Midtown Family Clinic (Stage 4 – System Recommendation)

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Midtown Family Clinic System Recommendation Report
University of Maryland
University College
Class: IFSM 305 7985
Name: Andy Tran
Date: 5 November 2017
Table of Contents
I.
Organizational Analysis and Requirements
A. Introduction
B. Strategic Use of Technology
C. Components of the Information System
A. Functional Requirements
B. Summary
Introduction
The Midtown Family Clinic is a private healthcare facility owned and managed by Dr.
Harold Thomson. The clinic began its operations in 1990. An increase in the number of family
residences is what motivated Dr. Thomson to open the clinic. The clinic employs two nurses who
assist Dr. Thomson in both administrative and clinical operations. The clinic is currently facing
operational and financial challenges. The challenges are as a result of an increase in the number
of patients and a limited number of staffs. The clinic largely relies on a manual system of record
keeping and managing finances. This has increased the workload of the two nurses and the
waiting time for the patients. The patients wait for a minimum of 1-2 hours to be attended.
The administrative and clinical operation challenges have led the clinic to consider
implementing an Electronic Health Records (EHR) system. This is a very important move as the
system would automate a lot of operations, reducing the workload of the nurses and the waiting
time for the patients (Menachemi and Collum, 2011). The increased efficiency would enable the
clinic to increase the number of clients it can handle thereby increasing its revenue. The system
would remove the need to use a third party company to bill insurance companies. This too would
increase the clinic’s revenue as there will be no billing expenses. This report provides
recommendations to the clinic on its system requirements.
I.
Organizational Analysis and Requirements
D. Introduction
The organization analysis and requirements section review the operations, staff and the processes
of Midtown Family Clinic. The purpose of the review is to identify the strategic ways in which
the clinic can use technology to enhance its operations. The review also looks at the problems,
processes, data/information, users of the system and the system requirements.
E. Strategic Use of Technology
For effective use of technology, an organization ought to carefully look at its strategic goals
and determine how technology can help achieve those goals (Stefanus, 2017). Below are
Midtown Family Clinic’s strategic goals.
1. Improve efficiency and profitability of the clinic to enable upgrading and expansion. The
EHR system would automate critical operations of the clinic leading to increased
efficiency. This would enable the clinic to handle more patients and in turn, increase
revenues that would help in upgrading and expansion.
2.
Investment of some funds in a major renovation. The EHR system would enable raise
funds for the renovations as the enhanced operations it brings would increase the clinic’s
clients and better financial management.
3. Rent extra space and open up a larger clinic. With an EHR system, the clinic would be
able to increase its current capacity leading to increased income that can enable the
expansion. The system will also ease records and financial management in the large
clinic.
F. Components of the Information System
An information system is made up of people, technology, processes, and data/information.
Below is an explanation of the components of the EHR system in relation to the clinic.
1. People – A very key component of any system is its users. An effective system must
capture the needs of the users and enable them to do their jobs efficiently. Below are the
users of the EHR system in Midtown Family Clinic and their roles.
A. Dr. Thomson, Owner and Manager. Dr. Thomson would need a financial
management function, and an appointment scheduling function.
B. Vivian, Nurse Administrator. Vivian would need an appointment scheduling
function and a billing function.
C. Maria, Nurse. Maria would need a patients ‘record filing and retrieval function,
and a prescription refill request function.
2. Organizational Processes – Organizational processes refers to how tasks are organized
and coordinated to produce a good or offer a service (Stefanus, 2017). Below are
processes that can be supported by an EHR system in the clinic.
C. Records filing and retrieval process. The EHR system would improve the process
by replacing manual files with electronic files which are easy to store and quick to
retrieve. They can be backed up to ensure the records are not lost. The system
would also minimize the space needed for manual files if any.
D. Billing process. The system would improve the billing process by removing the
need for keeping manual financial records. It would also remove the need of
relying on a costly medical billing company to bill patients’ insurance companies.
E. Scheduling appointments process. The EHR system would introduce an integrated
appointment management module that can be shared between Dr. Thomson and
the front desk attendant. The process can be further enhanced to enable patients to
request for appointments through a web platform instead of calling the front desk
attendant for that.
