Postmenopausal Women With Abdominal Obesity

Post Menopausal Women With Abdominal Obesity Int J Medinform Jan 20

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Day R, Roffe D, Richardson K. Implementing electronic medication management at an Australian teaching hospital. Med J Aust. 2011;195(9):498–502. Dykes P, Carroll DAH. Fall TIPS: strategies to promote adoption and use of a fall prevention toolkit. Paper presented at AMIA Annual Symposium. 2009. Schnipper JL, McColgan KE, Linder JA, et al. Improving management of chronic diseases with documentation-based clinical decision support: results of a pilot study. AMIA Annu Symp Proc. 2008;1050. Ingebrigtsen T, Georgiou A, Clay-Williams R, et al. The impact of clinical leadership on health information technology adoption: systematic review. Int J Med Inform. 2014;83 (6):393–405. Office of the National Coordinator for Health Information Technology. Interoperability Standards Advisory, Draft for Comment; 2015. 2016. The Leapfrog Group; 2015. DISCUSSION QUESTIONS 1. The U.S. Department of Health and Human Services Agency for Healthcare Research and Quality has identified seven Portfolios of Research. The full list can be viewed at Two of the Portfolios of Research that are of key importance to this chapter are (1) Health Information Technology and (2) Patient Safety. Describe how these two Portfolios of Research relate to the ONC’s Health Information Technol- ogy Patient Safety Action and Surveillance Plan: June 2013 (Washington, DC: Office of the National Coordinator for Health Information Technology, 2013). 2. What is the utility of Donabedian’s structure-process- outcome model as the basis for evaluating quality of care and patient safety associated with a health IT application? Describe two limitations. Discuss how the framework for patient safety and research design can be used to overcome these limitations. 3. Use the framework for patient safety and quality research design to create a comprehensive plan to support success- ful implementation of Bar Code Medication Administration. 4. The Office of the National Coordinator (ONC) is taking actions on health IT and patient safety as described in their Health IT Patient Safety Action and Surveillance Plan by improving the safe use of health IT, learning more about the impact of health IT on patient safety, and leading to create a culture of shared responsibility among all users of health IT. A description of this initiative is located at implementers/health-it-and-safety. Describe the implica- tions of this initiative from an interprofessional prospec- tive for either your current work setting or that of the case study presented later. CASE STUDY Western Heights Hospital (WHH) is a 1125-bed, 5-hospital academic healthcare system servicing central and western Massachusetts. WHH is the only designated Level I Trauma Center for adults and children in the area and is home to New England’s first hospital-based air ambulance and the region’s only Level III Neonatal Intensive Care Center. WHH launched a 5-year strategic plan with a fundamental goal of a system-wide move from a predominately paper environment to an electronic one. Phase I included implementation of an EHR system consisting of order entry for all laboratory, radiology, and patient care orders. Addi-tionally, clinical documentation was implemented, includ- ing admission assessments and all nursing flow sheets. The nursing informatics counsel, a 25-member group of nurses representing all disciplines, developed the clinical content. The clinical content was custom built using both free text and structured data entry fields within the application. 420 UNIT 5 User Experience, Standards, Safety, and Analytics in Health Informatics Person al use o nly, do not repr oduce. shayna .rocourt @stude nt.ashford.edu Person al use o nly, do no t reprodu ce. shayna .rocourt @stude nt.ashford.edu Person al use o nly, do not reprodu ce. shayna .rocourt @stude nt.ashford.edu Person al use o nly, do not reprodu ce. shayna .rocourt @stude nt.ashford.edu Person al use o nly, do not reprodu ce. shayna .rocourt @stude nt.ashford.edu Person al use o nly, do not reprodu ce. shayna .rocourt @stude nt.ashford.edu Person al use o nly, do not reprodu ce. shayna .rocourt @stude nt.ashford.edu Three months after go-live, hospital leadership is reporting that it is unable to report on various state and federally man- dated quality measures. These measures track healthcare qual- ity based on national standards, are compared to nationally accepted benchmarks, and are used to plan ways to improve quality. Leadership has communicated that the reports gener- ated by the system are incomplete and are putting the hospital at financial risk due to lower reimbursement rates. Clinicians are eager and excited to continue to develop content in the application. However, the project’s program manager is proposing a stabilization and optimization approach and does not want to go forward with content development until the issue of reporting has been assessed and addressed. Discussion Questions 1. Assuming that you are the clinical content manager and lead all reporting efforts, what approach would you take to address the reporting problem? 