Telemedicine has been incorporated by healthcare providers as an extension to the traditional medicine practices in a bid to boost healthcare delivery. It has therefore enabled the provision of effective healthcare to individuals located in different locations. Some of the strategies used in telemedicine include Still Image Transmission, e-health, video conferencing, the creation of patient portals, and the remote monitoring of the patient's vital signs. Some of the advantages that come with such telemedicine aspects include accuracy, safety, and reliability (Fernandes, O'Connor, & Weaver, 2012). The diagnostic accuracy ensures that correct diagnosis thereby eliminating any need for a face to face meeting. The therapeutic impact that comes with telemedicine has improved patient management by enabling access to an important patient outcome such as cardiac telemetry thereby improving patient health. One of its significant implications includes the fact that it has acted as a motivating factor driving the improved access to healthcare since it not only reduces healthcare costs but also lowers the rates of healthcare initiatives cost escalation. Secondly, efforts in telemedicine have led to a competition in health services a factor that has significantly changed the way health institutions and clinicians are paid across the country. Therefore, patients have in turn become more conscious of the cost which has caused them to limit the overuse of health services.
The telemedicine programs have several challenges that affect them. According to a recently conducted survey, “inadequate telemedicine parity laws and Medicare reimbursement are among the top challenges faced by telehealth programs” (Fernandes, O'Connor, & Weaver, 2012). Therefore, in a bid to correct this, states must create more parity laws that cover both private insurers and reimbursement to the services provided via telehealth. The laws will require all the commercial health insurance companies to cover all the services provided via telehealth similar to the services that are covered in person. The other significant problem facing telemedicine includes the time and cost taken to enhance the technical training of staff members and accumulation of equipment. In resolving this, state and the federal government must provide financial aid to hospitals moving towards the direction of telehealth.
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Telemedicine has a vital role in influencing leadership and governance. With regards to leadership, the success of any technological innovation in the healthcare system depends on proper leadership. Healthcare industry leaders must demonstrate the urge to employ the technology and address the associated challenges that come with it. In terms of governance, both the state and federal governments must provide monetary assistance to healthcare institutions in a bid to guarantee the efficiency of programs. With regards to the role of a Chief Information Officer (CIO), these professionals need not only to support but also leverage reliability when it comes to telemedicine and telehealth. The telemedicine further meets the demands of the Health Management Information Systems (HMIS) since it is designed not only to enhance information exchange between the physician and the patient but also as a method of "supporting planning, management, and decision making in health facilities and organizations” (Nagel, Pomerleau, & Penner, 2013). In tandem with the provisions of the HMIS, telemedicine thereby creates an organizational culture that draws its strength from valuing planning and patient interaction.
It remains critical to understand that the role of an enterprise resource system is to integrate systems and software in a bid to increase efficiency across an entire organization. Telemedicine might require incidences where health information might be exchanged from one health professional to the other. Therefore, this might call for interoperability, an essential aspect of the enterprise resource system, in a bid to enhance efficiency. Some of the legislation and regulations that might influence the implementation of this system include the Affordable Care Act (ACA) and the HIPAA laws. With regards to the ACA, proper parity laws will need to be created in ensuring reimbursement of services covered under telehealth. HIPAA laws will require the laws to consider essential aspects such as privacy and confidentiality of patient information. CIOs might assess the merits of a telehealth strategy depending on its efficiency, health outcomes, engagement, and overall satisfaction rates.
Patient Portal
The patient portal is a by-product of the implementation of information technology created to automate patient transaction in administrative or clinical contexts. The portal has enhanced the availability of patient data and further improved reporting as an essential aspect of the transaction system. Through the patient portals, the board, management, and other interest groups can acquire vital hospital data required in meeting various regulatory requirements. Through the patient portals, hospitals are increasingly focusing on performance improvement by leveraging clinical systems, financial systems, and most importantly, patient satisfaction. The patient portals are usually connected to the electronic medical records (EHR) to ensure access to the patient data. The patient, therefore, can access several vital aspects such as physician notes, laboratory results, health histories, and discharge summaries among others. The technology is slowly becoming a mainstay in the healthcare industry with research conducted by the National Coordination for Health Information Technology (ONC) showing that up to 64% of hospitals have implemented it (Osborn et al., 2013). Regarding their implications, the creation of the patient portals must be in line with the Health Insurance Portability and Accountability Act on confidentiality. However, there are fears that it could reduce patient-physician engagement given that majorities of diagnostic information are accessible on the portal.
