Electronic Health Record in the Independence Medical Center

Introduction

The Independence Medical Center currently applies an Electronic Health Record (EHR) system that does not allow physicians and other medical professionals to collect and analyze patient data efficiently, which is reflected in the inadequate workflow and the need to avoid some processes outlined in the EHR. This proposal aims to provide recommendations regarding strategies that can be applied by the organization to improve the EHR management, alight those strategies with organizational goals, discuss modern data processing trends that this hospital can leverage, and substantiate the recommendations using evidence-based practices.

Recommendations

The application of EHR alters the approaches to healthcare in terms of collecting, using, and analyzing patient data since before this innovation, all medical professionals recorded data on paper. While the advancement is a critical element of improving the care services, despite working in accordance with the Meaningful Use recommendations, it is evident that the existing software does not allow this medical center to apply the advantages of EHR fully. The current issues that require improvement through the changes that will be described in the next paragraph are – not-cohesiveness of the EHR, in -correspondence with the daily tasks of the personnel, lack of data exchange methods. According to Mackenzie (2018), the intolerability of different health management systems is a common problem that arises with the widespread application of EHR. The author argues that this is the primary issue of these systems because it does not allow physicians to access the full information regarding the patient’s history and diagnosis. A similar problem can be witnessed at the Independence Medical Center and should be resolved using the steps outlined in this proposal.

Thus, the following changes are needed – a new system that incorporates all elements of the hospital’s work, reimbursement claims processing that allows making alterations to forms in accordance with different requirements of insurers, compliance of the new EHR and hospital management system with the actual workflow of employees, automatic synchronization of data between various departments. The technological changes will involve an altered system that is more cohesive and incorporates all patient data, including admission records and laboratory results, and personal preferences regarding treatment strategies, by the patient-centered approach. The logistical changes will involve a shift in the hospital management system that is responsible for scheduling shifts and ordering supplies, which is critical for ensuring an efficient workflow. The medical personnel will have better software to work with, which will allow them to input patient data and search for the required information more easily.

In order to track patient experience, which will help the Independence Medical Center enhance its patient satisfaction rates, natural language processing software can be integrated into the new EHR. Mejia (2018) states that such systems already exist in the market and do not require additional alterations to the existing EHR. Additionally, this will help predict risks for patients. However, the most crucial element of the natural language processing applied in healthcare establishments is that it allows reducing the patient admission and diagnostics time by inputting information processed from a physician’s speech (Mejia. 2018). Other novel strategies that this medical center can use to improve stakeholder engagement and implement a coherent EHR strategy will be discussed in the following paragraphs. However, this medical center should focus on developing a system, which enables natural language processing, deep learning, and big data analysis that will aid in leveraging all aspects of EHR.

The main challenge that can obstruct this organization from successfully implementing the EHR recommendations described above is connected to patient data transfer. It is because the Independence Medical Center will have to transition from the old system Opus towards a new software while continuing to provide healthcare services to individuals. Additionally, the process of adaptation and training of personnel will require time and can obstruct from use of the system right away. These issues should be discussed with the information technology specialist that the Independence Medical Center will hire to ensure that a suitable solution is developed.

Organization’s Goals

Data products, as well as anticipated outcomes from the recommendations presented above, align with the establishment’s organizational and clinical targets. The primary stakeholders, in this case, are the employees of the Independence Medical Center – both executive and medical professions, such as financial managers, nurses, laboratory workers, physicians, and others. Additionally, a critical group of stakeholders is the patients because their safety and quality of diagnosis depend on information collection and analysis, which is facilitated through the EHR. Finally, the community living in the area where the independence Medical Center operates can benefit from a better EHR because the contemporary data analysis strategies allow healthcare organizations to collect information and develop cohesive prevention strategies that can aid large groups of people. Mackenzi (2018) argues that improper management of patient record keeping is a common cause of physician burnout. The issue impairs the quality of work and, therefore, can affect the outcomes of treatments. Additionally, the overall work environment of the hospital is typically affected by burnout due to additional stress that can be experienced by other medical professionals too.

It should be noted that EHR systems that offer improper functions and obstruct the workflow of a hospital also contribute to the burnout of medical professionals. Mackenzi (2018) states that “the burdensome user interface” is the cause of the problem, which can be seen in the example of the Independence Medical Center (para. 5). Thus, this proposal aims to create a pleasant work environment for all stakeholders within this medical center and help it achieve clinical and operational excellence.

