Question

Below are two scenarios, based on information learned in this course. You will need to write a 2 page paper for each scenario. Each paper should address the questions provided in the applicable scenario. Please use our textbook, internet search, and any personal knowledge you might have to complete the assignment. Please cite all sources, and follow APA formatting techniques.

Scenario 1: Combining data in an EMR system

A large healthcare enterprise in the Mid-Atlantic region that was created by a merger owns two acute care hospitals, a rehabilitation center, an outpatient surgical center, and three long-term care facilities. Each of these institutions uses a different EMR system. Admitting privileges extend to 550 physicians who have office systems that interface with at least one of the acute care EMR systems.

The vision is to create an environment to support communication, care coordination, and data sharing across the organization in preparation for a regional EHR system. The organization also wants to move quickly in order to take advantage of the incentives offered by the government and meet mandatory requirements.

Executives have decided to focus on the acute care facilities first and use lessons learned there to integrate the other centers at a later time. Hospital A uses certified EHR applications and has implemented ancillary systems, CPOE, and clinical documentation whereas Hospital B has a highly customized, beloved old mainframe computer that is outdated and no longer supported by the vendor. Instead of selecting a new system for both hospitals, the software programs used in Hospital A will be implemented in Hospital B.

There are many types of barriers that can interfere with the implementation of a unified EMR system. Give an example of at least three barriers types that exist and could cause issues given the scenario above.

Answer 1

Ans) Much of the thrust of this report concerns how to maximize the benefits that this committee believes can be realized from the construction and operation of inclusive and comprehensive health databases. In examining these questions, the committee has focused on what it calls health database organizations. HDOs are emerging entities of many different characteristics in states and other geographic regions of the country; the committee made two key assumptions about them: (1) HDOs have access to and possibly control considerable amounts of person-identifiable health data outside the care settings in which those data were originally generated and (2) the chief mission of HDOs is public release of data and results of studies about health care providers or other health-related topics.

The broad-based value of HDOs and their databases might be said to be the provision of reliable and valid information in a reasonably timely manner to address all the major questions in health care delivery—access, costs, quality, financing and organization, health resources and personnel, and research—facing the nation today and in the coming years. The narrower benefits that might accrue to a variety of potential users, including patients and their families, health care providers, purchasers and payers, employers, and many other possible clients in the public and private sectors.

- In assembling the data that will go into products for all such users and uses, the committee had sobering concerns about the quality of those data. Thus, it recommends that HDOs take responsibility for assuring data quality on an ongoing basis, and in particular take affirmative steps to ensure: (1) the completeness and accuracy of the data in the databases for which they are responsible and (2) the validity of data for analytic purposes for which they are used [by HOOs. The committee also recommends that HDOs support and contribute to the regional and national efforts to create CPRs and CPR systems.

- Initially, HDOs will attempt to provide data for particular users and uses to answer particular kinds of questions. Nevertheless, advances in the creation and operation of computer-based databases, whether centralized or far-flung, can be expected in the coming years. The committee believes that thoughtful appreciation of their potential and anticipation of their potential limitations will hasten that progress. The development of HDOs—their structure, governance, and policies on disclosure as well as on protection of data—must be designed for the achievement of these long-term goals.

- The major responsibilities of HDOs in carrying out a critical mission: furnishing information to the public on costs, quality, and other features of health care providers in a given region or community. The committee adopted two strong assumptions as it began to consider this topic. The first is that considerable benefits will accrue to interested consumers and to the public at large from having access to accurate and timely information on these aspects of the health care delivery system with which they deal; this has been the thrust of the present chapter. The other assumption is that HDOs supported by public funds ought to have a stated mission of making such information available, and this will be a core element of several committee recommendations. The committee also assumes, however, that harms can arise from some uses of the information in such databases. For this reason, in the next chapter the committee considers administrative and other protections that it believes HDOs should put in place.