Similar to telemedicine, the patient portal can also face a plethora of challenges. First, there are concerns over the security of the patient information. Hackers and data thieves can use this as a leeway to access private patient information. However, when appropriate safeguards are put in place, such concerns can be minimized. Some of the strategies for meeting security challenges include using strong passwords and protecting the hospital database utilizing a firewall. Secondly, the lack of incentives that come with the system has significantly affected the patient's interest. Patients want more engagement which cannot be guaranteed by the portals. Therefore, solving this problem will require caregivers to combine the portals with thorough doctor sessions to ensure that patients draw meaning from the information provided in the sites.
Just like any other technological innovation in the healthcare industry, the patient portal has an impact on the level of leadership and governance. First, it will influence the particular nature of leaders that ascend to positions of power in the healthcare industry. Leaders must demonstrate a high level of innovation and the willingness to adapt. On the other hand, governance will also be influenced as the all the levels of government will need to invest in such systems that promote efficiency and patient outcome. Here, the role of the CIOs will encompass the initiation of data warehouses (Osborn et al., 2013). The CIOs must also focus on handling patient data and achieving quality trends. It is in this regard that the CIOs will need to create an enterprise based analytics as part of the healthcare information system. With regards to HMIS, patient portals enhance the management of patient information and also enable the creation of a positive culture that values the patient content.
As earlier discussed, the patient portal can be integrated with the EHR in an effort to ensure that patient information can be easily tracked. Most importantly, the data is shared among different departments including pharmacy, clinical, and laboratory among others. As such, this ensures that it meets the requirements of an enterprise resource planning where networks and systems need to be created to provide an efficient exchange of information. One of the most significant legislation that could influence this particular technology is the HIPAA law. As earlier discussed, the patient portals can be vulnerable to data theft and infiltration from unauthorized third parties. It is in this regard that hospitals and other care facilities must comply with HIPPA guidelines in ensuring that the information of the patient remains within the disposal of only the required individuals. CIOs might assess the merit of the system based on several factors. The first one includes how well it promotes patient engagement and outcomes. Secondly, they will also evaluate how the strategy meets the privacy and confidentiality laws and lastly, how well the patients report satisfaction with it.
Computerized Physician Order Entry (CPOE)
The CPOE is another 21 st -century technology that has taken root in the health sector. It involves a process where medical professionals enter and send treatment instructions and medical orders electronically using a computer application rather than the paper charts. It comes with the benefit of reducing errors that might arise from the ambiguity of handwriting and the transcription of medical errors. The fact that the technology reduces errors means that it enhances patient's safety. It leverages the efficiency in submitting medication and lab results to other respective facilities and departments (Schiff et al., 2013). Most fundamentally, it can streamline the process of reimbursement and can also be integrated with other critical aspects such as the EHR. The system further comes ensures that errors of handwriting are averting including those that might come as a result of drugs with similar names. However, there are several concerns regarding CPOE with various health institutions asserting that the system does not necessarily prevent the patient from harm. Several adverse drug events have continued to persist even in the wake of the CPOE use (Schiff et al., 2013).
Another significant challenge that comes with the system is that it can experience problems, especially where there are cases of workflow disruption. Therefore, it calls for careful planning of the implementation process that will, in turn, minimize all the workflow disruptions that might arise. Most clinicians have demonstrated the lack of knowledge or expertise to use the systems. Averting this challenge requires the health institutions to create a training program that will ensure that all the departments receive adequate training and appreciation of the system. Today, most healthcare institutions have either incorporated the system are in a process to do so. Due to its proven efficiency, several departments such as the United States Department of Health and Human Services have recommended the incorporation of this system in health organizations (Schiff et al., 2013). Part of the reason for the recommendation includes the fact that it promotes safety and guarantees overall efficiency.
