Personal Narrative: My New Internship With RHIO

Health Information Exchange (HIE) supports both transferring and sharing of health related information that is usually stored in multiple organizations, while maintaining the context and integrity of the information being exchanged (HIE, 2014). The goal of health information exchange is to expedite access to and retrieve clinical data to provide safe efficient, effective, equitable, timelier patient-centered care (HIE, 2014). HIE “provides access and retrieval of patient information to authorized users in order to provide safe, efficient, effective, and timely patient care” (HIE, 2014).

Demonstrate a responsible way to share health data among other hospitals and academic researchers that will develop new medical therapies and drugs.

Health Information Exchange (HIE) has become a major component in today’s healthcare. Health information exchange provides a secure way for providers to appropriately access and electronically share a patient’s medical information. Therefore, reducing duplicate testing, minimizing medication errors and providing a link among electronic health records (EHR) in order to provide quality healthcare.

HIE face a range of challenges as they try to get hundreds and even thousands of participants in sharing data. Getting data in front of doctors and other clinicians is one of the biggest challenges HIEs face. Ideally, it would be delivered directly to a providers' EMR system, so when a patient goes to an outside lab for blood tests, the results would show up in the electronic record at the doctor's office, and the doctor would be notified that the results are there. However, with limited EMR use across the country, HIEs have had to provide alternative delivery methods. HIE is considered to be one of the key components of the national health IT infrastructure being established by the HITECH Act. Policymakers and health care providers believe this health IT infrastructure will produce a number of benefits, many of which are directly related to HIE.

State wide HIEs- is run by the government of the particular states, or may be the (SDT) State’s Designated Entity. Regional/Community HIOs- is inter administrative and depends on a difference of funding sources but most are not for profit. Even though the significant use program that’s been fueling modernized HIE activity accomplished over the years, health information exchange efforts has been flowing for more than a decade. Subsequently burning through seed money some health information exchange have run out of funds. Persuasive medical management providers contribute advice with adversaries about their patients has been a hard bargain, as has the approach of hospitals and physicians compensating contributions fees to engage in and become economically supportive with these data backup training. The Meaning Use benchmark demanding more patients facts giving are developing people’s

“An electronic health record (EHR) is a digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users.” (healthit.gov) The EHR mandate was created “to share information with other health care providers and organizations – such as laboratories, specialists, medical imaging facilities, pharmacies, emergency facilities, and school and workplace clinics – so they contain information from all clinicians involved in a patient’s care.” ("Providers & Professionals | HealthIT.gov", n.d., p. 1) The process has proved to be quite challenging for providers. As an

Health Information Exchange is the electronic movement of healthcare information amongst organizations according to the national standards. HIE as it is widely known, serves the purpose of providing a safe, timely, and efficient way of accessing or retrieving patient clinical data. Health Information Exchange allows for doctors, nurses, pharmacists, and other vital healthcare professionals to have appropriate access and securely share vital medical information regarding patient care. Health Information Exchange has been in efforts of developing for over 20 years in the United States. In 1990 the Community Health Management Information Systems (CHMIS) program was formed by the Hartford Foundation to foster a development of a centralized data repository in seven different geographically defined communities. Many of the communities struggled in securing a cost-effective technology with interoperable data sources and gaining political support. In the mid-1990s a similar initiative began known as the Community Health Information Networks (CHINs) with the intention of sharing data between providers in a more cost-effective manner. In 2004, the Agency for Healthcare Quality and Research Health Information Technology Portfolio was funded $166 million in grants and contracts to improve the quality and safety to support more patient-centered care. This was the beginning of the progress we have seen in HIE today. Health Information Exchange devolvement serves the purpose of improving

I completed my internship at Saint Agnes Home, Inc (SAH) located in West Hartford Connecticut. I was assigned to single Teenage Mothers. The Saint Agnes is a non-profit program licensed group home run by the State of Connecticut Department of Children and Families for pregnant and/or parenting adolescents and their babies. The mission of the Saint Agnes program is to provide residential care and support services to single pregnant and parenting teen mothers and their babies. The Saint Agnes Home program emphasis values, respects life, and recognizes the unique dignity and optimum potential of each person served. The program is staffed by licensed clinical social workers, registered nurse, and other college prepares professionals.

