Info System / Health Care

Running head: MIDTOWN CLINIC RECOMMENDATION REPORT 1

Midtown Clinic Recommendation Report: Stage 2

Kyami Clarke

University of Maryland Global Campus

Dr. Mark Revels

IFSM 305 7980 Information Systems in Health Care Organizations

Fall 2019

MIDTOWN CLINIC RECOMMENDATION REPORT 2

Contents Introduction and background ....................................................................................................................... 2

Organization Analysis and Requirements ..................................................................................................... 3

Introduction .................................................................................................................................................. 3

Strategic use of technology........................................................................................................................... 3

Components of an information system ........................................................................................................ 4

Functional requirements ............................................................................................................................... 7

Summary ....................................................................................................................................................... 7

Sharing Data .................................................................................................................................................. 7

Introduction .................................................................................................................................................. 7

Need to Share Data ....................................................................................................................................... 8

Type of Data to be Shared .......................................................................................................................... 10

Data Interchange Standards ....................................................................................................................... 11

Summary ..................................................................................................................................................... 12

References .................................................................................................................................................. 14

Introduction and background Dr. Thomson had a noble idea of opening a medical facility known as Midtown in 1990.

This idea was strongly influenced by the cropping up of many family residential buildings in his

locality. From the onset, the clinic experienced several challenges that rendered it ineffective. It

was seriously understaffed. Dr. Thomson could only afford to employ two nurses to aid him in

operations. The few staff members could not manage to handle an influx of patients seeking

services. Poor services were occasionally rendered. Patients complained of having to wait for

prolonged periods before their appointments were honored. On average, the wait time was nearly

2 hours. The overreliance of the clinic on manual records further compounded the problem.

Tracing patient records in a manual system is a tedious process that results in the loss of valuable

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time. The clinic urgently requires to institute an Electronic Health Records (EHR) system to boost

its operations. This would be an essential step in the digitization drive that would bring many

benefits to the organization. The workload per nurse would substantially decline. This would

translate to better service delivery to patients as the wait time decreases. The revenue streams of

the clinic would receive a significant boost because many patients would be served. This report

analyzes the clinic and provides the associated recommendations.

Organization Analysis and Requirements

Introduction The focus of this section is on the evaluation of the operations that characterize the

Midtown clinic ranging from processes and staff members. The overriding objective of the review

is to assess how technological integration through EHR would boost the operational efficiency of

the clinic. The assessment would focus on the challenges, data, processes, system requirements,

and users.

Strategic use of technology Appropriate technological utilization is premised on how efficient entity goals are structured to

align with the technology under consideration. Technology is always an enabler that simplifies

how an entity cost-effectively executes its task. The strategic objectives that characterize the

Midtown clinic are chronicled below.

1. It is boosting the profitability portfolio and efficiency of the clinic to facilitate future

upgrades. EHR would bring unrivaled automation to major processes that characterize the

clinic ranging from storage and retrieval of patient records (Hammons & Dowd, 2015).

This translates to efficiency. The revenue streams of the clinic are bound to increase as

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many patients are served. Additional finances would be utilized to fund the expansion and

prioritized upgrades.

2. Acquisition of additional rental space to set up a more prominent clinic. EHR has a net

effect of boosting the productive capacity of the clinic through service to many clients.

This implies that the clinic would have the requisite funds to procure the rental space.

3. Renovation investment. The accomplishment of any significant renovations requires

extensive funding. EHR are essential catalysts of this process. The efficiency that EHR

brings ensures that the firms can make substantial savings on costs. The clinic would

undoubtedly be in a better liquidity position to handle renovations.

Components of an information system The components that define an information system (IS) range from people, processes, data,

and technology. The explanations about the components have been provided below. The focus is

on the EHR of the clinic.

1. People – They constitute a vital component. IS is designed with an important goal of

satisfying the needs of these individuals. They range from owners, analysts, and workers

who would be utilizing the system to facilitate their daily endeavors (Hammons & Dowd,

2015). The utility of any system emanates from the inherent ability to capture and facilitate

individual functions in our case. The following people would utilize EHR of the Midtown

clinic.

a) Dr. Thomson – This individual performs dual functionalities of being the manager

and de-facto owner of the clinic. EHR may be particularly helpful to Thomson in

managing the finances of the entity. It would be relatively easy to manage

inventories and apportioning costs in real-time. Additionally, EHR would aid in the

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scheduling function. Patients can book their appointments with the doctor online.

