HIM 6640 Case Studies in Health Information Management
Name: Bayo Oshunlalu
Case #: 1 – 19
Case Title: Primary Ambulatory Care Center EHR and Meaningful Use.
Qu. 1. What major elements do you need to consider in the project to propose a selected EHR system and become a meaningful user?
Gaining familiarity
A multi-physician-owned primary ambulatory care practice and the board of directors seek to embark on implementing an EHR system that will enable the organization to meet the meaningful use requirements of the American Recovery and Reinvestment Act (ARRA). The decision to embark on the project was mainly driven by the incentive program offered by the stage I of the HITECT/ARRA, and to provide the organization with the capability to streamline their registration, billing, and bedside documentation process.
Recognized Symptoms
The first step necessary to begin with the EHR implementation process is the assessment of the organization’s readiness for an electronic system; these assessments will include the expectation of the organization regarding the proposed EHR system, the clinical goals of the practice, and the financial ramification of embarking on the EHR project. Furthermore, the assessment will highlight various processes that will include administrative procedures, clinical workflow redesign, data collection process and data integrity issues, how literate are staff members with computers (the need to offer education program in basic computer usage), special
EHRs adoption is an essential part of improving patient safety and the quality of health care by reducing errors, allowing access to complete and accurate medical information to produce better patient outcomes. Although, it seems like a win/win situation there are still some challenges that appear when implementing an EHR. Some challenges would be Time, Cost, Work- Flow Distribution, Security/Privacy, and Interoperability just to name few. Interoperability is defined as the ability of a computer system or software to exchange or make use of information, which can create a major issue for any organization if these systems are not communicating properly. Security and Privacy are always a concern because implementing HIPAA measures is not an easy task. Not only do you have to comply with the federal level organization still need to recognize state laws which can often be more stringent. Especially, when you need to cover areas such as mental health, drug and alcohol services, genetic testing, HIV, and family planning issues. Change management would be enacted to overcome any issues involving process change resistance. It is a methodical approach and application of knowledge that use tools and resources to deal with this type of change. Methodologies would
The software related Electronic health record implementation need to be appropriate for the needs of the organization and budget.(Swab, & Ciotti, 2010) The EHR software system has many areas of market depending upon the size of the hospital bed size. The first criteria for the vendors according to the bed with 100 and small hospital The Electronic health record system cost about between $ 1 million and 2 for the electronic health record system The electronic health record software cost for the organization about medium hospital cost is much larger than the first one. It comes around three to ten million. The hospital and organization with more than average bed cost for the electronic health record system will be higher amount than the other one. The cost and amount of electronic health record system will depend upon the size of the hospital . The management has to decide about the budget for the organization. (Swab, & Ciotti, 2010). The organization must evaluate its mission and goals in light of its particular strengths and weakness and in light of the demand for services and competition in the external environment. Based on that evaluation it can make a plan that will take advantage of opportunities like Electronic health record implementation according to the goals of an organization.(Finkler, Ward, & Baker, 2007).
A wave of medical errors and patient deaths caused by healthcare providers renewed the search for a viable EHR system in 2000. Electronic health records would allow "providers to make better decisions and provide better
In the recent years, EHR implementation has been one of the biggest change that occurred in the health care delivery system. The adoption of EHR system which aims to improve the quality of healthcare, however, has met a lot of issues and barriers that are detrimental to its success. Thus, for any healthcare organization to achieve a favorable outcome after the EHR implementation, numerous factors have to be examined. Merrill (2010) has listed down the top ten factors for a successful EHR adoption. It includes right leadership, shared vision, right culture, governance, physicians, nurses and key stakeholders are engaged early and accountable to lead the clinical transformation, resources, clinical content standardization, realistic timelines and expectations, effective training and communication plan, and right vendor partnership relationship.
I will line up subject matter experts who know the business processes for the new system and can provide guidance to developers and programmers during build out.12 In addition, assign a business expert full-time, or nearly full-time, to the implementation; and create a steering committee that includes subject matter experts and developers, that meet frequently.12 A detailed plan will be developed to describe the functionalities of the system and how to measure the performance of the system and its output. The EHR system has to be compliant with requirements of Health Insurance Portability and Accountability Act (HIPAA) which helps ensure the privacy of electronic health information.13
To better understand where my facilities progress is concerning EHR’s, I will first explain the six step process in implementing an EHR. In the first step, an organization must assess their preparedness to initiate an EHR. This includes their
The purpose of this paper is to discuss the ehr mandate and how it relates to affordable care act. The six steps in implementation of an electronic health record and how I would use them in the nursing home. The definition of what meaningful use is and what is HIPAA and what could happen if those laws were violated
The system should be fully integrated including care coordination, sustainability and quality improvement efforts. The selected EHR must provide features and functions to facilitate the achievement of both CMS Meaningful Use (Stages 1-3). The features and function of the EHR should not require any additional hardware, software or program development.
