Health Care Org/Management week 3
Health Care Org/Management week 3 HCA 340 -002
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HCA 340 -002
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This 6 page Class Notes was uploaded by Loretta Hellmann on Friday February 12, 2016. The Class Notes belongs to HCA 340 -002 at Western Kentucky University taught by Steven W. Maddox in Spring 2016. Since its upload, it has received 31 views. For similar materials see HEALTH CARE ORG/MGT in Nursing and Health Sciences at Western Kentucky University.
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Date Created: 02/12/16
Week 3 Notes Thursday, February 11, 2016 9:36 AM Chapter 3: Health Information Technology Historical overview 1900s: advent of commercially produced off the shelf systems for large volume sales to hospitals Lack of standardization continues to prevent interface across software platforms 2004: President Bush established office of the national coordinate for health information technology as the first step in creation of the nationwide health network 2009: Obama's The American Recovery and Reinvestment Act (ARRA) through the HITECH ACT, designated $20.8 B through Medicare and Medicaid to incentive physicians and health care organizations to adopt and achieve "Meaningful Use" of EHRs. HITECH Act of 2009 Programs Beacon community program assist communities in building HIT infrastructure and information exchange capabilities Consumer e-health program help empower Americans' access State health information exchange cooperative agreement Program HIT Exchange Program Strategic Health IT research Projects Shortcomings HITECH programs and funding drive toward HER adoption but: EHR technology does not allow most systems to interface with each other Large numbers of desperate "siloed" systems unable to exchange patient record in an efficient and secure manner HIT to be successful Technology Often mistaken belief that the "right technology" or "right HER" is more important Right technology requires a database, easy compared with needs for policies Policies and procedures Describe in exquisite detail the ways an organization carried out its work HIT implementers must understand all details; the hit system often brings undocumented procedures to light for the first time with is a cause for system failure Culture Institutional and organizational culture is the most critical, least studied and least understood of all HIT implementation components Individuals must change the way they work Steadfast admin Require training and patience with stall Federal Govt. response to HIT implementation challenges Federal financial incentive for EHR attempts to bridge chasm between cost and benefits for large health care organizations and private practices ONC org: 191 FT staff, has a $66 M budget HIT Policy and Standards Committees have multiple expert workgroups composed of payers and health care industry representatives HIT Opportunities Driving force for HIT: overcome human limitations associated with information volume, complexity and fatigue Combines humans strengths with computer data go create a hybrid with intuition and date processing capacity. Out preforming previous computers and humans (Computerized Decision Support System CDDD) Electronically based system matching individual patient data with computer knowledge Error prevention and appropriateness assurance: "soft stops" and "hard stops" AHQ, CDSS Assessment, evidence Strong- ordering, preventive care and recommended treatments Moderate- clinical studies Low- efficiency of user, hospital length of state, and health quality of life Health Information Exchanges Barriers to inter-institutional/provider information sharing No common platform for multiple vendor systems Highly voluminous and complex data HIPAA security and privacy regulations Continuous advancements in knowledge and technology Health Information Exchange Architectures Monolithic model: member institutions transmits copies of clinical data to one central repository, all the patients data in one place Disadvantages Variable timelines of transmissions Mixed date makes all institutions responsible for HIPAA security Difficult individual institution control of data Federal model: date resides within each institutions system, HIE database contains only a master patient index of unique institution patient record numbers and demographic data Provides real time information available per episode of care by authorized user. Advantages Each institution maintains complete control Trans institutional data is up-to-the-minute accurate Veterans Administration Health Info System Model Unlike U.S. as a whole, the VA is a single payer model with universal HER system with CDSS and CPOE Closed system with single set of data standards ONE pharmaceutical formulary, one provider group, one laboratory system E-prescribing adoption Much more successful than overall EHR adoption Physician increase of 3 fold Future Challenges Increasing research evidence supports the value of EHRs in several areas ex: improving preventive care delivery, but also in-conclusive and negative findings Profit-making companies have offered alternative approaches with personal health records to the nationwide health information network with little success like Microsoft, google, and others Creative of standardized formats for data portability, work culture barriers, expense, training requirements 50+ years of effort finally yield recognition of the variety and complexity of issues
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