosis and healthcare needs. Against this backdrop, medicine and healthcare organizations will have to evolve towards new models of reference; and to drive such complex evolution, it is imperative that a new generation of Project Managers be equipped with an innovative approach to their work.

The challenges of future healthcare

Today’s healthcare systems are faced with the need to adapt to radically changing diagnosis and healthcare requirements, and this need is set to grow in the future. The roots of this change lay in the following:

  • Demographic factors, such as population aging and migration.
  • Epidemiological factors, such as the rising incidence of chronic pathologies.
  • Economic factors, such as the shrinking active work force, which will result in more limited availability of resources for health and social spending.

Medicine and healthcare organizations will thus have to evolve towards new reference models that recognize and meet these challenges. Failure to do so will lead to the gradual deterioration and potential collapse of the entire social structure as we know it.

The objectives of future healthcare

In the field of medicine, the evolution already under way is leading towards a preventive approach, involving early diagnosis and personalized care. Research in the field of genomics, although still in its infancy, has already opened a new chapter in the history of medicine.

From an organizational stand point, healthcare institutions will need to move towards network type models, in which the hospital represents the treatment point for acute pathologies, with high levels of technological and assistance input, as envisaged at the beginning of the decade by the Renzo Piano Commission in the Ten Guiding Principles for Hospitals of the Future. Within the framework of this healthcare network, hubs for the treatment of acute pathologies will be complemented by a range of other hubs, from territorial care, involving general practitioners and ambulatory centers, to home care; which together, will constitute a fully fledged and effective extension of acute patient facilities. New organizational models will have to redistribute economical resources from the hospital to the territory, empowering this second in order to achieve wider and cheaper care services. The healthcare network will also have to embrace Personal Health Informatics tools and solutions, which other systems have already started to develop like Google (Google Health) and Microsoft (Microsoft HealthVault).

As mentioned from the latest World Health Report 2008, the target is to deliver healthcare with equity to all the citizens, independently from their economic possibility. Failure to do so will result in social instability. The goal can be reached through an increased role of Primary Care, as well defined from the WHO report, entitled “Primary Health Care: now more than ever.” General practitioners play a strategic role in healthcare needs addressing, treating directly low profile diseases (usually associated with chronic pathologies), and sending patients to acute care facilities only for specific serious diseases. General Practitioners are even fundamental in all the prevention activities.

From an economic stand point, considerable attention will have to be given to issues of prevention, de-localization, standardization, and appropriateness of treatments, and improved efficiency and quality, with a view to using the limited resources available to best effect.

New healthcare projects

So what will be factoring into the projects design, to guide and support future healthcare?

They will be increasingly extensive and heterogeneous. They will also include a wide range of components and aspects, which are listed and discussed below.

1)    Building and plant engineering

Increasingly, the building and plant engineering aspects of projects will need to be centered upon people (both patients and healthcare personnel) and the environment. In terms of design and construction, healthcare facilities will need to adhere to principles of humanization, urbanity, and sociality, as well as gearing themselves towards providing effective support for the processes that they will be required to perform in everyday use. Energy and environmental issues will also play an increasingly important role and will lead to the design of facilities with low environmental impact, which are energy self-sufficient. Lastly, safety, both during the construction phase and subsequent use, must be given adequate attention and resources.

Based on a projection of current design trends, the diagnosis and treatment centers of the future will be as follows:

  • Comfortable and reassuring for patients, their families, and healthcare personnel.
  • Light and open, in order to facilitate socialization without compromising individual privacy.
  • Homogeneous and integrated into their urban context; sustainable, in terms of energy and the environment.
  • Safe and efficient in operational terms.

2)    Diagnostic technologies

As far as diagnostic technologies are concerned, the emphasis will shift increasingly towards integrated diagnostics, in which a key role will be played in vivo Diagnostic Imaging (TAC, RMN, Angiography, Ultrasound, Molecular Imaging, etc.) and in vitro diagnostic solutions. These technologies will increasingly be used in conjunction with one another along with a central role in ensuring early diagnosis and providing genuinely personalized treatment.

3)    Information Technology and Healthcare Processes Management

Information technology will play a vital role in the very existence of the healthcare model of the future. All the new technologies (from plant engineering to medical technologies) will continue to generate a growing quantity of data and information, which will need suitable instruments and applications to handle them. By analyzing this immense wealth of information, it will also be possible to develop statistics-based knowledge models for facilitating the planning of treatments using specific predictive models.

Information Technology is becoming the backbone of the entire organization, in terms of communication, and will also be used in the management of all internal processes, whether administrative or clinical, according to a continuum in which the dividing lines between distinct items become increasingly blurred.

Of all the various aspects and components, the healthcare projects of the future will have to give top priority to the operational processes (first clinical, then administrative) typically associated with healthcare institutions. These processes will have to be analyzed and optimized on the basis of scientific literature, and nationally and internationally consolidated best practices.

The various actors and institutions of the healthcare processes, from the general practitioner, to the Local Health Unit, the Acute Care Hospital and the rehabilitation facility, must be connected through specific networks, being able to support information sharing an application interoperability between them with the final goal to support the single patient along its own entire lifecycle.