2. Preadmission testing data are currently collected on paper. The chief of surgery has identified an opportunity to have these data collected in the new EHR system by the preadmis- sion testing area in the outpatient setting. Many of the col- lected data elements are shared with the current admission assessment. Describe how this effort can be approached. What methods can be used to implement the process? 3. Using the PSQRD methodology, identify an area of quality improvement in the hospital setting, develop a process plan, and identify the expected outcomes. 421CHAPTER 24 Patient Safety and Quality Initiatives in Health Informatics Person al use o nly, do not repr oduce. shayna .rocourt @stude nt.ashford.edu Person al use o nly, do no t reprodu ce. shayna .rocourt @stude nt.ashford.edu Person al use o nly, do not reprodu ce. shayna .rocourt @stude nt.ashford.edu Person al use o nly, do not reprodu ce. shayna .rocourt @stude nt.ashford.edu Person al use o nly, do not reprodu ce. shayna .rocourt @stude nt.ashford.edu Person al use o nly, do not reprodu ce. shayna .rocourt @stude nt.ashford.edu Person al use o nly, do not reprodu ce. shayna .rocourt @stude nt.ashford.edu DISCUSSION QUESTIONS 1. How does the U.S. regulatory framework work to ensure patient safety? 2. Describe two express powers and one implied power given to the federal government in the Constitution that has implications for health-related technology. 3. Name two federal agencies and describe their role in the regulatory oversight of health IT. 4. What are the different types of healthcare fraud and abuse statutes? 5. What are three major issues with mHealth applications and wearable devices? 6. How are patient privacy rights impacted by labor and employment regulations? CASE STUDY A 50-member multispecialty medical practice has decided to implement a new EHR system. The practice chooses the new EHR system based on both clinical functionality and the prac- tice management and billing functionality that is demon- strated specifically because the EHR sales representative repeatedly states that the new EHR can reduce patient visit times (thus increasing the number of patients a provider can see in a day) and increase reimbursement to the practice by helping the practice “correctly code” to the highest E/M (evaluation and management) code available. While the healthcare providers and practice administrator are impressed with the new EHR, the new system will cost $2,000,000 for the EHR software and $250,000 for the asso- ciated hardware, plus yearly maintenance fees of $125,000. These costs exceed the practice’s budget. One day, while meet- ing with the vice president of a community hospital, the prac- tice administrator mentions this issue and how the practice will have to delay purchasing an EHR due to the budget con- straints. The VP states that the hospital will be happy to cover 85% costs for the new EHR system if the practice agrees to (1) consider their hospital first before sending a patient to any other potential competitors including not just ER or inpatient admission but outpatient diagnostic services and hospital- owned specialty practices, (2) include the hospital’s logo on patient education materials printed from the system, (3) use the hospital’s template for designing data entry pages for practitioners, and (4) use the hospital’s template for the patient portal in the design of their patient portal. Discussion Questions 1. Explain the basic requirements for a hospital to help finance the purchase of an EHR system by a provider. 2. Discuss whether the proposed course of action would be permissible under current fraud and abuse regulations. 3. If the structure of the proposed donation is not permitted under current fraud and abuse regulations, explain what steps the parties would need to take to make the transac- tion compliant. 4. Explain common issues related to use of EHR and healthcare fraud. 5. Discuss how the proposed new EHR could potentially facilitate healthcare fraud.