Advanced Medical Software - Assignment Example

?Laboratory Information System for Academic Medical Center Scenario A. Between the two solutions, the Enterprise wide fully integrated solution would best serve the laboratory information system (LIS) needs of an academic medical facility. For one, it simplifies the interfaces needed to serve the core of the patient care systems, rather than the convoluted linkages involved in the BOB system. Also, implementing a fully integrated solution generally costs less than the BOB packages. While BOB appears practical for it provides the option to spread implementation over wider time duration, it would actually cost more than the fully integrated solution (Robinson n. pag). Also, it is more convenient to use considering the speed and the volume of data available in the system (Robinson n. pag). Lastly, it facilitates more efficient project management: a single service provider gives more detailed, responsive, and coordinated action in times of system errors or even, in the regular maintenance of the system. B. An example of a fully integrated solution is the HNA Millenium ®, a system built to automate electronic medical record, patient care ordering, review of resident orders, closed-loop medication management, health information management, and access management (Krishna 18). For its laboratory system component, it seeks to reduce the average turn-around time for laboratory and radiology reports (“The Gemini Project” 117). Diagnostic results are expected to be made available to the physician within seconds after verification. Another example of an integrated solution is Matrix’s Tafnit ERP system, a comprehensive solution for laboratory functions. It installs the “Autolab” LIS that is used to issue referrals and obtain data for billing (“Assuta Medical Centers” n. pag). On the other hand, an example of Best of Breed solutions is the Soft Computer’s Laboratory Suite--designed to optimize laboratory operations while ensuring tight coordination with the laboratory instruments, robotics, and other information systems (“Laboratory Information Systems Suite” n. pag). Another is the LIS by Clinlab, designed by medical technologists to aid of client/server applications. It promises high performance, back up data storage, and unlimited system capacities (“Product Overview” n. pag). Scenario 2 Detailed Requirements Document i. Stakeholders The most essential initiative in an organization is to provide the needs of its stakeholders--for without them [stakeholders], an organization works as good as nothing. Incorporating radiology images into the Personal Health Record System would further advance this initiative and is expected to benefit various stakeholders. Below is the list of the prospective stakeholders with their corresponding needs: 1. Patients- More than anyone else, they are the ones who would want timely and easy access to services. Remarkably, patients today have low levels of tolerance for delayed or lost reports and films. Patients’ minimum expectation [that needs to be served] is to receive quickly generated, readily available, and reliable radiological reports (Thrall). 2. Referring physicians- As much as possible, physicians would like to have timely access to patient information. For decades, film handling and delivery systems for hard-copy reports have frustrated physicians because of these systems’ inefficiency and poor reliability (Thrall). 3. Hospitals- Primarily confronted with severe cost-cutting pressures, hospitals seek to find cost-cutting measures: lowering the average lengths of stay, cutting the length of care-process cycle, as well as eliminating some unnecessary inpatient days. Interestingly, hospitals are eyeing on the radiology department to achieve the aforementioned objectives (Thrall). 4. Radiologists- Similar to physicians, these key stakeholders are also confronted with unreliable and inefficient hard-copy film management systems. A more improved infrastructure for practice-support and implementation of systems is vital for their tasks (Thrall). ii. Existing Workflow The following diagrams show the typical workflow of three different processes in radiology, which are commonly the sources of inefficiencies and unreliability in the system. 1. Exchanging information with referring physicians (Corepoint Health 3) 2. Radiological interpretation process (Corepoint Health 4) 3. Billing and coding process (Corepoint Health 5) iii. Future Workflow The following diagrams represent the workflow of enhanced processes in radiology. (Corepoint Health 6) (Corepoint Health 7) (Corepoint Health 8) iv. Limitations/Problems In the physician-referring process, problems arise out of the inefficiencies involved in the manual processes--starting with patient referral up until the delivery of final patient report. As the diagram shows, it would take days to complete this process since three out of four steps require manual effort. These manual processes include receiving of paper orders and updating of patient information, correlating patient data, images, and reports, and physician’s manual entry of patient report in the EMR system. In effect, both turnaround time and report delivery are lengthened (Corepoint