3. Data/Information
The table below lists the data/information that the EHR system would require.
Data/Information Items Needed for EHR System
1.
Name of Patient
2.
Date of Birth of Patient
3.
Contacts of Patient
4.
Address of Patient
5.
Insurance information of Patient
6.
Bill of Patient
7.
Patient’s medical History
8.
Current Prescription of Patient
9.
Patient’s laboratory test Results
10. Appointment Date and Time of Patient
F. Functional Requirements
Functional requirements refer to the key requirements of the EHR system. The table
below lists the functions that the EHR system should perform.
Functional Requirements
1.
The system should accept and store patients’ information in a database
2.
The system should allow the retrieval of patient’s information from the
3.
4.
5.
6.
7.
8.
9.
10.
database
The system should accept, process, store and retrieve information on
patient’s appointments
The system should retrieve current prescription data in case of prescription
refill request
The system should process the patients’ payment and issue a receipt.
The system should issue billing request to insurance companies
The system should generate financial reports for the manager
The system should accept, store and retrieve staff information
The system should generate staff payroll
A. Summary
Use of EHR system will be very critical in the management of Midtown Family Clinic.
When put in place, the system will be able to integrate all the services and functions of the Clinic
to achieve its strategic goals. Proper management, easy patient storage, and retrieval,
confidentiality and integrity are major areas that will be addressed by the system. The
components and the requirements of the EHR system have also been detailed. The analysis will
help the clinic understand its system requirements and guide in procuring a good EHR system.
References
Healthit.gov. (2017). What is an electronic health record (HER)? Retrieved from:
https://www.healthit.gov/providers-professionals/faqs/what-electronic-health-record-ehr
Menachemi, N., & Collum, T. H. (2011). Benefits and drawbacks of electronic health record
systems. Risk management and healthcare policy, 4, 47.
Stefanus, R. (2017). Business Processes and Information Systems. Retrieved from:
http://www.academia.edu/4655309/Business_Processes_and_Information_Systems
Sharing Data: Midtown Family Clinic System
University of Maryland
University College
Class: IFSM 305 7985
Name: Andy Tran
Date: 19 November, 2017
Table of Contents
I.
Sharing Data
A. Introduction
B. Need to Share Data
C. Types of Data to be shared
D. Data Interchange Standards
E. Summary
A. Introduction
Safe sharing of healthcare data has the potential of significantly benefiting healthcare
organizations. For instance, sharing of patient data may help healthcare providers in reducing the
rates of readmission, avoiding medical errors as well as decreasing repeated testing. However,
healthcare facilities should consider all the regulations and policies when it comes to sharing any
information.
B. Need to Share Data
Considering Midtown Family Clinic case study analysis, there are quite some
organizations that the center communicates with including laboratories, other healthcare
facilities, insurance companies, just to name but a few. However, this discussion focuses on the
major two organizations that Midtown Family Clinic communicates with on a regular basis and
which are Midtown Insurance Agency and Midtown Nursing Home. Midtown Family Clinic
works together with this organization purposed to deliver effective and reliable patient care
services.
External Organization #1: Midtown Insurance Agency
The first organization that Dr. Thomson’s clinic communicates with on a regular basis is
the Midtown Insurance Agency which deals with more than half of the health insurance covers in
the area. Most of the patients in Midtown seek insurance services from this agency, and as such
regular communication and sharing of data with Midtown, Family Clinic plays a significant role
in the operation of the clinic. This is so because the clinic relies on the services of this company
in receiving payments for patients who have a health insurance cover with MIA. As such, for the
insurance company to make payments to the clinic it has to get the necessary information
regarding the patient from the clinic.
External Organization #1: Midtown Nursing Home
Dr. Thomson also maintains regular communication with the Midtown Nursing Home
which happens to be the closest healthcare facility to Midtown Family Clinic (Aspden et al….,
2008). There are some cases or diseases that Dr. Thomson may not be able to handle (such as
cases requiring major surgeries), and thus he refers such patients to the nearest facility for
specialized services which in this case is the Midtown Nursing Home. Besides, he may not be
present at times, and the two nurses he has employed may not be able to handle cases that require
the services of a professional doctor. In such cases, the nurses also refer the patient to the
Midtown Nursing Home. During such processes, the Midtown Family Clinic is required and
must submit the information it has about the patient which may include previous medical records
to the Midtown Nursing Home.