Patients would be saved from the burden of waiting for long hours without service.

b) Vivian – Being the nurse administrator, EHR would be an essential tool in the

performance of roles like scheduling and billing functionalities. An automated

billing system ensures that recording, compilation, and analysis of bills is done in

a better fashion. Proper scheduling guarantees that the limited nurses in her purview

are deployed in the most effective methodology to optimize returns.

c) Maria – As the nurse, EHR will facilitate her in performing a host of roles ranging

from electronically recording and retrieving patient records from EHR databases.

The performance capacity of the nurse would exponentially increase.

2. Organization processes - These processes encompass the logical segmentation and

coordination of tasks in a manner that guarantees that services rendered to clients are

quality and satisfactory. Midtown EHR would support the following processes.

a) Recording and retrieval process – EHR would provide a radical makeover to these

processes. Manual records that dominated the operations of Midtown would be

converted to digital formats. The digitization would simplify the retrieval process.

Virtually all the records would be accessed instantly by a simple click (Larkin &

Holston, 2016). Loss of records through careless handling would not arise. The

records would be digitally backed up at the inputting phase.

b) Billing process - EHR would bring sanity in the manner in which the Midtown

clinic handles its bills arising from operations. The need to maintain tedious

manual financial records would be forgone. The bills would be electronically

monitored and generated by the EHR system. Moreover, the necessity to rely on

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third-party entities as the only facilitators to bill patients’ insurance companies

would be forgone in totality (Webster, 2014). The elimination of such cost drivers

would place the clinic on a profit trajectory.

c) Appointment scheduling process – EHR would digitize how appointments are

made. An integrated module that is fronted by the EHR would facilitate seamless

coordination of appointments between the doctors and his attendants. This would

undoubtedly alleviate the risk of collisions or dishonored appointments that are a

source of irritation among customers. Moreover, the system can be revamped to

catapult prospective clients into seeking appointments through online platforms

(Webster, 2014). The need to solicit appointments through attendants would

subside.

3. Data

The following table stipulates a list of data sets that the EHR system would be composed of to

facilitate efficiency in the execution of its tasks.

Data Items Needed for EHR System 1. Patient name 2. Patient date of birth 3. Patient phone contact 4. Address of the patient 5. Patient insurance information 6. Outstanding patient bill 7. Medical history of the patient 8. Current patient prescription 9. Laboratory test results of the patient 10. Date of appointment and time

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Functional requirements They specify the expectations that the EHR system is supposed to accomplish (Larkin & Holston,

2016). The preceding table catalogs the list of essential functions that the system must execute.

Functional Requirements 1. The system should have the inherent capability to facilitate the storage of patients'

records in a database. 2. The system facilitates the accessibility of patients' details from a database logically and effectively. 2. Patient appointments should be accepted, processed, and easily retrieved by the

system. 3. The present and past prescriptions should easily be retrieved from the system

to facilitate the refill process. 4. Patient payments must be processed through the system and a corresponding

receipt issued as proof of the transaction. 5. The system should generate billing requests to health insurance companies 6. The system should have the capability to generate appropriate financial reports

to facilitate decision making. 7. Staff details should easily be stored and retrieved from the system 8. Payrolls data should automatically be generated from the system. 9. The system should be compatible with organizational processes.

Summary The integration of the EHR system in the operations of the Midtown clinic would be an important

milestone in its history. The system would propel the entity towards the achievement of its

stipulated goals. The system addresses significant areas that are consequential to the clinic ranging

from proper information storage, efficiency, and sound management. The analytic details that have

been provided above are crucial in informing the right decision.

Sharing Data

Introduction Midtown Family Clinic wants to improve the center and store patient information

electronically to convey viable patient administrations and quality consideration. Hence, the center

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will cooperate with different organizations with information; to serve patients while making it less

convoluted for the patients and medical caretakers in the facility. Consequently, sharing a

considerable amount of information will not help since each department needs particular

information to help patients, depending on their scope of service that they offer. Two external

organizations and the information required to be shared between them and the center to serve

patients are evaluated in this stage. w is to assess how technological integration through EHR

would boost the operational efficiency of the clinic. The assessment would focus on the challenges,

data, processes, system requirements, and users.