The administrative stakeholders, including the CEO and other managers that ensure the efficiency of operations in the Independence Medical Center, will benefit from these recommendations due to improved cost efficiency. According to Mackenzi (2018), issues with improper EHR system implementation lead to increased costs associated with a need to hire additional information technology staff and additional training for the medical professionals. The problem is the adaptation of the personnel to EHR systems. However, the current workforce at this Medical Center has prior experience in working with EHR system Opus, thus, a better EHR should improve the workflow. Additionally, the administrative stakeholder group will benefit from the enhanced reimbursement claim processing system with a minimized number of errors, which should help enhance the revenue of the organization and improve the daily work of financial professionals.

The administrative goals of the Independence Medical Center involve achieving an efficient workflow in regards to patient admission and treatment, shift scheduling, and supply management. This will allow the establishment to improve the work satisfaction of its employees as a more cohesive easy to use EHR system and hospital management software will not require additional time or adjustments from the staff. Additionally, the process of diagnostics will improve as the information will be shared among medical teams for a more accurate assessment.

Categories of data that should be collected to evaluate the outcomes of the implementation of the recommendations include patient satisfaction rates, physician work satisfaction rates, self-reported burnout of the personnel, and several rejected reimbursement claims. In this way, the Independence Medical Center will be able to reach its primary goal and achieve clinical excellence by providing individuals with high-quality healthcare. Additionally, the revenue, which is crucial for any business, should be improved as well.

The EHR and other hospital management systems have been applied for several years within the US, and many new strategies for leveraging the collected data and enhancing the process of collection and analysis were developed. According to Blumenthal and Squires (2015), the question of patients having control over their personal information is becoming increasingly popular in the field of health information. On the one hand, physicians can only recommend the best approaches and treatment methods to their patients without forcing them to accept a specific choice. Therefore, a similar strategy should guide the information technology applied for collecting and storing information about patients.

The strategy outlined above is supported by the US government, which is reflected in the Fair Information Practice Principle. According to these recommendations, health establishments such as the medical center in question should work towards ensuring both safety and transparency of information they have (Blumenthal & Squires, 2015). One aspect of this is the provision of an opportunity to make an informed choice about the approaches used by the medical establishment in regards to data processing. Thus, this organization should develop guidelines and strategies that the medical personnel will apply targeting the presentation of the information collection and storage techniques employed by this center. The limitation of this approach is the collection and application of health information that can pose a potential danger to others (Blumenthal & Squires, 2015). This includes dangerous diseases that can be spread through human-to-human contact or substance abuse issues.

The recommendation for the Independence Medical Center includes developing a strategy that will help inform patients about the type of health-related information stored by the establishments and individuals that can access it, including the specific circumstances that facilitate this access. This includes an extensive explanation regarding why particular information is required for a health provider for an accurate assessment of one’s health. It is evident that this medical center should aim to implement a cohesive system capable of processing large amounts of data by the current health information trends. Westra et al. (2016) state that “emerging issues of team-based care, precision medicine, and big data science underscore the need for health information technology (HIT) tools for integrating complex data inconsistent ways to achieve the triple aims of improving patient outcomes, patient experience, and cost reductions” (p. 260). The authors recommend the hierarchical worksheet ontology as a valid approach to combining all the benefits of EHR systems and applying for these programs in practice. The suggested strategy incorporates a focus on patient-centered care, which is necessary for the modern healthcare environment through the facilitation of teamwork across different departments.

This will allow this medical center to provide services that are significantly higher in quality by sharing information within the departments by collecting information about specific health-related characteristics and particular preferences of patients regarding treatment options. The former is a significant aspect of contemporary healthcare services, which should be considered because it allows adhering to patient’s wishes and ensuring that all professionals working on the specific case are aware of those desires. Additionally, particular frameworks have to be applied by establishments similar to the Independence Medical Center to manage the big data it can collect. Westra et al. (2016) recommend using i2b2 or Informatics for Integrating Biology and the Bedside to achieve this goal. Flowsheets, as part of this concept, incorporate information about the status of a patient is at a particular timeframe.

The data that the Independence Medical Center will be able to collect through the new system implemented by these recommendations will be more cohesive because it will incorporate several domains of the hospital’s operations. Zhao, Henriksson, Asker, and Boström (2015) state that secondary use of healthcare data facilitated by the widespread application of EHRs allows healthcare establishments to develop practices for enhancing community health and raising awareness regarding specific issues affecting the population. This is enabled by the ability to analyze large volumes of data describing health state, the treatment that was applied, causes, and outcomes over extended periods. Therefore, the next trend in contemporary healthcare informatics is the use of information collected by hospitals for the improvement of policies and strategies that target health initiatives. More specifically, Zhao et al. (2015) recommend using EHRs to study the effect of medication and develop preventive measures that will help mitigate adverse events and complications. All the strategies outlined above can be applied in the patient admission process and data evaluation to ensure continuous improvement of data collection and analysis.

