ifsm 305 assignment case study 4

Medical care institutions have provided care for their patients since old times before the digital technology era that we are in today. Medical institutions like clinics and hospitals which existed during those previous times, used paper based methods to get most of their basic operations done within the institutions. Operations like obtaining, saving and updating customer details, keeping appointment schedules, and sharing customer data with other institutions. Now in the modern era of technology, the same operations are needed but are simpler now than back then, thanks to digital technology.

The sharing of data between institutions is necessity in the medical profession in for various reasons. The institutions that require such data have different reasons for that as well. For these reasons, data sharing between institutions needs to be properly set and streamlined process for maximum efficiency.

Of the many institutions that exist in the medical industry, two institutions are very crucial to the process of administering medical help to patients; Laboratories and Insurance companies.

Laboratories are essential to the process of diagnosing and treating an illness in a patient for various reasons. First of all, a patient’s diagnosis process can be a difficult problem and a rather complicated one too. When a doctor listens to a patient describe the symptoms of an illness, he/she gets a general idea of what a patient is suffering from and may need further information from a laboratory to confirm his findings. In such a scenario, the doctor sends the patient to a laboratory either within the institution or outside the institution. The laboratory will most definitely require accurate information about the patient to understand the basic nature of the condition of which the patient is required to be tested on, background information like allergies and any other relevant information. This information is usually given by the doctor or retrieved from data storage facilities like a file or a digital database.

Insurance companies are also essential in the process of treating a patient for various reasons. The major reason however is for the purposes of billing of patients expenses. These companies need information about the expenses incurred by a patient during treatment. Such information may include: laboratory test costs, drugs and medicine costs and doctor consultation fees. Proper communication and data sharing frameworks need to be put in place for this purpose as well.

Medical care institutions often need to share patient information with external institutions for the purposes of satisfying and fulfilling customer needs. These institutions are of different natures and most often require different information from medical institutions and also provide different information to medical institutions for different purposes. The information needed/provided by laboratories and insurance companies is listed in the table below:

The Electronic Data Exchange (EDI) standard is the structured transmission of data and information between organizations by electronic means. This data exchange standard is used for the exchange of electronic between an organization like a medical center and a laboratory. This is because the data is usually structured and contains data items required for the successful completion of the tasks required by a medical center. The importance of this data standard is that there are very few occurrences of data errors due to errors in typing (Mahato, 2019). It is a method that guarantees that information arrives intact on the other end of the channel.

The LEDES (Legal Electronic Data Exchange Standard) is important when exchanging data that may have legal implications like the exchange of data between a medical institution and an insurance company. LEDES was developed specifically for the exchange of a data within the legal industry (Wikipedia, 2019). The four data exchange format types in LEDES are: electronic billing (e-billing); budgeting; timekeeper attributes; and intellectual property matter management. These formats are what make LEDES so suitable for exchange of data between a Medical Institution and an Insurance company.

Electronic Medical Record (EMR) is an important system for managing patient information within a medical institution and between the medical institution and external institutions which may require such information. Opposed to the traditional manual and paper systems, these EMR systems are proving to be effective and fast. Patient information needs to be available to doctors, care givers, insurance firms and patients themselves without much hustle on any party. The use of data interchange standards to share data between institutions, that may be using different types of applications is very intuitive and important. The hustles of having to print papers every time one is going to claim compensation from insurance companies, visiting a laboratory or purchasing medicine from a pharmacy.

References\

Mahato. (2019). Electronic Data Interchange (EDI) | Documents | Steps | Advantages | e-Commerce [Video]. Retrieved from: https://www.youtube.com/watch?v=RBlqyflpWtA

Wikipedia. (2019). Legal Electronic Data Exchange Standard. Retrieved from: https://en.wikipedia.org/wiki/Legal_Electronic_Data_Exchange_Standard