MHA6120 WEEK 2 DISCUSSION AND PROJECT INSTRUCTIONS

MHA6120 Week 2 Lecture 1

Healthcare Information Systems

Aspden, Corrigan, and Wolcott (2004) have cited that the Institute of Medicine has long advocated the increase acquisition of information systems that will facilitate safe and quality care in the twenty-first century. Health information systems are technology-based collections, archiving, and processing of patient throughput, documentation of clinical treatment, management, and evaluation. In addition, HIS also support mechanisms to meet the regulatory requirements and business and management processes such as quality, risk, utilization, and materials management. Applications such as electronic health record, laboratory and imaging applications, medical coding, medical billing, decision support management, and human resource management are just a few service-oriented applications of HIS.

HIS are utilized by physician providers, outpatient services, hospital organizations, health plans, integrated healthcare delivery systems or network, and accountable care organizations (ACO). Public health practitioners and administrators are also in the midst of looking at health information systems to support population management (Wager, Lee, & Glaser, 2017). The architecture and infrastructure of an information system must address the complex needs and requirements of providers, organizations, and systems. It is through HIS that data is managed and becomes a valuable source for evidence-based decision making, evidence-based practice, clinical and process improvement, and evaluation of clinical, financial, and business outcomes. It is also through HIS that we can engage the population we serve. A properly designed healthcare information system architecture and infrastructure must achieve critical measures of cost containment, interoperability, quality data, IT safety, as well as real-time portability for the provider, patient, and user access. HIS must also meet the Health Insurance Portability and Accountability Act (HIPAA) privacy, as well as security and breach standards to ensure legal protection of health information.

Students of healthcare management/administration may not only benefit in acquiring the basic foundations in healthcare information system acquisition and management but also harvest knowledge and skills to keep up with the past face innovations, changes, and regulations in HIS.

Link to Resource

Review the following link to learn more.

Case Study–EHR Implementation Best Practices  opens in new window

References:

· Aspden, P., Corrigan, J. M., & Wolcott, J. (Eds.). (2004). Patient safety: Achieving a new standard for care. Washington, DC: National Academies Press. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK216080/

· Wager, K. A., Lee, F. W., & Glaser, J. P. (2017). Health care information systems: A practical approach for health care management (4th ed.). San Francisco, CA: Jossey-Bass

Additional Materials

From your course textbook, Information Systems for Healthcare Management, review the following chapter:

· Government Policy and Healthcare Reform

From the Internet, review the following:

· Aspden, P., Corrigan, J. M., & Wolcott, J. (Eds.). (2004). Patient safety: Achieving a new standard for care. Washington, DC: National Academies Press. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK216080/

· Wager, K. A., Lee, F. W., & Glaser, J. P. (2017). Health care information systems: A practical approach for health care management (4th ed.). San Francisco, CA: Jossey-Bass

Healthcare Data Quality and Healthcare Information

Healthcare information is complex and highly regulated. It is vital for the critical outcomes of clinical care and business processes, as well as regulatory compliance. Clinical care information may include, but not limited to, multidisciplinary assessment and management, medical imaging, laboratory results, and other diagnostic information. Healthcare business information includes, but not limited to, coding, billing, materials management, decision support, and others. Healthcare information comes from a variety of clinical and support services, making data management complicated. Clinical information is continuously archived and evaluated for outcomes of care as well as financial outcomes. Clinical and financial information are also an integral component of regulatory compliance, risk analysis, performance management, resource management, and strategic planning.

The power and utility of healthcare data are mainly dependent on meaningful and comprehensive design of information systems and applications that are accessible and lead to data aggregation and analysis for care improvement, regulatory compliance, evidence-based practice, and process improvement in clinical, ancillary, and financial services. Poor data quality inhibits or prevents process improvement for clinical, financial, and business improvement, as well as regulatory compliance. In short, bad data leads to bad clinical and financial outcomes.

Healthcare Data Quality and Information

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The Power and Utility of Healthcare Data Quality and Information in Clinical Care

· Quality data informs patients, providers, and organizations of the clinical outcomes of care.

· It leads to improvement in clinical, managerial, and financial processes.

· It informs risk managers of the clinical risks that require risk interventions.

· Quality data helps quality improvement practitioners in evaluating clinical outcomes as well as identifying the areas for clinical and administrative improvement.

· Quality data can lead to timely and focused interventions.

· It supports patient safety.

How Poor Data Quality Inhibits or Prevents Process Improvement for Clinical, Financial, and Business Improvement

· Poor data leads to incorrect evaluation and interventions of clinical and managerial issues.

