Assumptions about the Healthcare Institution - Essay Example

Health Care Informatics Using your experience either as an employee or a patient of a health care system, identify five operational goals and three strategic goals that relate to the use of a health care information system. Assumptions about the healthcare institution The following operational goals fit for a doctor-owned hospital. The largest examples of those hospitals include the Mayo Clinic and the Cleveland Clinic, but there are a large number of such doctor-owned and -run clinics in the United States. This will also assume that the clinic works with capitated and self-pay patients, but with relatively few PMO patients as compared to most hospitals. Finally, although the hospital is not-for-profit, it generates surplus revenues due to its high reputation for service and good patient outcomes. Five Operational Goals 1. Improve patient care through sharing of information. This means that all patient data should be available to all health care providers at any time, anywhere within or outside of the institution. This also means that the physicians and other health care professionals can share with colleagues outside the institution, for teaching, consultation or links to satellite healthcare facilities. 2. Improve efficiency through faster transmission of results between physicians and departments. That means that if, for example, a patient has undergone lab tests, an MRI, a CT and a stress EKG, all the results should be readily accessible at the time that the doctor makes a therapeutic or diagnostic decision. 3. Improve billing cycles. This means getting the necessary information to the billing department in a form which can be submitted to an outside agency for reimbursement. Even in a heavy private-pay and HMO setting, such as this fictional clinic, it is important to have such an access. In a hospital which does, for example, $360 million in Medicare, Medicaid and third-party insurance billing per year, a 1-day saving in time from procedure to billing can shave $1 million off that hospital's accounts receivable (i.e. free up cash of $1 million for every day saved). 4. Make healthcare delivery more efficient and productive. Hospitals are in a service business, but are relatively people-intensive and unorganized. To the extent that a hospital can use computer tools to reduce staff per patient, staff per procedure, or staff per dollar of patient revenue, those computer tools help the hospital to be more efficient and productive. 5. Link to outside institutions which refer patients to our facility. Hospitals which value their high-margin operations, such as cardiology, oncology and orthopedics, depend on outside referral from primary care physicians and community hospitals. The better the connectivity between the referring doctor and this institution, the more likely that this hospital will receive those patients. Three strategic goals 1. To become the number one hospital in the region for patient referrals for tertiary care. That means that this hospital needs to establish, then maintain, a better outcomes record than other hospitals in the region. 2. To reach out to patients directly, in a way that involves the referring physician, but gives the patient the ability to help understand and direct his/her health care. 3. To use computing to supplant humans as the primary mode of communication. The longer-term goal is to eliminate paper, entice the health care professionals to use computer tools more thoroughly, and thereby to improve productivity. 2. Search the Internet for information about joint application design (JAD). Summarize the information you learned in the form of a memo to your supervisor outlining the use of JAD in the development of an RFP. Memo To: Mr. Supervisor Re: Relevance of applying Joint Application Design (JAD) to our implementation of new computer infrastructure. Dear ___, This memo covers the application of the tools of JAD to our specific situation at the Clinic. I believe that proper application of this technique will help us in developing a responsive system that corresponds to the strategic and operational goals which have been outlined in the past1. The primary aspect of JAD is the ability to bring together all stake-holders to help in the design and development of an infrastructure in order to meet the Clinic's needs. Since we are a doctor-owned and directed facility, it is doubly important that our physicians and other healthcare professionals take a guiding role in the design and implementation of such systems. The cooperation and direct personal intervention of the managers at this institution, nearly all of whom are physicians, will also be necessary in order to help convince their colleagues to learn the software and system tools which can help us all to achieve our organizational objectives. The fundamentals of JAD include bringing together all of those with a major say in the use of our systems, in order to insure that all basic needs are met. At our Clinic, these major functions include: 1. Physicians treating patients 2. Diagnostic physicians, including radiologists and pathologists. 3. Nursing station heads and nurses 4. Billing and coding 5. Those interacting from the outside, including referring primary physicians and satellite/dependent hospitals. The primary elements of the JAD process include: 1. JAD project definition 2. R&D on user requirements 3. Preparing for a JAD session 4. Conducting and facilitating the JAD session, and 5. Predicting and getting sign-offs from management and those involved in the JAD. Note that a skilled facilitator can help this process significantly. Regards, Your MIS specialist 3. Assume you have been assigned to be the Implementation Coordinator for a new information system for your organization. Draft a brief implementation plan that includes leadership, membership, frequency of meetings, and monitoring of progress. You should also include an implementation timeline. MEMO TO: MIS Manager at the Clinic RE: Implementation plan for our new information system Dear _____, As discussed, this memo provides an outline of an Implementation Plan for our new HCIT system, which will act as the backbone and jumping-off point for further technology implementations in the future. I. Establishing an implementation team Since this is an institution-wide initiative, I propose that we include a full-time member from each function, including: nursing, billing, physician (note, we can use a resident here, but it has to be someone computer-savvy and well plugged in to the staff), radiology/interventional cardiology (to represent the image-heavy functions) and a representative from the IT department of at least one of our referring hospitals. I propose that the leader of this project is the CEO of the Clinic for three reasons: (1) he is himself a physician, which will help with acceptance, (2) this will emphasize the importance of the success of this project toward meeting our overall goals, and (3) it will insure that others who are dedicating people to the team take it seriously. II. Frequency of meetings Since the implementation team is full-time, we will have regular daily meetings. Since this is a "representative democracy," each of the permanent members of the team needs to have weekly meetings with input and implementation teams in their various department. There should be a quarterly presentation to the Chairman (our CEO) and Board on progress. III. Monitoring progress I will propose a timetable in a second memo, but the overall goal is "creep, crawl, walk, run." That is, we need to give the group some initial successes and credibility, and take elements of the project that are easiest first. That way, we can get them in the habit of creating consensus, which will be needed for the future (like, say, convincing physicians to stop writing by hand). The Implementation Timeline 1. Formation of the permanent team 1 month 2. First meeting .5 month 3. Appointment of team members in each dept 1 month 4. First team member meeting .5 month 5. Complete implementation plan, sign-off, JAD 2 months 6. Complete detailed JAD per department 3 months 7. RFP formulation 2 months 8. RFP process to conclusion 3 months2 9. Vendor implementation, finish specs 3 months 10. Implementation step 1 3 months3 11. HCIT Implementation 3 months4 12. Billing implementation 3 months 13. Per major application, additional 3 months. 4. Create a user survey that would enable you to analyze the effectiveness of a health information management system. Identify at least five questions to ask. This is for the cardiology department (note that each will have slightly different needs) a. What is the volume of images and total file sizes that you generate per day, per week, per month How do these image quantities change over the year b. Where do you need to have access to these images In the cath lab In your office At home At a referring hospital For your referring physician c. Does the patient need access to these images Should it be full DICOM, or compressed d. What other alphanumeric information do you need with your images What inputs do you need, such as preliminary and final reporting e. How do you want to add in the patient diagnostic and therapeutic information Would you be willing to work with voice recognition for some elements Would you be willing to work with "canned" scripts in order to describe patient characteristics Do you need drawings of the heart and various conditions Read More