With regards to the leadership, CPOE calls for a change in strategic management and philosophies because it involves the changing of a system in its entirety. It might also require an administration that believes competency where the existing staff must undergo training to meet the demands of the new system. The government at different levels will offer financial services in a bid to enhance training of the medical staff that will be using the system. Strategic HMIS planning and organizational culture will also improve given that the system will leverage data and information management. It will ensure that all information is directed into a patient portal or an EHR hence enabling future reference. Therefore, this will not only enhance efficiency but also improve patient outcomes since the doctors and nurses will keep track of patient information.
As earlier intimated, the role of an enterprise resource planning system is to ensure data management through the creation of networks within an organization. As described, the CPOE can be connected to a system of EHR and the patient portal to enhance feeding and retrieval of information whenever possible. As such, this will create a network of operations where different departments within the hospital will draw immense benefits. The CIO, in this case, will have an opportunity to build the integrative systems to promote the enterprise resource planning model. Furthermore, they are tasked with the responsibility of assessing any possible loopholes that might come with the use of these technological elements thus enhancing improvements. The primary regulation that might impact the operationalization of CPOE remains the HIPAA. Drafting patient information should be done by methods that promote confidentiality and privacy. In an effort to assess the merits of the system, the CIO will acquire inputs not only from the patients but also from the health professionals who will be using the system. They might also reflect on the patient outcomes and their satisfaction scores. Lastly, they can also appraise the system with the aim of addressing the loopholes and shortcomings.
Global Trends in HMIS in the Next 5 Years
The Health Management Information Systems (HMIS) is part of the six primary building blocks for leveraging health systems. It is a data collection system primarily designed to enhance management, planning, and decision-making in healthcare facilities. According to statistics, major hospitals are in the process of incorporating the HMIS as part of their system by initiating systems such as the telehealth, patient portal, and the CPOE among others. Therefore, more is expected to come in terms of improving the systems and forming better networks that can improve on the patient outcome. One of the global trends that will occur in the HMIS will be on interoperability. Here, these systems will be integrated with a network to ensure that every necessary department will access them (Abdelhak, Grostick, & Hanken, 2014). The importance that comes with this is that patient data will up for comparison, a factor that will enable critical stakeholders to make important decisions.
Secondly, with more information being stored on the online platforms, there is an increasing need to protect the data in compliance with the health record laws. Online data is vulnerable to online threats especially the hackers who might attempt to steal the information for various use including blackmail. Therefore, one of the trends is to ensure that the data is secure and free from any form of infiltration. As such, this will require the invention of software and systems applications that will guarantee the safety of healthcare data. Thirdly, information governance is another trend that is expected to catch up with the health industry in the next five years. Strategies must be installed to ensure that health information is not only secured but also in tandem with the required laws touching on privacy, reimbursement, and insurance among others (Abdelhak, Grostick, & Hanken, 2014). Management touches on compliance with ethics and law and also guaranteeing that the information is part of the organization's strategic management.
References
Abdelhak, M., Grostick, S., & Hanken, M. A. (2014). Health Information-E-Book: Management of a Strategic Resource. Elsevier Health Sciences.
Fernandes, L. M., O'Connor, M., & Weaver, V. (2012). Big data, bigger outcomes. Journal of AHIMA, 83(10), 38-43.
Nagel, D. A., Pomerleau, S. G., & Penner, J. L. (2013). Knowing, Caring, and Telehealth Technology: “Going the Distance” in Nursing Practice. Journal of Holistic Nursing, 31(2), 104-112.
Osborn, C. Y., Mayberry, L. S., Wallston, K. A., Johnson, K. B., & Elasy, T. A. (2013). Understanding patient portal use: implications for medication management. Journal of medical Internet research, 15(7).
Schiff, G. D., Amato, M. G., Eguale, T., Boehne, J. J., Wright, A., Koppel, R. ... & Bates, D. W. (2015). Computerized physician order entry-related medication errors: analysis of reported errors and vulnerability testing of current systems. BMJ Qual Saf, 24(4), 264-271.