C. Types of Data to be Shared
(i)
Patient demographics
The patient’s demographics include the name, date of birth, gender, address, as well as
the unique patient identifier. These details are used in statistical analysis. As such, maintaining
this data is very important for correct billing and in providing an opportunity to gauge the
practice performance outcomes in terms of demographic groups (HealthIT.gov, 2014). This data
element is being passed to the insurance agency and also to the nursing home, and they also
share the information with the clinic. When Midtown Family Clinic refers a patient to the
Midtown Nursing Home, they send the patient’s demographics to the nursing home. Once Dr.
Thomson has seen a patient, he sends the patient’s information to the nursing home. Patient
demographics play a huge role in the enabling the clinic to avoid any medical errors.
(ii)
Medical history
A patient’s medical history is a record that has events and circumstances that happened in
the past. For instance, past illness, treatment, injury and any other firmly medical fact. This
information is sent from the clinic to the nursing home since it informs the doctors of any
previous medical condition or treatment that a patient could have had. Incomplete or inaccurate
medical histories may result in a potential threat of drug interaction and treatment duplication
(Hale & Nester, 2002).
(iii)
Medication list
A detailed medication list will provide data such as the medication’s name, dose, the
source of medication, starting and stopping of medication, and much more. This data element
will be going from Dr. Thomson’s clinic to the nursing home and also to the insurance firm. Any
given health care facility or organization that deals with patients’ medications should and must
have a detailed list of all the medications that a particular patient could be using. Hale and Nester
(2002) confer to this by detailing that doctors and pharmacists have the knowledge and
experience of scrutinizing any drugs that could be questionable and thus they can only optimize a
patient’s medical therapy based on the detailed list of medication.
(iv)
Clinician’s notes
Clinician’s notes are essential in the documentation of a patient’s progress and constitute
a data element that is shared between the clinic, nursing home, and the insurance firm. The clinic
will communicate the notes to the nursing home and vice versa. The notes will indicate any
change of care to the patient and therefore allow both Dr. Thomason and the doctors in the
nursing home to compare their notes showing a continuum of care. The clinic may also send the
notes to the insurance firm so that they can be filled in the patient’s form which will
consequently help in determining the full details of the policy and whether the patient will
insurance firm will cover for the medical expenses.
Midtown Insurance Agency
Data Element or Item
Data Goes TO/FROM Midtown Family
Clinic
1. Patient’s details/demographics
Information goes from Midtown Family
Clinic to Midtown Insurance Agency
Information goes from Midtown Family
Clinic to Midtown Insurance Agency
Information goes from Midtown Clinic to
Midtown Insurance Agency
Information goes from Midtown Insurance
Agency to Midtown Family Clinic
Information goes from Midtown Family
Clinic to Midtown Insurance Agency
2. Medical history
3.Medication list
4.Medicare information
5.Amount of money used
Midtown Nursing Home
Data Element or Item
Data Goes TO/FROM Midtown Family
Clinic
1.Patient demographics
Information goes from Midtown Family
Clinic to Midtown Nursing Home
2. Past medical record
Information goes from Midtown Family
Clinic to Midtown Nursing Home
3. List of medication
Information goes from Midtown Family
Clinic to Midtown Nursing Home
4. Clinician’s notes
Information goes from Midtown Family
Clinic to Midtown Nursing Home and vice
versa.
5.Allergies
Information goes from Midtown Family
Clinic to Midtown Nursing Home
D. Data Interchange Standards
External Organization #1: Midtown Nursing Home
Several data interchange standards apply to sharing of data in not only healthcare
facilities but in all organizations. The first standard that can relate to Midtown Family Clinic is
the standardization of the data dictions as well as terminologies exchanged technologically. This
is provided in the Systemized Nomenclature of Medicine- Clinical Terminology (SNOMEDCT). This standard is crucial since it enables all the organizations to have the same interpretation
of all the data elements shared and also reduces the errors that could occur in the delivery of
patient care services. According to Aspden et al… (2008), exchanging data between the clinic
and the nursing home with both of them having standardized data dictions and terminologies will
result in quality patient care. For example, standardizing the clinician’s notes that Dr. Thomson
will send to the nursing home and vice versa will ensure that it will be way much easier to
understand and provide accurate and reliable medical reports for both of the facilities.
