Case Study Week VII Are Electronic Medical Records a Cure for Health Care? MGT 5014 – Information Systems Dr. Bourgeois Summary “The information contained in the medical record allows health care providers to determine the patient’s medical history and provide informed care. The medical record serves as the central repository for planning patient care and documenting communication among patient and health care provider and professionals contributing to the patient’s care (Medical Records, 2012). ” Medical information today is still being kept by using paper medical records.
In 2010, 80 percent of doctors and 90 percent of hospitals were still using paper medical records. This is in the United States. With the enormous cost of medical care spending is inflated because of inefficiency, errors, and fraud. Information technology may provide the answer by streamlining the current use of paper medical records into a unified national electronic medical record (EMR) system. The creation of this system is at the urging of the government and many insurance companies are also lending their support to the development of EMR systems (Laudon, 2012). In 2009, the United States spent $2. 5 trillion on health, which was 17. 6 percent of its gross domestic product (GDP). Approximately 12 percent of that figure was spent on administrative cost, most of which involve the upkeep of medical records (Laudon, 2012). ” An EMR system will reduce medical errors, improve care, create less paperwork, and provide quicker service to patient. This is the belief of many experts and will also lead to future savings of an estimated $77. 8 billion per year. The government has a short term goal for health providers to have an EMR system in place by 2015.
The long term goal is to have a nationwide EMR system for medical for medical record keeping. A major obstacle to overcome is the systems that have been development and implemented in 2010 will they be compatible with one another in 2015. This could jeopardize the goal of national system where health care information could be shared by medical providers. There are many smaller obstacles that heath providers, heath care IT developers, and insurance companies need to overcome for electronic health records to catch on nationally, including patients’ privacy concerns, data quality issues, and resistance from health care workers (Laudon, 2012).
Other obstacles to overcome are the smaller medical practices and hospitals because of the cost of an EMR system. To offset these cost the government plans to use money provided by the American Recovery and Reinvestment Act. “First, $2 billion will be provided up front to hospitals and physicians to help set up electronic records. Another $17 billion will also be available as a reward for providers that successfully implement electronic records by 2015 (Laudon, 2015). ” To qualify for this money, medical providers must show “meaningful use” of their EMR system.
Those who fail to comply will face with new EMR system standards will face penalties. Question 1 There are many factors in management, organizational and technological difficulties in building an EMR system. These factors are physician and organizational resistance, high cost and lack of capital, and technology incompatibility. “The biggest obstacle is the lack of institutional commitment. Many hospitals in the United States are losing money and cannot afford all of the technologies and services they would like.
Because it takes at least a decade to select and implement a comprehensive clinical information system, beleaguered executives are often reluctant to initiate a long-range strategic project that they might not be able to see through to fruition. Lack of commitment may also be attributable to concerns about demonstrable returns on investment in information technology, and there are some examples of wasteful failures. However, the number of well documented examples of financial savings and improved quality is increasing. Even if the cost and uality benefits of clinical information systems are appreciated and the institutional leadership is committed to the idea, the lack of capital remains an issue both for hospitals that are losing money and for private practices (Clayton, 2001). ” This is very big barrier to overcome because these institutions are set in the norms and changing these norms will be very difficult. Some physicians are not tech savvy, and may be resistant to change. The hospital staffs will find it difficult to change to a new EMR system because of the long time use of paper record keeping.
Training on this new system will be very interesting because of physician and staff resistance to change. Changing people’s mindset will become the biggest challenge for management and organizations. Another hurdle to overcome will be technological. Technical matters, the uncertainty of quality, functionality, ease of use, and lack of integration with other applications (Electronic Medical Records, 2005). Will these technologies be compatible with each other? Incompatibility between systems; user interface, system architecture and functionality can vary significantly between suppliers’ products (Electronic Medical Records, 2005).
The system will need to be integrated and will require consistent use of standards, for example medical terminologies and high quality data to support information sharing across wide networks. Interoperability is will be the key for an EMR system work. This will support Data transfer and sharing on much more than a local or enterprise-wide scale, knowledge transfer and integration, medical terminology transfer, mapping and integration, image transfer and integration with clinical and non-clinical applications (Electronic Medical Records, 2005).
Management will have to deal with the organizational and technical difficulties of building an EMR system. They will have to lead the change in organizational resistance and champion this change for the betterment of the organization. Management will need to be out front and lead in the technical changes that will take place in the organization. As far as leading the technical integration of the system, they will need to well verse in the technical changes that will occur and management will need to show tangible proof that these changes are needed to better improve their health care system.