· Poor data quality leads to costly and inappropriate interventions.

· It leads to inefficiency and unsafe clinical practices.

Additional Materials

From your course textbook, Information Systems for Healthcare Management, review the following chapters:

· External Environment

· Government Policy and Healthcare Reform

From the Internet, review the following:

· LeSueur, D. (2018). 5 reasons healthcare data is unique and difficult to measure. Retrieved from https://www.healthcatalyst.com/5-reasons-healthcare-data-is-difficult-to-measure

· Markel Foundation. (2006). Background issues on data quality. Retrieved from http://bok.ahima.org/PdfView?oid=63654

· Patel, P. (2013, January 07). Bad data, bad decisions [Web log message]. Retrieved from https://blogs.perficient.com/2013/01/07/bad-data-bad-decisions/

Regulations and Standards Affecting HIS

Regulations and standards affecting HIS revolve mainly around ensuring privacy, confidentiality, and security of each patient’s personal and healthcare information. We will not address HIPAA security in this lecture. An extensive lecture on security will be addressed under Week 4.

Privacy is a constitutional right, and healthcare organizations are mandated to protect every individual’s right to privacy (Wager, Lee, & Glaser, 2017). However, with the advent of electronic information and availability of personal and health information through the cyber space, the threat to privacy and confidentiality of patient information is a major concern for policy makers and healthcare administrators.

Privacy and Confidentiality of Patient Information

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Patient’s Right under HIPAA

Right to privacy and confidentiality of personal, physical, and medical information.

What Information of the Patient Is Protected and How

Right to privacy and confidentiality of personal, physical, and medical information are protected through a healthcare organization’s policy and procedure that will ensure the following:

· Personal health information may be disclosed only for health purposes with limited exception.

· Personal health information should not be distributed without authorization unless there is a clear basis for doing so, and the receiver of information must safeguard it.

· The consumer must have access and control of his or her health records and must be informed of the purpose for which the information is being disclosed and used.

· Improper handling of personal health information may be subject to criminal and civil recourse.

Reference:

Wager, K. A., Lee, F. W., & Glaser, J. P. (2017). Health care information systems: A practical approach for health care management (4th ed.). San Francisco, CA: Jossey-Bass.

Who Can Look at and Receive Your Health Information

Covered entities such as healthcare providers, healthcare plans, healthcare clearing house, designated representatives, and per Center for Disease Control (CDC), public health representatives for public health purposes.

References:

HHS.gov. (n.d.). Individual’s right under HIPAA to access their health information. Retrieved from https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/access/index.html

MMWR. (2003). HIPAA privacy rule and public health. Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/m2e411a1.htm

The three sources of legal protection of patients’ personal and health information include:

· The Federal HIPAA Privacy, Security, and Breach Notification Rules

· State Privacy Laws

· Federal Trade Commission Act (Koch, 2016 as cited in Wager et al., 2017)

The HIPAA was enacted in 1996, and since then it has gone through several revisions and amendments. HIPAA superseded The Privacy Act of 1974 and the confidentiality of substance abuse patient records. The current HIPAA Privacy Rule specifically focuses on personal health information. This information is related to a person’s physical and mental health, the provision of his or her healthcare, or the payment for healthcare. The individual is treated as the subject of information. The personal health information of an individual is created or received by a covered entity. It is transmitted or maintained in any form, e.g., paper, electronic, or oral (Wager et al., 2017).

The Federal Trade Commission Act of 2010 requires businesses not covered by HIPAA such as personal health record vendors to notify “individuals of any security breach” (Wager et al., 2017).

As students of healthcare administration, you need further knowledge on who are the HIPAA-covered entities and how health information can be released to them. You need to understand the enforcement of regulations and the standards of the Breach Notification Rule. Also, check your state privacy laws on personal health information.

Reference:

· Wager, K. A., Lee, F. W., & Glaser, J. P. (2017). Health care information systems: A practical approach for health care management (4th ed.). San Francisco, CA: Jossey-Bass

Additional Materials

From the Internet, review the following:

· Federal Trade Commission. (2010). Complying with the FTC’s Health Breach Notification Rule. Retrieved from https://www.ftc.gov/tips-advice/business-center/guidance/complying-ftcs-health-breach-notification-rule

· Office of the National Coordinator for Health Information Technology. (2018). Health IT legislation. Retrieved from https://www.healthit.gov/topic/laws-regulation-and-policy/health-it-legislation