The high cost of healthcare continues to rise and many in the United States are optimistic for health information technology to reduce and improve our current situation. Health IT encompasses a broad array of new technologies designed to manage and share health-related information. When properly implemented, these systems can help coordinate patient care, reduce medical errors, and improve administrative efficiency. Therefore, implementing a Regional Health Information Organization (RHIO) will help the National Health Information Network (NHIN) achieve their goals in improving quality of care for the citizens of the United States. Thus, in order for the health IT to deliver on its promise, several obstacles must be overcome.

14. Capability to exchange key clinical information among providers of care and patient-authorized entities electronically

In health care, patients’ lives are in the hands of the health care practitioners, health care organizations, insurance companies, and to some degree, even health care technology. The growth and future implications of evidence-based medicine (EBM) through improvement of technology in health care are important today, because health care practitioners and organizations want to ultimately decrease cost, improve quality of care, and increase access to health care (Glandon, Smaltz, & Slovensky, 2014, p. 28). One way to achieve these goals is through the implementation and improvement of EBM and interoperability which will enhance the efficiency of work production resulting in these positive outcomes. According to Glandon, Smaltz, and Slovensky (2014), EBM is an “information management and learning strategy that seeks to integrate clinical expertise with the best evidence available to make effective clinical decisions that will ultimately improve patient care,” (p. 6). “Interoperability is the ability of different information and communications technology systems and software applications to communicate, to exchange data accurately, effectively, and consistently, and to use information that has been exchanged,” (Iroju, Soriyan, Gambo, & Olaleke, 2013, para. 1). Without interoperability and EBM, fundamental data and information such as patient records cannot be easily shared across and within enterprises having a direct impact on the quality of care. It

This week I began my 6-week internship at Blue Cross Blue Shield of Nebraska (BCBSNE). The first day was a common orientation for all new employees, internally denoted to as the “onboarding process” where all employees are told they matter. This full-day session communicates the core mission, vision and goals of BCBSNE, organizational structure, operating objectives, and workplace culture. BCBSNE is a not-for-profit health insurance company that is focused on collaboration to find the best solution for their customers; in other words, they are customer-focused. Since the implementation of the Affordable Care Act (ACA), many changes to the health insurance market required a change in the organizational structure and culture of BCBSNE. Through partnerships with providers, the goals of BCBSNE are to be responsive, accountable, minimize errors, and decrease costs – all components of the ACA. BCBSNE has strategically aligned their goals to those of the government-mandated goals, and implemented them at all levels of the organization, making them competitive in the health insurance market. I found this very fascinating: I was very excited after day one!

Last summer, I was able to intern at Clary Document Management, a small company that my soccer coach owned. I worked in the Data Management department, where I handled medical records for hospitals, doctors, and patients. Because the company was relatively small, I was able to get a really close look at an entrepreneur and his business. I have always been interested in one day developing my own business, but while interning last summer this interest really grew and began to branch out. More recently, I have also begun thinking about going back to Ecuador and establishing a business there. While I was able to get a small insight to the world of business last summer, the Endeavor Argentina internship will be able to further increase my knowledge in Latin American business, while also being able to provide to the Latin American community.

I am still in the middle completing my internship with Metro South Addiction and Mental Health Service which is a branch of the Queensland health system. The main focus of my internship was on a festival that Metro South was running called Positive mindset Creative Arts Festival,

Today was the first day of internship. I attended a new hire training secession about 8 hours and heard about the history of Novogradac & Company LLP, met the partners of the firm, completed all new hire paperwork and turned in to HR. In addition, I learned about ProSystem Engagement which company has been using for audit and tax preparation software. At the end of the day, all intern received a tour of office and met their own team members.