CON 321 Health Related Research

Question: Essay The Electronic Medical Record: Efficient Medical Care or Disaster in the Making? You are the Chief Information Officer (CIO) of a large health care system. Medicare has mandated that all medical practices seeking Medicare compensation must begin using electronic medical records (EMR). Medicare has incentivized medical practices to place electronic medical records in their offices by giving financial bonuses to medical practices that achieve certain goals. These EMR systems are supposed to allow communication between practitioners and hospitals, so medical information can be rapidly transferred to provide more efficient medical care. The EMR will enable physicians to allow access to the records of their patients by other providers. Eventually these records are supposed to be easily accessed so any physician or hospital will have complete medical information on a patient. The physician practices in your health care system have been mandated to use the Unified Medical Record System (UMRS). The UMRS was designed by a central committee; all hospital-owned physician practices have been mandated to use the system. As part of the incentives, Medicare will add dollars back to each practice when they meet goals for reaching meaningful use (MU). MU has been defined by the U.S. Department of Health and Human Services (n.d.) as â€œusing certified electronic health record (EHR) technology to: Improve quality, safety, efficiency, and reduce health disparities Engage patients and family Improve care coordination, and population and public health Maintain privacy and security of patient health information. It is a step-by-step system requiring electronic functions to support the care of a certain percentage of patients (Jha, Burke, DesRoches, Joshi, Kralovec, Campbell, & Buntin, 2011, p. SP118). One of the hospitals in your system has many primary care and specialty practices; however, the UMRS system was designed primarily for the primary care practices. The committee that developed UMRS did not consider the needs of the specialty practices, which are significantly different from the primary care practices. This issue has been brought to the forefront by several medical specialists who have stated UMRS is not only cumbersome, but also extremely difficult to use. UMRS also does not give the specialist the information he needs. Specialists noted that after UMRS was implemented, it took them approximately 10 to 15 minutes longer to see each patient. Since an average day for a specialist consists of seeing between 20 and 25 patients, adding 10 to 15 minutes per patient adds 200 to 250 additional minutes, or 3 to 4 hours more each day. And, the physician cannot see the same number of patients each day. This represents a 30% decrease in productivity because of the amount of time it takes to use UMRS. Now the specialist office schedules constantly run significantly later than they should, and patients become unhappy and impatient. Several of the specialists reported that several patients have gotten up and left without being seen. In short, the mandate to use UMRS has impacted the efficiency and productivity of the subspecialists and specialists, further decreasing revenues for the system. In addition, all the physicians have complained the UMRS does not communicate well with other electronic medical record systems, or even the hospital’s own patient information systems. There is no real integration of the medical databases as intended, levels of meaningful use are unclear, and in some areas, difficult to achieve, again because the UMRS was tailored to primary care practices prescribing patterns. Specialists, particularly surgeons, do not write many prescriptions. Surgeons have been mandated to write electronic prescriptions to reach meaningful use; however, in many cases this is not appropriate for surgical patients. These issues and concerns were reported to the central committee that created UMRS in response to federal mandates and financial incentives. The committee responded it cannot modify the system to make it friendlier to specialists and sub-specialists, despite the fact that procedures performed by the sub-specialists account for substantial revenues. Revenues are down and the morale of the specialists and sub-specialists has plummeted to the point that many are talking about taking early retirement or leaving the system. Still, the committee refuses to fix the problems. Since you are the CIO of the entire health care system, the situation is now in your hands. What will you do? Task What are three organizational issues this case illustrates? Create and present a plan for how EMR could be implemented in a system with multiple types of practices. Be sure to address the issues of physician specialty, productivity, and satisfaction, as well as patient satisfaction. Answer: Introduction Technology is important in health care. All the healthcare facilities should embrace the use of modern technologies. It can help in improving the efficiency and quality of production. The paper presents a critical discussion on the challenges faced by the organization when implementing the use of EMR in its record-keeping system. Organizational Issues In The Case Study The case study demonstrates that the organization is facing certain issues that need to be resolved. These are 1) poor management system, 2) lack of motivation for the employees, and 3) resistance to change. The management is not competent because it does not make important decisions that can push the organization to the next level. Although the management has agreed to comply with the government’s directives, it has not made efforts to properly manage all the activities to ensure that they generate profits to the organization. Meaning, if not measures are taken; the organization might face serious financial difficulties or even lose business. Besides, the management has been demoralizing its workforce because they are excluded from major decision-making processes. Some employees have expressed their desire to quit the organization or ask for early retirement because they feel demoralized (Schwalbe, 2015). Finally, the organization is facing a problem in the implementation of its change strategies. The efforts of the management to introduce changes in its information system are derailed by the employees who fiercely resist it. Implementation Plan For EMR From the analysis presented, the current state of EMR is not good. The system is failing because it was not properly installed. Therefore, what needs to be done is to make the necessary improvements to ensure that it is properly installed. In the implementation plan, a proper feasibility study should be carried out to ensure that a fully-functional system which suits all the stakeholders is installed (Mandl & Kohane, 2012). Once the feasibility study is completed, a trial should be made. Here, a piloting program should be to test if really the system is suitable for use by all the specialty and sub-specialty users including the physicians, pharmacists, and the nurses (Shaw, 2012). However, for the system to be beneficial, it should have quality productivity, efficiency and speed that can enable it to support the storage and timely retrieval of the patients’ data. References Mandl, K., & Kohane, I. (2012). Escaping the EHR trap—The future of health IT. The New England Journal of Medicine, 366(24), 2240–2242. Schwalbe, K. (2015). Information technology project management. Cengage Learning. Shaw, M. J. (Ed.). (2012). Information-based manufacturing: technology, strategy and industrial applications. New York: Springer Science & Business Media.

CON 321 Health Related Research

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