AbstractThis case study is about me being the lead person at a multi-facility regional hospital. My committee has been tasked with evaluating the possibility of a new health information system that will enable the hospital to electronically collect and share patient medical history information among various hospital centers and departments. Currently, each hospital center maintains paper copies and files of patient records, which are separately managed and stored at each facility. Very few of the electronically based information system are integrated between the various centers and locations.
To add to the challenge, the CIO informs me that most of the members on the committee have very limited experience with information systems and databases. However, the CIO is aware that you are studying health informatics, so she has asked you to help familiarize the committee with fundamental concepts related to databases systems and relevant health information standards. In addition I will explore three possible vendors that offer electronic medical record products and compare and contrast the functions of three and list the barriers of the implementation process.
Database Characteristics and the Language of Health Information
The purpose of a database is to provide an organized model of maintaining, storing, managing and retrieving information. The concept is largely based on the use of tables to hold information much like that of a spreadsheet. These tables are arranged in columns and rows where each row pertains to a specific dataset or record and each column represents a specific attribute of the data set. Although databases are similar to spreadsheets, databases are much more powerful and useful in the way data is manipulated, gathered and presented.
Database structures take on 2 common forms: The flat data file and the relational data file. Advantages of a flat data file: All data is stored in a single location that is familiar and easy to work with, and no manipulation of data files prior to analysis. Some disadvantages of a flat data file are:
Only a limited number of values can be calculated per query and any adjustments applied to multiple dataset values must be done repeatedly. You only use flat data files when interested only in a small, predetermined set of values, when a number of coded variables is small and when the comfort level with a multiple data file structure is low. Some advantages of the relational data file is that it can grow to any number of values, reduces coding task, Simplifies data cleanup, and it have smaller data files to manipulate.
Disadvantages of a relational data file are that it is complex to implement, the data must be manipulated prior to analysis, and it must be able to select a single value per query for any given analysis. You use the relational data file when large number of values per study are possible. Various types of medical data and information records relevant to this project include everything that makes up an individual’s personal health record. We also want to make sure our patients Medical records are protected.
The American Health Information Management Association defines this as “an electronic, universally available, lifelong resource of health information needed by individuals to make health decisions”. The importance of uniform terminology, coding and standardization of the data cannot be over stressed in a project such as this. A single method of procedure is required to ensure a comprehensive and uniform end result between all facilities.
Common terminology that adheres to the standard set forth by the industry will aid all facilities intheir coding and reporting efforts and create a consistent environment across all processes. Several standards have been established by agencies and regulations such as the American National Standards Institute, Joint Commission, The American College of Radiology, The American College of Pathology and HIPPA just to name a few. Additionally, there are standards set for the transfer of electronic data such as DICOM, HL7 and HTTPS which will become the guidelines for this projects IT strategic plan.
I have chosen three vendors for you to review the first one is McKesson, which we currently use for some of our other programs and we already have an established relationship with this vendor. McKesson empowers hospital-employed or affiliated physician practices by extending the hospital’s clinical infrastructure to physicians in their practice. The ultimate goal is to create a one-patient, one record model across care settings. Common tools, common content, common workflow and integrated data all contribute to helping physician practices deliver faster, better and safer patient care.
The second vendor I choose is Epic. Epic is supposed to be the new wave of the future. The EpicCare EMR is rated #1 in its category by KLAS Enterprises and has been for the last 10 years straight. The system makes physicians more productive by simplifying the important patient-facing elements of care delivery. EpicCare is a physician-friendly system in use by providers representing more than 100 specialties. It installs easily with our pre-built Model System and configures to meet specific workflow requirements.
Instead of starting from scratch, Epic customers build on the content from successful customers – including decision support, order sets, reports and documentation tools. Epic is known for bringing physicians up to speed on time, on budget and with high-performance tools – from orders and results to integrated voice recognition and other documentation shortcuts. The last vendor I chosen was MedStar.
MedStar provides software solutions for the healthcare industry. MedStar’s medical practice management software is a state-of-the-art, integrated medical billing software and medical appointment scheduling software designed for healthcare practices and providers, healthcare management groups and medical billing services. MedStar’s EMRWorks is an electronic medical records software – EMR – designed to improve patient care by facilitating the creation and storage of medical records and reports, providing easy access to patient history, simplifying the development of treatment plans and providing interfaces to pharmacy and laboratory providers.
MedStar is easy to use, feature-rich and easy to customize to meet your practice’s documentation needs. MedStar’s EMR can improve your practice’s productivity and patient care.
As a whole I think it is vital for a health system of our size to establish a system where we can see records from one facility to the next without having to fax or use a courier to deliver records. This technology give use the edge on our competitor to be seamless and cut down on errors. I hope that all of you review this information with the best interest of our patients because anything that is in the best interest to the patient is in the best interest to the company.
ReferencesBlair, J. S. (1999). An overview of healthcare information standards. Retrieved May 15, 2010, from http://lists.essential.org/med-privacy/msg00186.html Unified medical language system (2004) National Library of Medicine. Retrieved on May 15, 2010 from http://www.nlm.nih.gov/pubs/factsheets/umls.html www.mckession.com