External Organization #1Midtown Insurance Agency
An interchange standard that can suit the exchange of information between the clinic and
the insurance firm is the Health Level Seven (HL7) standard. This entails standards in the
sharing of electronic health data. HL7 is comprised of many standards that guide the sharing of
healthcare data between different automated systems used in the facilitation of patient care and
more in revenue generation. As such, Midtown Family Clinic should adhere to these standards
when sending information about patients to the insurance firm.
E. Summary
The sharing of healthcare data plays an essential role in ensuring that information on
patients is processed in a secure, reliable, efficient and successful process (Aspden et al., 2008).
The use of a standardized process of sharing information between Midtown Family Clinic,
Insurance agency, and nursing home will result in the provision of high-quality patient care.
Midtown Family Clinic will have a better chance of meeting its organizational strategic goals
and objectives in its alignment to the required data sharing standards such as HL7 and others not
discussed above.
References
Aspden, P., Wolcott, J. A., Bootman, J. L., & Cronenwett, L. R. (2007). Preventing medication
errors (pp. 367-408). National Acad. Press.
HealthIT.gov. (2014). Record Demographics | Providers & Professionals |
HealthIT.gov. Healthit.gov. Retrieved 18 November 2017, from
https://www.healthit.gov/providers-professionals/achieve-meaningful-use/core-measures2/record-demographics
Nester, T. M., & Hale, L. S. (2002). Effectiveness of a pharmacist-acquired medication history in
promoting patient safety. American Journal of Health System Pharmacy, 59(22), 22212225.Retrieved July 14, 2017, from http://www.medscape.com/viewarticle/446575_4
Ethical, Legal and Regulatory Policy (Stage 3): Midtown Family Clinic System
University of Maryland
University College
Class: IFSM 305 7985
Name: Andy Tran
Date: 3 December 2017
TABLE OF CONTENT
Ethical, Legal and Regulatory Policy Issues
A. Introduction
B. Types, Impact And How The Problems Will Be Addressed
C. Addressing the Most Difficult Issue
D. Summary
A. Introduction
Healthcare data contains patient information which Midtown family clinic should secure and
maintain confidentially. Sharing of this information raises ethical, regulatory and legal policy
issues. This report will highlight the various categories of these problems, their impact on the
selection and use of healthcare information systems, and how problems in the development and
use of electronic health records system will be addressed.
B. Types, Impacts and How Each Topic Will Be Addressed
Table of Ethical, Legal and Regulatory Policy Issues
Topic
1
Safe Design
Definition of the Topic
(minimum 2 sentences for each, a
definition in your own words)
Developing a program or structure
and integrating mitigation
mechanisms to minimize and
eliminate risks. For a healthcare
system, a designer should
incorporate encryption keys to
enhance the safety of patient data.
How the topic impacts and
will be addressed in the
selection and use of an EHR
system (minimum 4 sentences
for each topic – 2 on impact and
2 on how addressed)
A well designed and safe
electronic health record system
has substantial benefits
including better care and
decreasing healthcare costs. The
EHR system should undergo
adverse scrutiny, approval, and
oversight to assess and ascertain
their safety, accuracy, and
effectiveness.
2
Meaningful Use
3
Quality Improvement
4
Data Accuracy
5
6
Data Accessibility
Data Comprehensiveness
7
Data Consistency
8
Privacy
Meaningful use is the appropriate
and efficient use of a particular
item to fulfill an intended purpose
or requirement. The meaningful
use of healthcare systems is to
improve the safety, quality, and
efficiency of patient care.
Quality improvement refers to the
review of records by staff members
of an organization to evaluate their
quality and effectiveness of the set
standards.
It also refers to evaluating services
provided by an institution and the
results and comparing them with
the accepted standards.
It refers to whether the data stored
in a particular order is correct and
precise
Correct and consistent presentation
of data by the expected standa …
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