Latest-generation IT solutions will make it possible to incorporate the recommendations of treatment guidelines, protocols, best practices and policies into diagnosis and care processes, thus enabling the goals of standardization and appropriateness of diagnosis and care to be achieved.

Computers will take on the role of mentors in clinical activities, overseeing the various phases of clinical processes and the various players involved in them. Clinical data and information will be readily accessible at all times and from any device, while a fundamental respect for the rules of security and confidentiality will be retained. Computers will progressively cease to be heavy, stand-alone objects that are difficult to use. The various devices that we know today will merge further and become smaller, more personal, multi-channel units equipped with “natural” interfaces.

4)    Human Resources and Change Management

Despite this myriad of new technologies, the role of human resources and their cultural and organizational transformation will remain essential. Medical specialists, nursing personnel, technicians, and administrative staff will need to develop interpersonal skills, planning skills, and a collegiate sense of interdisciplinary co-operation, while adapting as quickly and effectively as possible to the major changes described above. Change Management will be a constant and critical component of the healthcare projects of the future.

A special mention must be done for the role of the patient, the very center of all the healthcare activities, increasingly informed, demanding, and attentive. A true focus on patient involvement will be one of the success key factors for any healthcare project.

New models and new skills for Project Management

All the components outlined thus far will be simultaneously present at project level, demanding new and varying skills and abilities from Project Managers. In particular, it will be necessary to push back the frontiers of project risk management and develop new strategies for identifying and attenuating risk.

Projects of this complexity will obviously need to be broken down into homogeneous sub-projects for the point of view of the goals to be attained, but good central co-ordination will play a key role in their success; therefore, Project Managers will have to enhance certain specific aspects of their knowledge base.

First and foremost, Project Managers will have to consolidate their basic skills (from Risk Management to Project Delivery, Contract Management, Project Control & Reporting, etc.). It is also imperative that the Project Managers of the future acquire elementary clinical skills, as it is vital in projects of this type, to have a clear perception of the main clinical processes and their administrative implications, the various roles and players involved, and the respective time requirements.

Without this type of background, Project Managers will struggle to interact credibly with medical and nursing personnel, recognize the real goals of the new model of healthcare and hospital facilities and assess all the diverse risks linked with the project. Much work, therefore, needs to be done in this field to define specific academic and experiential training routes for new Project Managers.

It is also imperative that these figures be equipped with organizational, resource management, and change management skills. Projects of the scope outlined at the beginning of this article involve thousands of human resources, with specialist and hyper-professional cultures, characterized by little or no aptitude for organizational collaboration. These resources must be progressively accompanied in their professional development and change management, so as to stimulate their interpersonal capacities, while respecting their specific professional skills.

An arduous task, without doubt, but one which must be attended to with the utmost care and dedication. In the healthcare projects of the future, human resources, in the final analysis, hold the key to the project’s success or failure; therefore, risk management skills must be complemented with methodologies and strategies of control in the field of human resource management.

In the final analysis, for the healthcare projects of the future, the traditional project management goals associated with monitoring times, costs and safety in the execution phase will have to be complemented with goals expressed in terms of change management and the implementation of appropriate, standardized processes.

Conclusion

The healthcare projects of the future are already taking shape. The new hospitals now being built are designed around the principles I mentioned earlier, and often include diagnostic and information technology, as well as the more traditional building components.

The healthcare of the future has already begun.

... The question is, are the Project Managers of the future ready for it?

About the author

Sara Luisa Mintrone began her career in Healthcare Information Technology in 1986 as a software analyst and programmer. From that moment, she experienced the evolution of Healthcare IT assuming different roles in technical, project management, and marketing areas. In 2005, she has been the first graduate of the online degree course in Communication & Marketing of Modena e Reggio Emilia University. Between 2005 and 2008, she was in the management field of Workflow Design and Clinical Solutions Management at Siemens Healthcare. Since 2009, Sara is the Director of Marketing and International Sales at Dedalus Spa, the leading company of the italian healthcare IT market.

Well known in the healthcare IT community for her bright and direct communication style, she’s keeping a constant eye on healthcare project management as a personal area of interest. She may be reached at Saraluisa.mintrone@gmail.com or +3934828181

References

R . Grol , J . Grimshaw, From best evidence to best practice: effective implementation of change in patients' care,   2003, The Lancet , Volume 362 , Issue 9391 , Pages 1225 - 1230 R., Elsevier; The Netherlands

E.Vignati, P.Bruno, Organizzazione per processi in sanità. Un approccio trasversale all'organizzazione per vincere le resistenze al cambiamento, 2003, Franco Angeli, Milano – Italy

Web references

Principles of Future Hospital

http://www.forumpa.it/forumpa2001/convegni/7/7.2/maurizio_mauri/maurizio_mauri_72.pdf

Personal Health Informatics

https://www.google.com/health

  1. World Health Organization: World Health Reports (1998, 2004)
  2. C. Ruta, Ai confini della medicina, 2006, EGEA, Milano
  3. Atti commissione ministeriale R. Piano - 2000
  4. World Health Report 2008