Health Informatics Assignment #solved

Background: A tertiary care center in the western United States has an installed base of EHRs supported by Cerner Corporation for inpatient areas and by Epic for outpatient areas. The EHR system consists of order entry for all laboratory, radiology, and patient care orders. Additionally, clinical documentation was implemented, including office visit notes, admission assessments, discharge notes and all nursing flow sheets. The clinical content (e.g., order template, care plan) was custom built using both free text and structured data entry fields within the EHR system. Other technology includes a suite of about 300 different applications supported by the information technology department.

 

BOOK:  Nelson, R. & Staggers, N. (2018). Health Informatics: An Interprofessional Approach (2nd ed.)

• Case 1: The current environment, while including robust capabilities of CPOE, is “siloed” with information. Healthcare providers complain that they have difficulty obtaining the “big picture” of the patient across systems and they have to remember information located in disparate systems. Nurses also complain that they have to “jump around” the inpatient system to find information they need for activities such as patient handoffs. Various stakeholders are burdened with integrating information themselves. Not only is this time consuming; it is potentially prone to error. Providers have developed numerous workarounds to the different systems in ambulatory and inpatient areas, including local data files (such as word documents) for patients they see frequently. 

  • Discussion Questions

    • The leaders in the organization begin to address these challenges and improve user experience. You are asked to join a committee who is in charge of developing strategies to improve the user experience. Where would you start to improve the user experience? What methods would you use to examine the issues addressed in this case? What could be the strengths and limitations of the selected method? 

    • The current environment promotes clinicians’ workarounds including creation of local data files for patients. What could be potential problems caused by locally stored data files? What approach would you take to resolve those problems?

 

• Case 2: Further the hospital leadership is reporting that they are unable to report on various state and federally mandated quality measures. These measures track healthcare quality based on national standards, are compared to nationally accepted benchmarks, and are used to plan ways to improve quality. The leadership has communicated that the reports generated by the system are incomplete and are putting the hospital at financial risk due to lower reimbursement rates.

  • Discussion Questions 

    • Assume you are a member of the quality improvement committee leading all reporting efforts. What approach would you take to address the reporting problem? Provide rationale for your choice.

    • Using the PSQRD methodology (see chapter 24), identify potential reasons of receiving incomplete reports, develop a process plan for improvement, and identify expected outcomes.

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