Health 3). Meanwhile, in the radiological interpretation process, radiologists are caught in the midst of digital images, papers, and dictation equipment. In this case, even with Picture Archiving and Communication System (PACS), this workflow still entails great manual effort. As a result, radiologists’ mobility becomes severely limited. Another challenge is to bring in the right expertise to the right patient at the right time (Corepoint Health 4). Lastly, in the billing and coding process, the problem lies on the high cost of labor hours and paper use in billing several facilities and organizations. Another problem lies in providing paper records for the requisition of demographic and insurance information (Corepoint Health 4). This would require manual retrieval from various applications, which would also contribute to inefficiency and unreliability. Particularly, turnaround time is once again lengthened (Corepoint Health 5). v. Plan of Action In order to counter the manual process inefficiencies in the referring physician process, information will be electronically integrated on the physician’s EMR. Using an HL7 interface, the referring physician could directly send patient demographics and order information to the RIS system. In turn, the RIS would send final report directly to the physician’s EMR. This action would enhance service levels--faster turnaround times and increased customer loyalty, reduce operational costs--saves time in placing fax orders and results as well in rekeying data, and reduce clerical or manual errors (Corepoint Health 6). Meanwhile, problems encountered in the radiological interpretation process could be solved through the use of multiple applications integrated in the enterprise-wide collaboration of clinicians and radiologists. Surpassing the PACS, this system would enable radiologists to see images and supporting documentation, so they could begin dictation in one click. Further, this system enables RIS to simultaneously provide voive recognition system as well as document management solution. Also, RIS does not require a single-vendor to achieve integration because an HL7 interface allows data sharing and workflow efficiencies. Essentially, this system would increase radiologist productivity, decrease cycle time and increase volume of completed reads, and would promote more value added services (Corepoint Health 7). Lastly, for billing and coding process, professional services would be integrated into the Hospital Information System (HIS) or EMR of referring facility. Still with the use of HL7 interfaces, RIS and other information routes for insurance coding could retrieve patient demographics and reports. Also, billing process could already be reduced to only few manual steps. In effect, this would reduce operational costs, decrease reimbursement cycle time, and increase accuracy (Corepoint Health 8). Overall, these future enhancements would have a positive effect on the workflows of the radiology department. Automation and technological advances would certainly promote workflow optimization. Consequently, care delivery, productivity, and customer satisfaction would be significantly improved. Finally, imaging centers that allow electronic data exchanges are able to strengthen their reputation and to take advantage of more business opportunities (Corepoint Health 9). Section 2A. The Functional Components of an Electronic Health Record System EHR System aims to provide health care services using the technologies today. As people largely depend on electronic devices in their transactions, health care providers aim to use such technologies in their services. Thus, the proposed system, which integrates Personal Health Record with Picture Archiving and Communication Services (PACS), allows both clients and providers to use services in the comfort of using those technologies. EHR system requires highly functional components that make EHR system applicable, productive, and easy to use. EHR System components include Administrative, Laboratory, Radiology, Pharmacy, Computerized Physician Order Entry, and Clinical Documentation (MITRE Corporation 6-8). In developing an EHR System, the Administrative system is required to have an electronic RADT process (registration, admissions, discharge, and transfer), which allows clients and service providers to share clinical information. As for the laboratory, radiology, and pharmacy components, their system needs to be interfaced to the administrative service component to allow electronic data sharing. On the other hand, EHR system needs to have a highly functional system of electronic clinical documentation (ECD) to share records to clients and providers effectively. ECD allows clients to access their medical records remotely, hence, less time-consuming. Computerized physician order entry allows clients to order health care services electronically. Furthermore, EHR system also provides clients with electronic transactions and scheduling of appointments with their physician. In this way, clients need not suffer the hassles of falling in line to schedule for an appointment. On this account, it can be said that the proposed EHCR system needs to be client-centered to give efficient, fast and