Health Information System Case Selection and Proposal

Background 

Setting 

Grand Hospital has been an early adopter of healthcare information systems, where it is currently employing a proprietary health care information system that provides services including the patient registration and revenue management (Ghani et al., 2015). The health informatics department also deals with EHRs with computerized physician order entries. The facility has also been proactive in providing the imaging services via a PACS and laboratory management services as well as pharmacy management. Wager, Lee, & Glaser (2017) help in defining the relationship between health care data and health care information. In the text, health information is defined as the processed health data. Healthcare data is regarded as the raw healthcare facts that are generally stored in the form of characters, words, symbols, and other measurements. One apparent thing that is noted about healthcare data is that it is not very useful for decision making. Once the data is processed further, it becomes the information that can be used in making the right decisions such as creating the knowledge on the bed occupancy rates and other pieces of information. The authors further build on the fundamental health information technology landscape to introduce the health care information systems, a broad category that includes the clinical administrative applications. Building on these applications, a healthcare organization such as the Grand Hospital can understand the ways in which it can implement the telehealth medicine protocol to improve its service provision and patient outcomes. 

Healthcare Services 

This paper will focus on the ways in which Grand’s early adoption of other healthcare information system technologies will impact on its adoption of telemedicine solutions. 

Problem 

Since 1995, the Grand Hospital has transformed from an institution that consistently receives more healthcare inquiries than could be accommodated regarding the physician practice opportunities to a healthcare facility whose average age of the medical staff is more than eight years. The main concern has been the widespread perception among physicians regarding high malpractice insurance costs, the lack of a substantive tort reform, and the unfavorable rates of reimbursement that are being paid to the physician specialists by the major health insurer in the region (Ghani et al., 2015). The region has an unfriendly physician venue that can allow for the establishment of sound healthcare practices. It is imperative that Grand should investigate and evaluate the creative approaches that can enhance its physician coverage for certain specialty services. Wager, Lee, & Glaser (2017) show that the evaluation of the possible approaches at its jurisdiction shows that the highly potential approach will be the effective implementation of the IT solutions. There are two primary categories of the health care information systems that will be applied in this case, which are the administrative and the clinical. The best way of creating the distinction is by the purpose ad type of data they contain. Administrative information contains primarily the administrative or financial data and is used in supporting the management functions and other general operations of the healthcare organization (emmat et al., 2017). The best example is the information used in managing personnel, finances, materials, and other equipment. On the contrast, the clinical information contains primarily the health-related information that is used by providers in diagnosing and treating the patients. Clinical information systems include the electronic health records, medical administration records and the computer provider order entries. 

The Intervention 

The Institute for Health Care Improvement (IHI) has come up with the essential approaches that can be used in implementing a quality improvement project. The first step is for the management in the organization to state what they are trying to accomplish by constructing the time specific measurable objectives (emmat et al., 2017). The next step is to establish the measures of the possible outcomes. The management needs to establish possible measures that may prove that the improvement plan works (Ghani et al., 2015). This implies that the management should plan, test, and study the quality improvement plan before incorporating it into the culture of the healthcare organization. 

Strategy for Implementation 

The plan-test-act (PTA) circle will be the foundation for the implementation of the change. The medical staff should identify a development plan that will be tested before being enacted upon by the Grand’s executive committee and board of trustees (Hofmeyer et al., 2016). The first area of malpractice that the healthcare facility shall focus in implementing the IT solution will be radiology, behavioral health crisis intervention services and the intensive visit physician services. In the aspect of radiology, Grand will be required to recruit a qualified and appropriately credentialed radiologist who will be on duty full time. The healthcare facility will also be required to appoint a credentialed psychiatrist who will also work full time to assess whether the behavioral therapy patients presenting to the emergency department at the healthcare facility may pose any form of danger to themselves or to others (Ghani et al., 2015). The healthcare facility will also be required to implement the plan of recruiting the intensive physicians around the clock, which will assist in assessing and treating the patients when members of the voluntary attending staff are not present (Islam et al., 2015). All the new recruits shall be required to be qualified in the application of telemedicine including fundamental knowledge on electronic prescription (e-Prescription) to enhance the provision of healthcare services for patients. 

Barriers to the Success of Telemedicine 

In as much as the proposal for implementation of telemedicine sounds lucrative in terms of responding to the current needs of Grand Hospital, its success may be hampered by various factors. The first barrier will be the increase in the costs of operation (emmat et al., 2017). The current annual budgetary estimate for the healthcare facility is approximately $130 million. This implies that the recruitment of the staff and the software and hardware components for the telemedicine will increase the costs to an annual budget of more than $140 million (Hofmeyer et al., 2016). On the other hand, the implementation process will be hampered by the professional requirements, where the staff members may lack the knowledge of application of the new telemedicine practices. Consequently, cultural factors including the societal norms in the adoption of telemedicine practices may highly impact its success. Wager, Lee, & Glaser (2017) note that the adoption and use of telemedicine has been low because of the lack of incentive money. The authors note that until the passage of the HITECH ACT of 2009, the adoption of telemedicine was fairly low. HITECH was the law that helped in funding in terms of making available the incentive money through the Medicare and Medicaid incentive programs for eligible professionals and hospitals to adopt and become meaningful users of telemedicine. 

References 

Ghani, M. K. A., Jaber, M. M., & Suryana, N. (2015). Barriers facing telemedicine implementation in the developing countries: toward building Iraqi telemedicine framework.  ARPN J. Eng. Appl. Sci ,  10 (4), 1562-1567. 

Hemmat, M., Ayatollahi, H., Maleki, M. R., & Saghafi, F. (2017). Future research in health information technology: A review.  Perspectives in health information management ,  14 (Winter). 

Hofmeyer, J., Leider, J. P., Satorius, J., Tanenbaum, E., Basel, D., & Knudson, A. (2016). Implementation of telemedicine consultation to assess unplanned transfers in rural long-term care facilities, 2012–2015: A pilot study.  Journal of the American Medical Directors Association ,  17 (11), 1006-1010. 

Islam, S. R., Kwak, D., Kabir, M. H., Hossain, M., & Kwak, K. S. (2015). The internet of things for health care: a comprehensive survey.  IEEE Access ,  3 , 678-708. 

Wager, K. A., Lee, F. W., & Glaser, J. P. (2017).  Health care information systems: a practical approach for health care management . John Wiley & Sons.