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Health Care Org/Management week 3

by: Loretta Hellmann

Health Care Org/Management week 3 HCA 340 -002

Loretta Hellmann
GPA 3.75

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week 3
Steven W. Maddox
Class Notes
25 ?





Popular in Nursing and Health Sciences

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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Popular in Nursing and Health Sciences


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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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