Module Four Discussion Topic One
Clinical information systemsand the influence of the
system on the healthcare delivery system.
Clinical information systems were intended to improve care delivery. Most of us would
agree clinical information systems have improved care delivery, however they have also
changed how we provide healthcare. “A CIS consists of a wide range of networking
technology, clinical databases, electronic medical records, as well as other clinical
informatics research evidence systems”!(Islam et al., 2018). Instant access to patient
medical records, laboratory testing, radiology results as well clinical decision-making
support data bases, billing, and clinical communication is amazing. Unfortunately, it is
also expensive to purchase, implement, and maintain. Without the incentives provided by
the HITECH act of 2008 some practices would not have been able to purchase even the
less comprehensive system. “The Act increased the rate of adoption of EHRs from 3.2% in
2008 to 14.2% in 2015. By 2017, 86% of office-based physicians had adopted an EHR and
96% of non-federal acute care hospitals has implemented certified health IT” (HIPAA
Journal, 2019).
Electronic medical records have demonstrated that they are better than paper for both the
practitioner and the patient. “We conclude that health information technology improves
patient’s safety by reducing medication errors, reducing adverse drug reactions, and
improving compliance to practice guidelines. There should be no doubt that health
information technology is an important tool for improving healthcare quality and
safety”!(Alotaibi & Federico, 2017). The cost of the clinical information system and the
change in reimbursement methods driven by electronic data forced smaller provider
organizations into business arrangements with larger partners. “These market forces have
caused physicians to increasingly see the need to become part of larger networks of
physicians which are able to engage as a group in alternative payment arrangement with
CMS, commercial insurers, self-insured employer plans and hospital organizations”!(Frier,
2020). Smaller or solo practitioner offices are hard to find. Many providers have given up
the task of running a business to the business executives.
Module Four Discussion Topic Two
Technology diffusion has been accompanied by issues
of cost, safety, benefit, and risk. Federal legislation
has aimed at addressing these concerns.Which do
you consider to be the most important area for
focus?
Each of these factors have similar weight because each one of them impact access to care.
Access to care drives down cost of care through earlier interventions. “Office visits can
also be reduced when large numbers of patients can be tracked by mobile devices with
abnormalities or significant changes in their conditions relayed to their clinicians with the
potential for text messages, e-mails, telephone calls or links to instructional web sites
reducing the potential need for an office or clinic visit”(Kane, 2014).
The cost of technology has changed the shape of care delivery. Providers tend to form
practice large practice associations in order to drive down the cost of EMR implementation
and maintenance. Practicing in a large groups allows patients access to care with expanded
hours, access to covering physician while their physician is away, and shared staff between
physicians. Technology also offers access to rural patients with patient monitoring and
telemedicine.
Safety in medicine is always a concern because clinicians and staff are humans even with
the best of technology there will be errors. Technology itself is not a complete fail safe
because humans program the technology. Are we safer now than before there was so much
technology? I would argue we are much safer than we were before the diffusion of
technology. Having worked in the world of the paper chart, before mandate use of gloves,
and quality and safety reporting I can anecdotally report we are much safer. Medication
errors due to inability to read physician handwriting, medical alerts, and reminders to fill
and pick up medications, automated notifications to physicians when a patient has not
filled a prescription have improved safety. Are there still gaps? Yes, of course but they are
found quicker and easier than they were previously. “The advantages of health information
technology (IT) include facilitating communication between health care providers;
improving medication safety, tracking, and reporting; and promoting quality of care
through optimized access to and adherence to guidelines. Health IT systems permit the
collection of data for use for quality management, outcome reporting, and public health
disease surveillance and reporting” (American College of Obstetricians and Gynecologists,
2015).
In addition, technology allows safety events to be easily reported, reviewed, and
catalogued to improve care. Reporting trends can be analyzed, and interventions created.
Mandatory reporting of safety events to public health organizations ensure that the events
are reviewed, and plans are created to ensure the event is not repeated. “With the increased
EHR adoption, public health data can now be more rapidly reported to public health
agencies” (Wu, 2014).
!
!
References
Alotaibi, Y., & Federico, F. (2017). The impact of health information technology on
patient safety.!Saudi Medical Journal,!38(12), 1173–1180.
https://doi.org/10.15537/smj.2017.12.20631
American College of Obstetricians and Gynecologists. (2015).!Patient Safety and Health
Information Technology. Www.acog.org. https://www.acog.org/clinical/clinical-
guidance/committee-opinion/articles/2015/01/patient-safety-and-health-
information-technology
Frier, D. B. (2020, December 4).!integrate super group. Medical Economics.
https://www.medicaleconomics.com/view/what-you-need-to-know-about-forming-
a-medical-super-group
HIPAA Journal. (2019).!What is the HITECH Act. HIPAA Journal.
https://www.hipaajournal.com/what-is-the-hitech-act/
Islam, M., Poly, T. N., & Li, Y.-C. J. (2018). Recent Advancement of Clinical Information
Systems: Opportunities and Challenges.!Yearbook of Medical Informatics,!27(1),
83–90. https://doi.org/10.1055/s-0038-1667075
Kane, J. M. (2014). Technology-based interventions in health care.!Epidemiology and
Psychiatric Sciences,!23(4), 323–326. https://doi.org/10.1017/S2045796014000444
Wu, L. (2014).!Issue Brief: Health IT for Public Health Reporting and Information
Systems. https://www.healthit.gov/sites/default/files/phissuebrief04-24-14.pdf
