The state of California is engaged in State Health Information Exchange (State HIE) program that is aimed at creating IT infrastructural solutions for meaningful, rapid, and secure exchange of patients’ health data across states. The state of California as a participant is responsible for the availability and adequate flow of information within its territory and ensure the connectivity of local and state levels of health care institutions. Within this program, California Health and Human Services Agency were awarded $38,752,536 to fulfill its role in this process (ONC, 2018a).
California also participates in Beacon Community Cooperative Agreement Program (BCCAP) that allocates funds to the development of Electronic Health Record (HER) infrastructure in a holistic manner within a given community. Such innovative community was built in San Diego, CA with the help of federal investment that amounted to $15,275,115 (ONC, 2018b). The goal of the project leaders is to broaden health information exchange, support weighted Medicare decision-making, engage patients in being more attentive to self-care, and decrease the number of unwanted tests.
Under the aegis of HITECH, California also develops a broad Medi-Cal Electronic Health Record Incentive Program that incorporates a range of targeted initiatives such as California Technical Assistance Program and adopt, implement, upgrade and meaningful use incentive (AIU and MU). Substantial federal financial assistance was provided to professionals and institutions that were appointed to extend the educated use of EHR (DHCS, 2016). As of 2016 when the last report was issued, official documentation and state-level legislation have been accordingly amended and prepared for the application of concrete measures.
The core benefit of role-based access system is the increased security of electronic health information of the patient. Within this framework, only the authorized personnel would have access to the patients’ information based on the level of authority of the former. This paradigm would ensure that no side individual is granted access to the privacy-protected electronically-stored data of a client. Increased security would protect healthcare organizations from unwanted legal pursuits for letting other parties’ access to classified files and therefore, increase the financial stability of hospitals and clinics. This notion will also promote trust among the clients as their data would now be stored safely and securely.
Arguably, the key to secure role-based access (RBA) is limiting the privilege of each role to certain classes of information within the electronic type of RBA. Under this limitation, even the higher-standing officials will not have access to full data but only a sufficient amount for successful fulfillment of their duties. Each entry should be logged and supervised for unwanted access (Pabrai, n.d.). Unique user IDs that track the role and their privileges would ensure traceability and accuracy of reports.
Prior to the implementation, each role and their access levels need to be planned and discussed. Thus, the type of role-based access needs to be tailored to the specific organization as the nature of the health care facility defines the roles and their information needs. It is noteworthy to mention, however, that disclosure of information in accordance with state and federal laws should be included in the RBA policy and explained to the clients. Given this layout, the proposed electronic role-based access approach to client health information will benefit the health care facility and become a meaningful factor of the patient service quality.
Consider feasibility and identify the challenges and benefits of a single provider in a rural setting that implements an EMR in their office
One of the rural clinic networks in California, Adventist Health West, shared their experience of successful implementation of EMR practices. In an interview, Loretta Sloan, an assistant vice president of this clinic, reports that all 50 rural health centers in some form adopted electronic means of storing and exchanging data between different stakeholders within the organization (Hagland, 2015). As she notes, it took about two years to convert clinics to electronic document flow, and certain challenges arose in the process.
One of the major challenges was standardization as clinics and specialists were accustomed to the former operations and had performed in a particular way for a long time. Yet, with the implementation of change management practices Sloan and her colleagues managed to overcome organizational rigidity in their rural clinics and improve the system’s performance. The process to meet the deadline that was set out by WHO for the implementation of EHR given the resistance of specific stakeholders was strenuous.
On the other hand, the benefits yielded by such transition were worth overcoming these challenges. The feasibility of the EHR was visible and significant as the speed of service increased. Less complicated document flow improved the efficiency of management and doctors allowing for a more diligent patient-centered treatment approach. Despite the challenges with implementing EHR standardization, Adventist Health West benefited from this innovation as it allowed for a greater resource economy, straightforward reporting, monitoring and further change execution which they planned (Monica, 2018). Thus, the implementation of HER benefitted the clinic in a major way and was feasible.
Department of Health Care Services (DHCS). (2016). Report to the legislature: Medi-cal electronic health record incentive program (October 2011 through June 2016). Web.
Hagland, M. (2015). Adventist Health West leaders manage EHR implementation in the context of expansion. Web.
Monica, K. (2018). 275 Adventist Health jobs transition to center for partnership. EHR Intelligence. Web.
Office of the National Coordinator for Health Information Technology (ONC). (2018a). State health information exchange. Web.
Office of the National Coordinator for Health Information Technology (ONC). (2018b). Beacon community program. Web.
Pabrai, U. A. (n.d.). RBAC and HIPAA security. Web.