Home Healthcare in the US - Research Paper Example

Home Health Care Thesis Topic: A detailed Analysis Report on Residential Clinical services in Merrillville Indiana, and the Information Management system used at the facility. I. Introduction II. Body Analysis of the chosen health care facility Location Type of setting Size of the facility Ownership Population served Services offered Users of the health information at the facility Physicians Nurses Administrators Support Services External Users How they access health records AllScripts Software Analysis of AllScripts software Functions of AllScripts Strengths and Weaknesses III. Comments and Conclusion Introduction Research was carried out surrounding the thesis statement; ‘a detailed analysis report on the Residential Clinical Services in Merrillville, Indiana, and the information management system used at the facility’. Information management systems have replaced manual filing in significant numbers throughout the healthcare industry, mainly because they perform duties far beyond filing in a time-efficient and cohesive manner. These software aide staff in general (administrators, physicians, and nurses) spend more time on patient care and less time on administrative duties which is a plus. The system provides a majority of advantages and as well as they provide information security to some extent. To be more specific, the paper speaks mainly of AllScripts software, the information management system used by the Residential Clinical Services. It addresses some of its features, weaknesses along with its strengths and security level. Data was collated through various sources i.e. interviews conducted with nurses, administrators and physicians and also a variety of web articles. Home Health Care The Residential Clinical Services situated in Merrillville, in northwestern Indiana was established in 1987. This home care facility was established to provide commitment to excellence in patient care. The Residential Clinical Services main mission is to help patients and their families make the transition from hospital to home as smooth as possible. The facility is administered by Aileen M. Ellicott NP and has a total of 23 employees working there. It also serves a wide populous in the Indiana state, inclusive of; Northwest Indiana to include Lake, Porter, LaPorte, Starke, Newton and Jasper counties. The agency offers skilled nursing, physical therapy, occupational therapy, speech therapy, and medical social services for financial or psychosocial counseling and identification of appropriate community resources. Home health aides are also available for those patients who are unable to manage their own personal hygiene, prescribe exercises and meal preparation. Additionally, their services include a comprehensive Oncology program with nurses highly competent in the total care and instruction of the patients with cancer. Programs such as Pain Management, Education, Supportive Care, Infusion Therapy, Chemotherapy, Antibiotics, Hydration and Nutritional Support are available for those patients in need. They also have a policy with local hospitals that enable the administration of blood and blood products to those patients already at home whose alternative would be an admission to the hospital or ambulance transport to an out-patient setting for an 8-10 hour stay. Home health care services are prescribed by physicians; therefore, their nurses maintain regular contact with the doctors to assure the best possible care. A nurse is available twenty-four hours a day and can be reached after office hours for emergencies or any problems that may arise. The physicians whose patients they care for at home will testify to a decrease in hospital readmissions as well as an improved quality of life for the patients. Presently, there are no physicians on staff at the facility. However, patients’ lab results and other important information about the patient are faxed to the physicians. In response, orders and information are faxed to the Residential Clinical Services Facility. On the other hand, the nurses who are on staff communicate health information via the telephone, weekly Wednesday conversance and word-of-mouth (report from other nursing staff) as observed at the facility. The medical secretary, billing specialist and even the receptionist who form the support services also use health information. In addition, external users such as Physical Therapist and Occupational Therapist also use medical information at the facility. The home care facility researched stores patients’ medical records both manually via a centralized filing system and electronically. Paper records are stored by the medical record number which aides the billing department, who uses record numbers rather than patient names to file claims with insurance companies and are locked away in a separate room in the administrative building. In adherence to the privacy policies at the facility, only authorized users have access to patients’ medical records such as nurses. However, in order for Nurses to access medical records they have to use a keycard issued to them to open the door. Once the file is retrieved, it is returned to the filing room by the person who took it. The external users gain access to the paper medical records through the nurses who are working in association with them. In addition, the Residential Clinical Services, ensures that once files are pulled from the filing cabinets, it is recorded, who took it and date of its return. If after a period of time, the files are not returned, then the medical secretary would make enquires about its return. The Medical Secretary, (K. Sanchez, personal communication, November 30, 2010) when interviewed referred to this system as the ‘Charging Out’ system and the process of chasing up missing files is called the ‘Follow-up system’. The facility also manages to accurately store medical record files through the use of a computer system. A senior staff nurse, (C. Schultz, personal communication, November 30, 2010) when interviewed stated during the conversation that, medical records filed electronically have restricted access, which means that individuals need the correct username and passwords to gain access to the information stored. However, not all individuals are granted full access to the information. For example, the physicians and nurses are granted full access to the medical records through the use of unique usernames and passwords. The reason for this is because they both need to keep abreast with the patients’ medical history and progress. On the other hand, Billing Specialists are issued a password granting access to only information in the medical file pertaining to insurance and billing matters. They utilize both methods of filing mainly because, there may be instances when the electronic filing system may fail and the paper medical records can act as a backup. Furthermore, it cannot be destroyed by an accidental power loss and hackers cannot access a manual filing system from another computer. This helps security issues. At the time of the research, it was observed that the information management system used was known as AllScripts. When interviewed, the medical secretary stated that they use AllScripts because one, they are the strongest provider network in healthcare, it’s innovative and they both share a progressive partnership. The AllScripts software also provides modes for registration, administration, nursing visit assessments, medical charting