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¶ … B, C and D. independently however please make sure all the questions are answered independently under each section.

After looking at the chart from the Value Steps (HIMSS), individually answer the following questions:

http://www.himss.org/ResourceLibrary/ValueSuite.aspx#/steps-app

Select one of the 5 steps:

My Selection is E: Electronic Information/Data

Discuss how your institution has implemented IT based on the step you have selected

The team for this step has set up this step by setting up the three different parts of the "E" paradigm, those being Data Sharing and reporting, Enhanced Communication and Evidence-Based Medicine.

Data sharing and reporting will be manifested by other data sharing and reporting, improved quality measures reporting, overall increase data-sharing and improved data recording, increased clinical trends and population health tracking, increased sharing amongst providers and improved security of patient records. In other words, there will be sharing with those that need the data, sharing with those that can use it and wield it but the sharing will not be with people that should not have it, for whatever reason.

Enhanced communication will include the increased use of the patient portal, the overall improvement of internal communication, the improved communications with patients and the improved communication among providers. Examples of this would include a good patient website that allows patients to log in and engage in self-service and that portal information being used to manage and improve care.

Evidence-based medicine will include improved access to data for research, an increase in the number of patients that tracked/included in the data warehouse, an increased use of evidence-based guidelines and other evidence-based medicine benefits.

3. How does the specific example improve patient care?

Specific examples of one of the last data points, that being improved access to data for research, would include improved breast cancer research, de-identified research data and analytics that reduce HAPU's. A specific meaning for the "de-identified" data would be data that is useful but is stripped of private and identifiable information such as name, socials security number and so forth.

B.You have been chosen to participate in the selection team for a new clinical information system to be purchased and implemented at the community hospital where you are a staff nurse. The selection team has been asked to develop an initial list of requirements that they would like to use for the evaluation of potential systems in relation to documentation of assessments for interprofessional use, including nursing, physicians, and some other departments such as physical therapy and occupational therapy.

Your task for this case study is to use the key considerations listed below to develop a list of system requirements for electronic documentation in a clinical information system, grouping the requirements into the four categories listed above. The key considerations include information that the selection team has gathered in anticipation of developing system requirements.

The selection team has decided to group the requirements that they identify into the following categories:

• Patient Care Objectives

• Usability

• Information Technology Department Objectives

• Organization Objectives

Looking at the available EHR systems available, pick the one that you would use and identify how the four categories match with that system.

https://www.nextgen.com/Info/Top-Rated-EHR-utm_source=Adwords&utm_medium=PPC&utm_campaign=Ambulatory&keyword=emr%20software%20electronic%20medical%20records&gclid=CjwKEAjwpsGqBRCioKet -- bp_QcSJADCtbsbiHrexyWdKoU4UbQ0-byiQ_m9If_-m6fpkpDtfXDxWBoCisjw_wcB

The link above points to an Electronic Healthcare Records system that works for the four objectives above in the following ways

ICD-10 Ready

MU2 Ready

Patient-facing support performance

Efficiency gained by clients

Effectiveness of claims processing

NextGen Ambulatory Electronic Healthcare Records is "easy to use, intelligent, integrated and inter-operable" (NextGen)

Has sustainability in its pricing model

The business partner in question is one that can be trusted over the long-term

Has third party data from the 2014 Ambulatory RCM Services Report that supports all of the above

Has several distinct sub-products including many of the ones mentioned already in prior questions

Next-Gen Ambulatory HER

Next-Gen Practice Management

Next-Gen Patient Portal

Next-Gen Population Health

Next-Gen RCM Services

They have some strong electronic healthcare record resources that include the following

E-Books -- Data analytics in healthcare

Billing Efficiency Checklist -- How to know if it's time to outsource

E-Book -- Five strategies for improving the health o fa population through collaborative care

E-Book -- Ten Steps to Prevent Patients from falling through the cracks

E-Book -- Five barriers to electronic healthcare record replacement

There are several webinars that can contribute to the learning base

Dangerous trends in healthcare and how to prosper despite them

Electronic Healthcare Records -- How to demand results!!

Live Demostration -- NextGen Revenue Cycle Management Services

Current version is 5.8/8.3 and comes in the form of an upgrade.

C.A hospital and an independent physician association (IPA) comprising 600 physicians have elected to apply to participate in the accountable care organization (ACO) program sponsored by the Centers for Medicare & Medicaid Services. The hospital and IPA will agree to provide healthcare to a minimum of 5000 Medicare beneficiaries. Because the individual entities are required to report to Medicare as one entity on 33 quality metrics, including seven patient encounter caregiver experience elements, the ACO is interested in facilitating the widespread adoption of electronic medical records within the ACO. Accordingly, the hospital intends to provide assistance to the individual physicians to obtain electronic health records. In addition, the individual physicians will be required to achieve Meaningful Use and comply with policies and procedures of the ACO. Regardless of the electronic health record they would like to purchase, the individual physicians will be required to exchange health information electronically to improve effective communication between healthcare providers, reduce duplicate visits, and lower the overall cost of delivering care to the Medicare beneficiaries.

Discussion Questions

1. Explain how the arrangement should be established to permit the hospital to assist the healthcare providers in obtaining electronic health records.

There is an enforcement and requirement to use the new standards that are in place. For example, it says above that there will be thirty-three metrics that will be looked at and everyone will be required to follow those metrics. The "meaningful use" requirement is huge and will go a long way in making sure that things go as they could and should.

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/index.html?redirect=/aco/

2. Describe the timeline and the potential financial impact to the individual healthcare providers who are involved in Meaningful Use of the program.

The timeline of a switch into such a system would probably need to occur over one to two years. There would be a financial impact because the old system and the new system would probably need to exist in parallel so that the integration and migration to the new system can be complete and completely followed through with so that there is no loss of data or loss of functionality. The new system has to be operational and with no gaps before the old system is turned off.

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/index.html?redirect=/aco/

3. Discuss the benefits of using health IT within the ACO program.

The benefits of using healthcare IT is that you can combine an accountable care organization with healthcare information services. This means things like entirely digital records, strong audit trails, strong levels of access for those that need the access, restriction of access for those that should see very little or none of the data, much quicker migration of data from provider to provider and from organization to organization and so forth. In other words, as an example, getting a record from one person to a person through handing it to them or through faxing it can easily and completely be replaced https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/index.html?redirect=/aco/

4. Discuss the implementation specifications that each individual healthcare provider as a member of the ACO must implement within his or her own facility and as part of a larger ACO to protect the security, confidentiality, privacy, and integrity of patient information.

Each organization would have to implement the proper parts for their part of the Accountable Care organization structure. They data would need to be accessible for those that should get it, it must be confidential from those that should not get it, data cannot be accessible for people that do not have rights to access (or at the times they might access it) but the data must be timely, accurate and proper in nature. Data cannot be late when it should be there earlier and it should not be incorrect whenever it gets there.

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/index.html?redirect=/aco/

D.Imagine that you have been appointed as Director of Clinical Decision Support at a healthcare delivery system. This healthcare system consists of several large hospitals and multiple outpatient clinics and uses the same EHR system across the enterprise. There has been limited CDS activity at the institution prior to your arrival. Now, with Meaningful Use and the increasing need to provide increased care value, the appropriate use of CDS is an institutional priority. The current CDS available at your institution consists primarily of off-the-shelf drug -- drug interaction and drug -- allergy alerting, which is the source of significant clinician complaints due to the rate of false-positive alerts. There is a strong sense within the institution's administration that IT in general and… [END OF PREVIEW]

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