Best Practices

The contemporary data analysis and storage strategies outlined above provide an understanding of the best practices that the Independence Medical Center can use to collect information, safely store it, and convert it into useful deliverables. When talking about strategies of applying EHRs, Shickel, Tighe, Bihorac, and Rashidi (2018) argue that “while primarily designed for archiving patient information and performing administrative healthcare tasks like billing, many researchers have found secondary use of these records for various clinical informatics applications” (p. 1589). Thus, it is advised that the Independence medical Center develops approaches allowing its personnel to use the new EHR system cohesively and for the benefit of the community. This outcome can be achieved by encouraging research and development of health management practices based on the information about treatment and results from the patient records. However, this strategy will require the medical center to hire an information technology specialist with experience in deep learning practices to facilitate the research process.

Additionally, the first step to implementing the EHR system improvement recommendations outlined in this paper is connected to choosing an appropriate EHR software with the help of an information technology specialist. According to Ratwani, Fairbanks, Hettinger, and Benda (2015), usability should be the primary focus when choosing a vendor because it “continues to be a point of dissatisfaction for providers” (p. 1179). One element of this is the approval of the EHR by the Office of the National Coordinator that provides certification for software with user-centered design. Ratwani et al. (2015) provide the following recommendations that should be used when evaluating a new EHR system before its purchase – “contextually rich studies of clinical workflow, recruiting participants for usability studies, and having support from leadership within the vendor organization” (p. 1179). This will allow the executives of this organization to understand whether the new system is consistent with the recommendations outlined in this paper and, thus, whether its implementation will help resolve the issues that currently persist in the establishment.

Next, this hospital should ensure that the data collected by its staff is secure. While the debate regarding the access of patients to their healthcare information remains to be unresolved, it is evident that the administration of this medical center should emphasize the aspect of ensuring the safety of data. Ash, Singh, Wright, Chase, and Sittig (2019) state that there are approximately ten critical elements that each healthcare establishment should implement to enable the safety of their record-keeping system. This recommendation is based on the best practices used by five hospitals examined by the authors. Firstly, the decision-making process of the management team should be reevaluated to ensure that activities such as reviewing, planning, and overseeing health record safety are part of their reoccurring routine. Secondly, the training of the personnel should incorporate strategies that help enable data safety. Finally, the physicians should be able to receive support from an information technology professional when working with EHR. Therefore, the process that allows the sustainable performance of the best practices is continuous monitoring and evaluation of metrics and workflow performed by the personnel.

Conclusion

Overall, the Independence Medical Center has to invest in the improvement of its EHR that will enable a cohesive workflow, patient safety and improve satisfaction with services provided by physicians. Although modern EHR has a variety of benefits, its inability to synchronize with other hospital management systems is a critical flaw. The current practices of data collection and analysis will allow this establishment to apply frameworks that help improve the quality of care through the application of best practices.

References

Ash, J. S., Singh, H., Wright, A., Chase, D., & Sittig, D. F. (2019). Essential activities for electronic health record safety: A qualitative study. Health Informatics Journal, 1-12. Web.

Blumenthal, D., & Squires, D. (2015). Giving patients control of their EHR data. Journal of general internal medicine, 30(1), 42–43. Web.

Mackenzie, C. (2018). The benefits and challenges of electronic health records. Web.

Mejia, N. (2018). AI for electronic health records (EHRs) and electronic medical records (EMRs). Web.

Ratwani, R., Fairbanks, R., Hettinger, A., & Benda, N. (2015). Electronic health record usability: Analysis of the user-centered design processes of eleven electronic health record vendors. Journal of the American Medical Informatics Association, 22(6), 1179-1182. Web.

Shickel, B., Tighe, P., Bihorac, A., & Rashidi, P. (2018). Deep EHR: A survey of recent advances in deep learning techniques for electronic health record (EHR) snalysis. IEEE Journal of Biomedical and Health Informatics, 22(5), 1589-1604. Web.

Zhao, J., Henriksson, A., Asker, L., & Boström, H. (2015). Predictive modeling of structured electronic health records for adverse drug event detection. BMC Medical Informatics and Decision Making, 15(4), S1. Web.

Westra, B., Christie, B., Johnson, S., Pruinelli, L., LaFlamme, A., Park, J. … Speedie, S. (2016). Expanding interprofessional EHR data in i2b2. AMIA Joint Summits on Translational Science, 2016, 260-268.