The most difficult task will be up to management because they will be the champion for the new EMR system and it is management who will have to get everyone on board, so the new system can move forward and provide the most important intangible benefit, better service to hospital patients. Question 2 According to Hill (2005) there are three phases in building an EMR system. These phases are the organizational phase, construction phase, and operational phase. Each phase has its own set of difficulties. The interaction with people is very difficult and all is these phases will be difficult.
The organizational phase deals with planning, identifying a vendor, and installation. The planning step involves gathering and hiring staff members who will participate in setting up the EMR system. “Planning also involves identifying the needs of the users and casting a general vision of how the system will be used in the medical office. Although this step may seem less intense or time consuming than other steps, shortcuts or ineffective planning can have consequences that aren’t easy to fix later in the time line (Hill, 2009). ” Identifying an EMR vendor is the next step in the organizational phase.
Finding an EMR vendor that will work with the organization, providing both user and technical support, is essential and finding right company to match the organizational needs is an investment for the long-term success of the EMR implementation. The information in an EMR system is too valuable for a medical practice to jeopardize with a company that lacks experience (Hill, 2005). Installation is the next step. The EMR vendor that is chosen should handle the installation of the hardware and software as well as ensuring the integrity and security of a network that must be accessible 24/7(Hill, 2005).
The construction phase is next phase of the implementation process. This phase includes customization, testing and conversion. Customization includes customizing the system to fit the organizational needs. Testing means testing the system so that the bugs and glitches are out of the system and the system is ready to move forward. Conversion is converting from the paper system to the new EMR system and is also means converting paper records into digital records. The operational phase is the final phase, but it is ongoing and continuous. The steps in this phase are launch, staff training, and maintenance and support.
The launch step is getting the system live and up and working. Staff training will be getting physicians and staff trained on how the new system works, plus getting them sufficiently trained to operate the new system. Maintenance and support will be involve keeping the system hardware and software up and running without too many problems. If there are problems have the proper maintenance and support personnel in place to correct the problems. All of these phases come with their set of difficult problems, but the ongoing problem will be resistance to change.
This is an organizational problem and can affect the whole implementation process of an EMR system. It goes back to getting management on board to champion the cause for the new EMR system. The two most problematic issues would be the organizational phase and training steps. If an organization is not behind the new system, training the staff would be very difficult. This all comes full circle because physicians and staff are used working with the paper systems and when trying to implement the new EMR system they might resist this move forward even though the new system is a better fit for the organization.
Question 3 Business process management (BPM) provides a variety of tools and methodologies to analyze existing processes, design new processes, and optimize those processes (Laudon, 2012). “BPM is never concluded because process improvement requires continual change (Laudon, 2012). ” BPM goes through ensuing steps: identify processes for change, analyze existing processes, design new processes, implement the new process, and continuous measurement. “BPM is an effective management tool on aligning organizations with the wants and needs/desires of clients.
This management approach promotes business effectiveness and efficiency while striving for innovation, flexibility, and integration with technology. This combination of forces with technology yields unexpected returns for the organization. Business process management attempts to improve processes continuously and thus is an ongoing process. It optimizes the process continually in phases. BPM is now considered as the backbone of enterprise content management (WOW Global, 2011). ” When designing an EMR system BPM can identify processes for change.
The change that needs to take place is the use paper medical record keeping and changes from paper to a new digital system. The next step would be analyzing the existing processes. In this step would be analyzing the use paper medical record keeping. The design team will identify redundant steps, paper-intensive tasks, bottlenecks, and other inefficiencies (Laudon, 2012). Designing the new process is the next step in BPM. The step will include designing the EMR system to fit organizational needs.
The new system will be documented and modeled for comparison with the old paper record keeping system. The new process design will need to be justified by showing how much it reduces time and cost or enhances customer service and value (Laudon, 2012). Management will need to show that this new system will be a greater improvement over the old system. They will have to show the tangible and intangible effects the new EMR system will have on the organization. Implementing the new process is next in line.
This part of process involves customizing, testing, converting to the new systems. Customizing is making the new systems fit organizational needs, testing the system to make sure it is running at a better than optimal speed, and converting the paper records into digital records. Part of the implementation process is training the physicians and staff on how the new system works. The final process of BPM is continuous measurement. Once a process been implemented and optimized, it needs to continually measured (Laudon, 2012). Implementation and training are ongoing processes.
According to Chin (2004), “Many system implementers believe that once a system is implemented, their work is done. The truth of the matter is that these systems are constantly changing. Application software, operating systems, hardware, technology, and medical knowledge about diagnosis and treatment are constantly changing. The myriad combinations and interactions of all these changes will keep a project team “implementing” at all times. ” Ongoing and continued evaluation, education, and training are necessary to enhance the effectiveness of the EMR system.