and billing. Numerous processes are automated and made simpler. When deeply analyzed AllScripts Homecare software time saving features helps the staff at the facility to spend more time on patient care and less time on administration. They were able to easily compare assessment data from previous visits while documenting data for the current visit. The software also enables them to view patients’ history for any item in a particular field, eliminating the need to read through irrelevant information. With a mouse click, the system also marks normal responses to routine physical assessments, enabling staff to focus on the clinical areas requiring their expertise. The system also handles both electronic and paper claims for Medicare, Medicaid, commercial payers, other third party payers and self pay patients. The facility customized their billing frequency and cycle; therefore, their billing cycles are automatically generated. The system provides transaction, administration and clinical support for the facility. With the AllScripts Homecare software, vital medical records are always at their fingertips. Patient status including referral, admission, transfer and discharge dates; primary diagnosis, HHRG and level of care can be viewed from a single screen using multiple tabs-one for each admission. A customizable assignment screen also shows all resources assigned to the patient including; staff, contractors, community resources, DME suppliers and more. You can see all caregivers at a glance, and that’s one way to ensure information is passed to the right people and additional persons are kept a minimum. To get a better understanding of the software, the functions of the AllScripts software was web researched. A web article cited AllScripts TouchChart Medical Document Management, AllScripts Electronic Forms, AllScripts Electronic Prescription software and AllScripts Optical Character Recognition as the major features of the software which each provide a unique function. First up is the AllScripts TouchChart Medical Document Management, its main purpose or function is to eliminate problems at the medical facilities. It eliminates problems like lost or misplaced charts, privacy issues associated with patient records, under-coding of patient visits and delayed access to patient information and rising storage and courier costs. Next up is the AllScripts electronic form. The TouchChart forms digital electronic forms. AllScripts Electronic Health Record Module TouchChart forms enable staff or providers to create a digital version of any paper form used within the practice, automatically storing forms in the patient’s record. Therefore, the purpose of the AllScripts Electronic form is to save on additional costs of reprinting or staff to complete auto-populated fields, because the electronic forms can be reused. Then there is the AllScripts Electronic Prescription Software. The purpose of this one is to aide physicians with prescription solutions. AllScripts has received rave reviews for this feature, mainly because with the usage of this software, there was a reduction in pharmacy call-backs; it increased patient safety with clinical decision support: drug interaction, allergy and dosage checks, increases prescription accuracy and reduces the potential for misinterpreted or illegible prescriptions resulting in medical errors. Lastly, there is the Optical Character Recognition (OCR). The main function of the OCR is make the process of locating data or documents using keyword searches simple. By simply marking the appropriate checkbox, TouchChart OCR electronically reads the words on the document and places them in a searchable database. The OCR also provides a relative amount of benefits such as; immediate document viewing and tasking, rapid document OCR functionality, enables patient studies and provides unlimited capacity for full text search. Does AllScripts homecare software interface with other systems? Yes it does. It interfaces with the hospital’s ADT system which allows for the easy registration of patients. The vendors of AllScripts also support the maintenance and continuous updates to the support industry requirements including PPS, Medicaid, HIPAA transaction standards, ICD-9-CM code sets, CPT codes, entry standards of HCPCS codes and requirements for password-protected electronic signatures. AllScripts Homecare software has made a significant difference in efficiency where providing healthcare is concerned. Three senior Nurses (S. Piffier, B. Welkie, J. Kupter, personal communication, November 30, 2010) when interviewed unanimously agreed that the user-friendly interface, the security of the system and continuous research and development updates are three of the strongest points of the software. They also mentioned that it eliminated the hassles of paper charts and also that it fostered smooth clinical workflow which is beneficial to the company. However, just like other software, it has its weaknesses and AllScripts weakness is it may become cumbersome and additional add-ons may boost the cost of the system. As stated before, AllScripts is the information management system used by the Residential Clinical Services. AllScripts is one of the most raved about software in the homecare and medical field. Two different types of research were used to gather information on the said software; first it was web researched and then employees; mainly nurses and physicians were interviewed about the software used at the facility. However, information provided by both sources was synonymous in most cases. The unique features associated with the software which provides clinical and decision support, and even transaction- processing functions which aides in the efficiency and cohesiveness of the facility are highlighted as some of the strengths of the system. Some other strengths highlighted were its user-friendly interface, the security of the system and continuous research and development updates. One weakness identified from the web article was additional add-ons may boost the cost of the system and one identified by the employees at the Residential Clinical Services was that the system may become cumbersome. In this case, cumbersome may mean that the system may become time-consuming and complicated. This seems a bit puzzling since there was a unanimous agreement that the system was time-efficient and user-friendly. The system was also supported by various tutorials to make usage of the systems simpler. This also gives the impression that some users of the AllScripts system were not comfortable using it. If that’s the case, I recommend they carry out a survey among the different departments that use the software. This survey can help to determine their level of competence using the system and how comfortable they are with it. The completion of the survey will also determine whether or not they may need to utilize another software program. Works Cited AllScripts (n.d.) Homecare-the intelligent way to manage home health business, retrieved December 3, 2010, from: http://www.allscripts.com/en/solutions/post-acute-solutions/homecare/show/homehealth.html Corey K., The Progressive Physician, (2008, May 12), AllScripts HealthMatics EHR Retrieved December 3, 2010, from: http://www.theprogressivephysician.com/reviews/review-allscripts-healthmatics-ehr.html MDS medical; Electronic Medical Records Software (n.d.), AllScripts EMR Software, retrieved http://www.mdsmedicalsoftware.com/medicalsoftware/EMR/allscripts/index.php Read More