reliable health care services. Section 3E. The Nature and Functions of PACS PACS is an electronic system used by health care service providers. It is used to obtain, archive, and retrieve clinical images digitally to ensure the convenience of both clients and service providers. Specifically, PACS allows sharing of images such as x-ray photos, radio isotope, ultrasound and MRI (“PACS”). As PACS ensures long time storage, it reduces costs in handling and purchasing manual storage devices. Additionally, this system also allows medical health care providers to share the medical records of their clients electronically. Furthermore, digitalized laboratory images allow clients and physicians to get unlimited copies of laboratory records and ensure that their medical documents are in a secure location. Additionally, computerized sharing of images ensures easy and remote access to laboratory records should clients decide to get second or third opinions from other health care providers. Thus, this kind of service is client-centered and aimed at providing easily accessible health care services using the technology today. The concept of PACS came out in 1980s when films and other manual storage devices prove insufficient to store images for longer periods (“PACS”). As a solution to this inefficiency, health care providers invent a system that could store images digitally, thus, ensuring that images would not be physically disintegrated. Aside from the electronic storage and retrieval features of PACS, it also allows digital image enhancement and improves the quality and resolution of images provided by radiological examinations. As digital images may be prone to image manipulation, Clinical Practice Guidelines provide regulations on image enhancements. Although PACS is a noticeable medical breakthrough that could be taken advantage of, its application in medical practice follows the standards of the Clinical Practice Guidelines. Section 4L. What Are Clinical-Practice Guidelines And How Are They Employed? As any professional practices need guidelines, the standards followed by medical practitioners are taken from the Clinical Practice Guidelines (CPG). CPGs are rules of conduct governing medical practitioners in their professional relationship with their patients (Open Clinical). These guidelines are made to assist the decision-making process of medical practitioners in relation to their patients. CPG serves as the law of medical practice, and it prescribes the appropriate conduct between practitioners and patients. Aside from regulating medical practices, this guideline also promotes continuing education to improve medical research especially in the field of health care services. Aside from promoting the welfare of health care service users, CPG also assists the professional development of practitioners. The application of CPG differs according to the stage of the illness and the age of the patient. For instance, the processes involved in treating cancer are not the same as those processes involved in treating asthma. Also, CPG prescribes the necessary processes that need to be used in different stages of illness. For instance, the processes involved in treating a stage three cancer are different from the processes used in treating cancer in the first stage. Furthermore, as older and younger patients are more vulnerable than adult ones, they are most prone to complications. Thus, it can be said that CPG is employed based on several factors including the culture of the country, the level of the illness, and the patient’s age (Clinical Practice Guidelines). These guidelines not only assist physicians in the decision-making process, it also promotes their continuing education. Works Cited “Assuta Medical Centers.” Matrix: The Leading Information Technology Company. Matrix, Web. 16 Dec. 2011. . Clinical Practice Guidelines. The Royal Children’s Hospital Melbourne, General Medicine, n.d. Web. 15 Dec. 2011. . Corepoint Health. Rethinking Radiology Workflow: Automating Workflow Processes, n.d. Web. 21 Dec. 2011. . Krishna, Santosh. Information Technology Business Models for Quality Health Care: An EU/US dialogue. Eds. Santosh Krishna, Andrew Balas, Suzanne Austin Boren. Netherlands: IOS Press, 2003. Print. “Laboratory Information Systems Suite.” SCC: Soft Computer. Softcomputer, Web. 16 Dec. 2011. . MITRE Corporation. National Institutes of Health. Electronic Health Records Overview. Virginia: US National Center for Research Resources, 2006. Print. Open Clinical. Clinical Practice Guidelines. Open Clinical, 14 Sept. 2011. Web. 15 Dec. 2011. . “PACS (Picture Archiving Communication System).” Biohealthmatics. Biohealthmatics, 10 Aug. 2006. Web. 15 Dec. 2011. . “Product Overview.” Clinlab: Advanced Medical Software. Clinlabinc, Web. 16 Dec. 2011. . Robinson, Phil. Best of Breed v. Fully Integrated. The Business Performance Improvement Consultancy, Web. 16 Dec. 2011. . “The Gemini Project: University of Illinois at Chicago Medical Center (UICMC).” Himss.org: Transforming Healthcare Through IT. HIMSSS, Web. 16 Dec. 2011. . Thrall, James. Meeting Stakeholder Expectations in Radiology Through Internet PACS. ImagingEconomics. ImagingEconomics, 2001. Web. 21 Dec. 2011. . Read More