This is needed so that physicians and staff can keep up with every changing hardware and software tools. Question 4 “Business intelligence and analytics promise to deliver correct, nearly real-time information to decision makers, and the analytic tools help the quickly understand the information and take action (Laudon, 2012). ” The five analytic tools to achieve these goals are; production reports, parameterized reports, dashboards/scorecards, ad hoc query/search/report creation, drill down, and forecasts, scenarios, and models.
Production reports are predefined reports based industry related guidelines. Users enter several parameters as in a pivot table to filter data and isolate impacts of parameters these parameterized reports (Laudon, 2012). Dashboards/scorecards are visual tools for presenting performance data by users (Laudon, 2012). Ad hoc query/search/report creation these allow users to create their own reports based queries and searches (Laudon, 2012). Drill down is the ability to move down from a more version of a summary to a more concise version of the details.
Forecasts, scenarios, and models have the ability to perform linear forecast, what-if scenario analysis, and analyze data using standard statistical tools (Laudon, 2012). Business intelligence and analytics in healthcare depends on turning data into insights. This will “ultimately create a better healthcare experience. Healthcare is still playing catch up. Healthcare is data rich, but, information poor. Good, talented, and knowledgeable resources will be necessary to make sense of the massive amounts of healthcare data available. Additionally, data in healthcare comes from heterogeneous sources and varying formats.
Data must be read, parsed, joined, and stored in a database for data analysis and interpretation which forms the foundation of business intelligence. In order to get started with BI a solid infrastructure foundation must exist as well (Chitnavis, Muhs, Wood 2009). ” These tools will be used to “organize clinical data, business and operational data to support disease management, outcomes management, clinical performance, process improvement, cost reduction, quality accreditation and predictive analytics (Healthcare Business Intelligence (BI), 2012). Business intelligence can convert a large amount of medical, financial, and administrative reports into clinical and statistical data that can be easily accessed by healthcare providers and support professionals. This data will provide knowledge of what is needed to improve the quality of service and patient care that is in such a high demand at this present time. Business intelligence and analytics will have the biggest impact on improved patient care and service. This will be done through better decision making throughout an organization with help of business intelligence and analytics. The data in any healthcare organization is spread across such areas as encounters, transcribed reports, labs, EMR, e-pharmacy, membership, finance, claims, billing and others (Healthcare Business Intelligence (BI), 2012). ” Business intelligence analytics will be bringing all of this information together, so that healthcare providers can provide the best possible service for their patients.
References: Chin H. (2004). The Reality of EMR Implementation: Lessons from the Field. The Permanente Journal. Retrieved on June 16, 2012, http://xnet. kp. rg/permanentejournal/fall04/reality. html Chitnavis B. , Muhs S. , Wood G. (2009). Strategic Business Intelligence and Analytics in Healthcare. Retrieved on June 17, 2012, http://www. wuss. org/proceedings09/09WUSSProceedings/papers/hor/HOR-Chitnavis. pdf Clayton P. (2001). Obstacles to the Implementation and Acceptance of Electronic Medical Record Systems. Retrieved on June 16, 2012, http://www. ncbi. nlm. nih. gov/books/NBK22845/ Electronic Medical Records. (2005). Retrieved on June 16, 2012, http://www. openclinical. org/emr. html#terms Healthcare Business Intelligence (BI). 2012). Retrieved on June 17, 2012, http://www. m-scribe. com/about-m-scribe/healthcare-business-intelligence-bi/ Hill D. (2009). Phases of an EHR Implementation: Steps to Building Success. Retrieved on June 17, 2012, http://blog. pchealthstop. com/? p=68 Laudon, K. and Laudon, J. (2012). Management Informations Systems – Managing the Digital Firm. Person Prentice Hall. Medical record. (2012). Retrieved on June 17, 2012, http://en. wikipedia. org/wiki/Medical_record Poon, E. , Blumenthal, D. , Jaggi T. , Honour, M. ,Bates D. , and Kaushal R. (2004).
Overcoming Barriers To Adopting And Implementing Computerized Physician Order Entry Systems In U. S. Hospitals. Retrieved on June 17, 2012, http://content. healthaffairs. org/content/23/4/184. full The Impact of Business Analytics ;amp; Intelligence in Health Care. (2012). Health Information Technology, Implementation, Insight, News, Spotlight, Today. Retrieved on June 17, 2012, http://www. ehrscope. com/the-impact-of-business-analytics-intelligence-in-health-care WOW Global. (2011). Healthcare Business Process Management (BPM) Solutions. Retrieved on June 17, 2012, http://www. wowglobal. com/hc_BPM. php