Need to Share Data Information sharing is the establishment of an effective healthcare management approach

(Skelley, 2013). Midtown Family Clinics have to impart information to various drug stores and

insurance carrier to increase the efficiency of the center. The center needs to impart information

to drug stores to endorse solutions like check the medical history of patients. Midtown Family

Clinic has to impart information to insurance providers to process medical claims and restorative

charging.

Midtown Family Clinic needs to cooperate with departments like the pharmaceutical ones

and drug suppliers to improve its service delivery to patients through avoidance of delays when

attending to them. The facility will utilize Electronic Health Records (EHR) to share information

among them and those still using the traditional means aiming to help patients to get their

prescriptions and for it to get better healthcare administrations. Also, Dr. Harold Thompson will

improve his facility in applying this strategy. There are such a significant number of information

components that can be imparted to those organizations even though each of them requires given

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information to ensure that they operate as desired. Some external departments that this center needs

to communicate with include the drug stores and health insurance providers.

1. External Organization #1 – Pharmacy

• Availing the appropriate drugs is vital to maintain a strategic distance from

unfavorably susceptible response or some other medical problem. Sharing remedies

electronically is the ideal approach to stay away from any issue. Midtown Family

Clinic is utilizing paper solutions that could be lost or misty to the drug specialist,

so sharing remedy data electronically will spare time for center, patient, and drug

stores. Significantly, the patient gets the prescription the specialist endorsed to all

the more likely treat them.

2. External Organization #2 – Health Insurance Providers

• Sharing patient's socioeconomics in detail is essential for both the facility and the

protection suppliers to bring up with each correspondence to abstain from confusing

one understanding with another. Patients' social data, including name, date of birth,

address, sexual orientation, and more, is guaranteeing that the patient being dealt

with is the correct patient. Keeping up this information is significant for exact

charging. This information will guarantee the administration has been given to the

correct patient by coordinating this information that was shared from the facility

with the protection's database. Nursing in Midtown Family Clinic will have the

option to refresh this information whenever before presenting the bill to the

protection suppliers. Appropriate technological utilization is premised on how

efficient entity goals are structured to align with the technology under

consideration. Technology is always an enabler that simplifies how an entity cost-

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effectively executes its task. The strategic objectives that characterize the Midtown

clinic are chronicled below.

Type of Data to be Shared Data sharing between Midtown Family Clinic with other external organizations is useful

for all the parties involved. The center is managing vast data consistently and offering this

information to others while utilizing EHR will be advantageous for the patients. For instance, the

center will impart information to the stores and health caregivers and, more likely, serve the patient

and get quick help without managing a ton of administrative work. A few information components,

like Patient Demographics and protection data, can be similar across all the organizations sharing

data. However, there are specific data that should be imparted to an explicit association. For the

EHR framework to be executed to address the issue to share information from Midtown Family

Clinic to drug stores and medical coverage suppliers, the kind of information to be shared must be

distinguished. The sorts of information to be shared just as to/from these associations will be

recognized in the table below.

Organization #1 - Pharmacy Data Element or Item Data Goes TO/FROM Midtown Family Clinic 1. Patient Prescribed Drug Details From Midtown Family Clinic 2. Patient Medication History From Midtown Family Clinic 3. Patient Allergies From Midtown Family Clinic 4. Pharmacy Contact Information To Midtown Family Clinic 5. Clinical Notes and Information From Midtown Family Clinic Organization #2 Health Insurance Providers Data Element or Item Data Goes TO/FROM Midtown Family Clinic 1. Patient Coverage Information To Midtown Family Clinic 2. Patient Insurance Status To Midtown Family Clinic 3. Billing Information From Midtown Family Clinic 4. Claims Data To Midtown Family Clinic 5. Diagnostic Information From Midtown Family Clinic

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Data Interchange Standards Appropriate technological utilization is premised on how efficient entity goals are

structured to align with the technology under consideration. Technology is always an enabler that

simplifies how an entity cost-effectively executes its task. The strategic objectives that characterize

the Midtown clinic are chronicled below.