Focusing on the outcome and not the process of the outcome, a needs assessment is a systematic approach to the electronic record adoption project scenario. The outcome of a needs assessment given scenario is the adoption of an Electronic Health Record system by the health care organization. For the site to adopt and accept implementation of an electronic health record system, benefits have to be clearly outlined and presented to the site staff. The staff must be convinced that the core functions of implementation of an electronic health records system is management of patient health information and data. Transitioning from an analogous patient records too EHR system, patient information and knowledge becomes immediately accessible and navigable by medical personnel. Electronic Health Record system would also provide the staff immediate access to testing result and CPOEs. Electronic health record CPOEs eliminates the self-evident sometimes ineligible physician order. Eliminating the time from when the physician prescribes the order to the time the procedure is performed is a core benefit to electronic health record application. Finally the staff needs to be informed that one of the outcomes of an electronic health record application system is decision support. Prevention, drug prescription, diagnosis, and disease management are functional EHR decision support functionality applications (“Comprehensive Needs Assessment,” ed.gov, 2001).
The scenario selected for this evaluation project focuses on the electronic health record. The scenario involves patient documentation, clinical decision support, and performing nursing notes. The project involves evaluation and implementation of EHR. The electronic health record and clinical decision support are not only relevant to my current organization but also are particular interest of mine. The electronic health record has helped to reduce the amount of paper which was a nightmare to maintain with the number of new patients being admitted daily. The electronic health record has also reduced the amount of missed documentation and errors. Any clinician can testify to the wasted time and poor communication among providers that sometimes results because antiquated paper records still predominate in our offices and on the hospital wards (Shortliffe, E. H., Tang, P. C., & Deimer, D. E., 1991). The clinical decision support system has been a great assistance to clinicians. Nurses, health visitors and midwives, as the largest group of healthcare professionals, record and generate most of the information used to maintain and improve patient care (Levy, S., & Heyes, B., 2012). Clinical support systems (CDSS) integrate information (ideally from high-quality research studies) with the
Hence, EHR 's are inherently complex amalgamations of diverse subsystems targeted toward varied users. The stakeholders are the users and must have a role in implementing any IT or EHR system into its work flow. An EHR can be customized to accommodate any environment depending on the level of expertise of the vendor and how long they have been in the business of creating an optimum system that 's customized to fit the organizations needs. For the most part, EHR 's must be designed for efficient, error free use. Ideally, an EHR is a system that encompass all the subsystems that make a hospital meet "meaningful use" criteria to acquire incentives for adopting EHR into practice. In the next five years, EHR adoption will no longer be a luxury, it will be a "MUST". EHR 's and other health information technology will be a necessity to practice medicine (econsultant.com, 2010). Rather than purchase several standalone systems, it would behoove one , in my opinion , to purchase an EHR that would satisfy all the needs of the stakeholders, the physician , nurses and other hospital staff and all parties involved in the tertiary practice too. Although LWMS 's budget is not large enough to accommodate the full cost of implementing an EHR,
Anita Ground also stresses on the huge importance of this planning stage by using a concept of system life cycle. It consists of feasibility study, analysis, design, programming, implementation, and lastly maintenance (Ground, 2011, VA TMS training material). The analysis phase in particular would coincide with what the author Yoshihashi is presenting in figuring out office strategy and researching EHR options. Identification of stakeholders and system requirement would play a critical role in EHR adoption (Ground, 2011). Stakeholders would include patients, family, clinicians, billing, registration, and coding as well as the external users such as Centers for Disease Control (CDC) and Centers for Medicare and Medicaid Services (CMS). Bottom line is that the new system being purchased would need to provide meaningful use to the clinic based on the current certification standards.
The U.S. Department of Health and Human Services (HHS) states that in order to realize meaningful use of the EHR technology, healthcare providers are obliged to apply the technology in a approach that enriches quality, safety, and efficiency of healthcare delivery; ebbs healthcare inconsistencies; involves patients and families; enriches care coordination; expands population and public health; and guarantees sufficient privacy and security guards for personal health information. (U.S Department of Health and
A readiness assessment can assist in identifying the readiness of an organization to successfully starting an EHR, the readiness for the staff to accept, and productively by using the EHR. The results will help assess what the current state of technology is, what is needed to make a
Hoping to encourage health care organizations to move toward health information technology (HIT) and electronic health record (EHR) adoption faster, the federal government allocated more than $14.5 billion dollars in Meaningful Use incentives in the 2009 stimulus. On the surface, adoption numbers seem to suggest the stimulus was successful. Today, four out of five hospitals utilize EHRs, and almost as many office-based physicians (78%) have adopted some form of EHR system, according to 2013 stats released by the Centers for Disease Control & Prevention (CDC). However, transforming the healthcare industry is more complicated than simply improving adoption rates.