Term Paper: Public Health Informatics

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Technology and Health Information Usage between Primary Health Care Providers in surrounding underprivileged communities within New York City.

Managing an overwhelming amount of health information presents one of the greatest challenges to health care improvement in the United States. There is a growing concern in New York that underserved populations are not receiving the quality of care that they should be receiving due to the cumbersome task of data transmission. The Department of Health and Mental Hygiene has developed a plan to provide technical assistance to physicians that serve New York's poorer segments of the population. This program will serve those that receive Medicaid or are uninsured. However, there are still many underserved populations that will continue to be at risk after implementation of the plan.

Technology and Health Information Usage between Primary Health Care Providers in surrounding underprivileged communities within New York City.

An analysis of a plan to provide unified electronic information exchange among New York's health professionals

Introduction

Importance of the Project

Primary Care Information Project

Stakeholder Analysis

Identifying the Target Population

Testing and Design

Plan of Action

Recommendations

Works Cited

Technology and Health Information Usage between Primary Health Care Providers in surrounding underprivileged communities within New York City

Managing the volume of information that must be transmitted in today's medical environment requires the use of electronic databases. Electronic databases allow almost immediate access to a patient's records and the ability to share records among different medical facilities simultaneously. Electronic information transfer has all but made paper medical records obsolete in many cases. Doctors prefer the ease and speed of electronic data transfer so that they can have the most complete and up to the minute records for the patient. The ease of data transfer helps the patient by giving their doctor the most complete information possible. There is a clear advantage to electronic medical records for both the patient and the doctor.

The transfer of electronic medical information became so common that many take it for granted. However, recent data indicates that there are several problems which hamper the ability of some doctors in poor communities to gain access to the important information that they need about their patients. There are several reasons why doctors may have difficulty accessing electronic data for their patients. They may not be able to afford state of the art systems, their systems may be old and incompatible with modern software, or the records themselves may not be compatible (AHQF, 2006). This problem is a great concern in areas such as New York City that has large sections of underserved communities.

Importance of the Project

The provision of excellent medical care should not be limited by ethnic background, language barriers, or geographic location. However, the inefficiencies of electronic data transfer among the medical community does place patients in underserved areas at a greater risk for medical mistakes or quality of care issues. Doctors need Information about the patient in order to make the best decision about their care.

In order to address these needs New York City has developed a plan under the direction of the Department of Health and Mental Hygiene (DOHMH) to assist doctors in obtaining electronic health records (EHR) systems. This program has appropriated $27 million to help provide 1,000 New York City Doctors with these systems by the year 2008 (MediLexicon International, Ltd., 2006). In addition, community health centers participating in the program are contributing an additional $13 million in aid.

The program consists of a consortium of 30 community-based primary care networks located at 150 sites in the city's most underserved communities. The systems would benefit more than 500,000 patients in these areas (MediLexicon International, Ltd., 2006). The health department is currently requiring laboratories to report information electronically. This allows doctors faster access to laboratory results than transmitting them via paper routes. In some cases this can mean the difference between making a right or wrong decision regarding patient care. The health department is also using handheld computers for making restaurant inspections (MediLexicon International, Ltd., 2006).

The use of electronic data by the health department not only cuts costs in the paper itself but also in the time needed to prepare it. Electronic data can be stored in a much smaller space than paper files. The New York City Health Department monitors close to 60,000 pieces of health information each and every day (MediLexicon International, Ltd., 2006). This number will continue to grow with the population. Electronic data management is necessary to maintain efficiency in a growing population. The health department must rely on electronic data not only for individual patient safety but for public health reasons as well. The health department will be able to better track the spread of communicable diseases and prevent potential outbreaks of deadly disease. The EHR systems will save lives and are necessary to maintain the function of the health department.

According to New York City Commissioner Frieden, the health sector is more than ten years behind most of the rest of the economy, in terms of information transfer and technology. The medical profession must deal with thousands of patient care guidelines, and tens of thousands of drug interactions (MediLexicon International, Ltd., 2006). The EHRs have the potential for creating millions of dollars in state Medicaid savings through the prevention of medical mistakes that could reduce hospitalizations (MediLexicon International, Ltd., 2006). Providing the EHRs makes sense in the short-term and in the long run.

New York City has one of the nation's finest public hospital systems. The next phase of the plan is to make improvements that carry this level of quality into the community health clinics, especially among those the practice in the city's poorest neighborhoods (MediLexicon International, Ltd., 2006). The EHR Systems will allow community health centers to link with hospitals and provide information that can help decrease life threatening medical errors. Patients will be able to navigate the Healthcare system easier because of that transfer of electronic information (MediLexicon International, Ltd., 2006). They will not have to wait for the transfer of information and the delay that it causes in their care. This is especially important in emergency situations where this information could be vital to the patient's life.

The primary benefits of the HER can be summarized as follows.

Seamless communication with other electronic information systems at hospitals and laboratories.

Better continuity of care from one facility to another.

EHRs provide more information to doctors on patients' medical history at a glance.

Information is more secure than paper records.

EHRs decrease errors in writing prescriptions.

EHRs are a valuable tool in evaluating the effectiveness of medical care.

EHRs will provide the Department of Health with clearer and faster data on emerging pubic health problems.

EHRs will improve preventive care and health maintenance at community health clinics (MediLexicon International, Ltd., 2006).

The EHR system integrates patient information, academic research, and decision support tools into a single system. It also allows the doctor access to past patient visits at a glance. Doctors and nurses can order medications, place referrals, order lab tests, and receive electronic information from pharmacists and laboratories through the same system (MediLexicon International, Ltd., 2006).

It is easy to see how the EHR system is an essential part of providing quality medical care to patients everywhere. Those in underserved community have the same rights to quality health care as persons living in other areas of the city. The benefits of the EHR to patient safety far outweigh the costs of providing the systems. City of New York recognizes the importance of providing the HER systems. The following will discuss a plan to provide critical electronic data systems to doctors who predominantly see Medicaid patients.

Primary Care Information Project

In response to the need to provide better access to electronic health information, the city has developed a plan called the Primary Care Information Project (PHIP). The project is being supported by the DOHMH and is dedicated to expanding the use of electronic information in underserved areas. The program has several initiatives that involve the implementation of an EHR system. In addition to providing access to EHR the program also plans to address the following additional issues.

1. "Expanding the use of electronic prescribing (eRx). Over the next three years, the City plans to expand eRx use to more than 2,000 providers who predominantly see Medicaid patients. Electronic prescribing can improve cost- effectiveness, prevent fraud, and greatly reduce medication errors and adverse drug reactions, and is relatively easy to implement in a short time." (MediLexicon International, Ltd., 2006).

2. "Use of clinical information systems to improve mandated reporting by in doctors and medical institutions to DOH and communication between the health department and health care providers." (MediLexicon International, Ltd., 2006).

3. "Electronic Health Records at the City's correctional facilities. The City has committed more than $10 million to the purchase and implementation of an EHR system that will help ensure the highest quality of care for people incarcerated at New York City's jails, and enable improved communication… [END OF PREVIEW]

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