1. External Organization #1 - Pharmacies

a. National Council for Prescription Drug Programs (NCPDP) SCRIPT

The NCPDP is an electronic standard for those associated with

administrative roles in the medical context dealing with the identification

of drugs. This standard identifies with apportioning, endorsement,

observation, and payments (National Council for Prescription Drug

Programs, n.d.).

b. The data interchange standard requires hardware, such as PCs, servers,

peripherals, and other IT applications (Interoperability Standards

Advisory, 2017). Exports can also be required to use the information

provided above.

c. Why the data interchange standard is significant is because it guarantees

the patient's information is safe when to and from health care departments

and organizations.

d. The Data Interchange Standard applies to the data elements listed and the

Midtown Family Clinic EHR system because it will permit simplified

processes and quicker correspondences between departments and offices.

2. External Organization #2 – Health Protection Suppliers

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a. Health Level Seven (HL7) Standard

This standard enables healthcare organizations to utilize standard

informing configuration to simplify sharing communication of medication

and transferring information imaging to external offices (Centers for

Medicare & Medicaid Services, n.d.).Various organizations are

communicating in various dialects that make issues, so this standard will

be utilized to fix this issue extraordinarily this standard is utilized for

clinical information informing.

b. Similar to the NCPDP, the data interchange standard requires IT hardware,

which is capable of exporting to utilize applications introduced to its gear.

c. The HL7 standard is significant because it encourages the center to share

information effectively without utilizing the traditional means (Change

Healthcare, n.d.). This standard will lessen the time and enable the

healthcare givers to be fast and efficient in providing services to patients.

d. This standard can be utilized to exchange data with insurance agencies

concerning the patient by keeping them up with the latest patient's

findings.

Summary Dr. Thomas's execution of EHR needs to share information to make his facility's

procedures smoother appropriately. To accomplish the sharing information process, the need to

share information must be distinguished just as sorts of information to be shared, and information

trade principles. Giving Midtown Family Clinic a need to share information empowers them to

trade electronic information with other wellbeing associations. Facilities are managing vast

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information consistently and managing external associations. The Midtown Family Clinic will

profit significantly by refreshing the center with more IT hardware to all the more likely store

patient's information and ready to share them on EHR frameworks for outside wellbeing

associations. The facility will convey and impart information to outside associations, for example,

drug stores and protection suppliers, to all the more likely serve patients. Be that as it may, this

sharing of data can turn out to be quicker and simpler when the facility receives the two

distinguished information exchange benchmarks, HL7, and NCPDP SCRIPT. Sharing patient's

information utilizing EHR frameworks will help Dr. Thompson to improve his center.

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References Centers for Medicare & Medicaid Services. (n.d.). Transactions Overview. Retrieved November

14, 2019, from Centers for Medicare & Medicaid Services:

https://www.cms.gov/Regulations-and-Guidance/Administrative-

Simplification/Transactions/TransactionsOverview.html

Change Healthcare. (n.d.). Claims/Encounters. Retrieved November 14, 2019, from Change

Healthcare: https://www.changehealthcare.com/support/customer-resources/hipaa-

simplified/transactions/claims-encounters

Interoperability Standards Advisory. (2017, July). Sending a Notification of a Long Term Care

Patient's Admission, Discharge, and/or Transfer Status to a Servicing Pharmacy.

Retrieved November 14, 2019, from HealthIT.gov: https://www.healthit.gov/isa/sending-

a-notification-a-long-term-care-patients-admission-discharge-andor-transfer-status

Hammons, T., & Dowd, B. (2015). Medical groups’ adoption of electronic health records and

information systems. Health Affairs journal, 24(5), 1323-1333.

Larkin, T. & Holston, F. T. (2016). Building a comprehensive clinical information system from

components. Cambridge University Press.

National Council for Prescription Drug Programs. (n.d.). About NCPDP. Retrieved November

14, 2019, from NCPDP: https://www.ncpdp.org/About-Us

Skelley, L. (2013, September 30). Accountable Care Means Sharing Data Between Payers and

Providers: You’ll Need More than an EHR. Retrieved November 14, 2019, from

HealthCatalyst: https://www.healthcatalyst.com/Accountable-Care-Organization-

Healthcare-Data-Sharing

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Webster, C. (2014). EHR business process management: from process mining to process

improvement to process usability. In Proc Healthcare Systems Process Improvement

Conference.