PHE 610 Electronic Medical Records And Quality Improvement ✓ Solved

PHE 610 Electronic Medical Records and Quality Improvement

Wall County has a local public health department, Wall County Health Department, that offers a variety of services, including primary care and outpatient behavioral health services for children and adults. The County serves predominantly uninsured, Medicaid, and Medicare patients in multiple locations around the County. In many communities within the County, the Department is the sole provider of physical and behavioral health services. The Department receives the bulk of its revenue from direct services, along with additional funding from the County’s general fund and small grants for environmental health and nurse home visiting activities.

The Department's budget aligns with the County's budget year, running from July 1 through June 30. The Department faces significant expenses, particularly in provider salaries and operating overhead across its four service locations. Recently, the largest Medicaid managed care and Medicare Advantage insurer, referred to as the Insurer, has approached the Department about joining its network. This network typically offers payment rates that exceed those from other payers; however, the Insurer has been known to decrease rates for providers that do not effectively manage populations to improve health outcomes.

The Department has not yet decided about joining the Insurer's network. For the past decade, it has utilized a statewide electronic medical record (EMR) system maintained by the State Department of Health and Human Services (DHHS). The EMR system provides limited reporting capabilities such as treatment gap lists, pharmacy utilization reports, and immunization status reports. However, the utilization of the system varies among providers and locations, with particularly low usage among behavioral health providers. Additionally, not all Department locations have trained providers on navigating the EMR system.

Recently, DHHS informed the Department that it will cease maintaining the EMR system within 120 days. Users will have access for up to 12 months after maintenance termination, but with no user support or security patches available during that time. Given recent severe budget cuts at DHHS, there will be no IT support or training provided. As the director of quality for the department, I have been tasked with creating a policy proposal to address the situation.

Policy Proposal for EMR System Transition

This policy proposal outlines the necessary steps for the Wall County Health Department to transition from the current EMR system, propose alternatives, and ensure that quality healthcare services are maintained for our patients. The proposed actions seek to minimize disruption in services and maintain compliance with healthcare regulations while ensuring effective population management and timely data access for providers.

Assessment of Current EMR Usage

Initially, the Department must conduct a thorough assessment of current EMR usage across all locations. This includes determining which providers are utilizing the system effectively and where training gaps exist. By understanding the current landscape of EMR usage, we can tailor future training and support initiatives to specific needs, thereby enhancing the quality of care through improved health records management.

Explore Alternative EMR Solutions

As DHHS will no longer maintain the current EMR system, the Department should research alternative EMR solutions. Key considerations should include ease of use, cost, integration capabilities with existing health workflows, and the ability to provide comprehensive reporting capabilities. Engaging with vendors that have experience in serving similar demographics will ensure that we select an EMR system that meets our unique needs.

Training and Support Plan

Once a new EMR system is selected, the Department must develop a comprehensive training and support plan for providers. This should include initial training sessions, ongoing training opportunities, and accessible user guides. Creating a mentorship program where tech-savvy providers can assist colleagues in adopting the new system can also foster a supportive learning environment.

Implementation Timeline

The transition to a new EMR solution must occur within the upcoming 120-day window. An implementation timeline should be established, outlining milestones such as vendor selection, system installation, and training completion. Regular follow-up meetings will ensure that the transition stays on track, and any issues can be addressed promptly.

Monitoring and Evaluation

After the implementation of the new EMR system, ongoing monitoring and evaluation will be key to ensure that it meets the Department's needs. This includes gathering feedback from providers, tracking system utilization, and measuring patient health outcomes. Establishing benchmarks for success will help in understanding the impact of the new system long-term.

Cost Implications

Financial considerations must also be evaluated in this transition. A detailed budget comparison between the current EMR system costs (nominal fees) and projected costs for the new system (license fees, training costs, etc.) will guide decision-making. Additionally, we should explore potential grant funding and partnerships with local agencies or health organizations to help support this transition financially.

Conclusion

The abrupt cessation of support for the current EMR system necessitates a proactive approach. By carefully assessing our current EMR usage, exploring alternative solutions, developing a robust training and support plan, and implementing a strategic timeline, the Wall County Health Department can maintain high-quality health services despite the challenges posed by the termination of the current EMR system. This policy proposal aims to guide the Department in adapting to these changes while ensuring continued quality improvement in patient care.

References

• HealthIT.gov. (2022). Elements of Effective EMR Implementation.
• CCHP. (2020). The Role of Community Health Centers in Providing Behavioral Health Services.
• CMS. (2021). Medicare Managed Care Manual.
• Kaiser Family Foundation. (2020). Health Care Costs: A Primer.
• Friedman, C. P., & Wong, K. (2021). Transforming Health Care through Telehealth: A Comprehensive Guide.
• NASEM. (2018). Strategies to Improve Quality of Care through Electronic Health Records.
• McGlynn, E. A., et al. (2015). The Quality of Health Care Delivered to Adults in the United States.
• Wagner, E. H. (2018). Chronic Disease Management: What Will It Take to Improve Care for Chronic Illness?
• World Health Organization. (2019). Digital Health: A Smart Investment for Health and Well-Being.
• Healthcare Information and Management Systems Society (HIMSS). (2021). EMR/EHR Utilization Best Practices.