MHA-FPX5062 Assessment 3
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Capella University *
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5062
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Health Science
Date
Dec 6, 2023
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docx
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Uploaded by bschulstad927
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HIM System Interfacing and Interoperability
Beth Doeden
Capella University
MHA-FPX5062 Healthcare Delivery Health Informatics
July 23, 2023
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Introduction
We will be reviewing if the health system should work to interface all health information
systems and their recent acquisitions to have all sites on the same software.
For safety and
efficiency reasons, it is essential to have real-time, accurate, and comprehensive information to
provide the best patient care.
Analysis
Different areas in the health system use different health information systems suited to
their specific needs.
We have met with critical stakeholders to discuss the current state, potential
risks, needs, and gaps.
Speaking with the vice president of medical services, the EHR currently
in use does not support their maternal and fetal medicine clinic or the emergency department.
They were also concerned about the EHR not keeping the meaningful use certification and how
the upcoming changes to meaningful use stage 3 were extracted and reported from the EHR.
Behavioral health uses its system as well as the EHR.
In addition, they need to work out
of federal programs to report infectious disease information, medication monitoring, and child
welfare.
The behavioral health system and EHR currently integrate, but the federal programs
still need to, which results in staff having to document in multiple areas.
The lack of integration
also results in places like social services not receiving real-time information about patients'
discharge from the department.
Internal medicine utilizes the lab and imaging systems and EHR mainly.
For lab and
imaging, they are using those systems for tracking and scheduling purposes.
The information is
supposed to be in the EHR, but they need to believe that the information is making it to the EHR
as it should.
They also have issues ordering medications on order sets they can access for other
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hospitals.
Not all hospitals have the same drugs, labs, or imaging procedures, but the order sets
presented have orders for all areas, resulting in many cancellations and orders.
The cancer center utilizes the lab and imaging systems.
They also have a specialized
module within the EHR that captures all the information for the care of cancer patients.
The only
ask is to have all the information they need in one place rather than look in several places.
The imaging department utilizes both the EHR and PACs.
The EHR tracks what imaging
procedures are complete and which are still outstanding.
A request of the department,
specifically radiologists, is to attach a patient photo to their images and scans to provide a more
personal touch to their work with the patients.
They cannot interact with patients like the techs,
so this is a way they could add a more human factor.
They would also like their dictated note
recordings attached to the imaging reports.
The pharmacy works with a pharmacy system, the EHR, and the formulary.
The
pharmacy system tracks the fill and refill process for medication, and the formulary tracks what
is in stock.
There is a vast gap between the ordering and filling process between clinical staff
and the pharmacy.
Often information needs to be included, such as allergies or contraindications.
Clinical staff can bypass this information which is a safety issue.
Duplicative documentation
also poses a safety issue, and condensing systems help reduce that risk significantly.
Information systems are entirely onboard with an interface engine as the interfaces
currently in place work but are resource intensive.
With the engine, complete real-time data can
be quickly and easily transmitted.
The only drawbacks are the cost, space, network, storage, and
cooling system.
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With all this information considered, many systems are in use within the health system,
and there is not one source of truth.
Departments have expressed frustration and must find
patient information in multiple places, which is time-consuming and needs reviewing.
Also, the
safety and security of the interface engine secure PHI upholding interoperability standards
(Boerner, 2015).
Meaningful use relies on a solid source of truth for reporting.
This is another reason to
have all clinical staff using the EHR, certified for meaningful use, and data exchange to be
strong.
The rest of our systems would need to be certified if extracting data may or may not
result in the system being replaced or upgraded (CMS, 2021).
There are pros and cons to staying with our current setup for our health information
management systems and switching to an all-in-one system.
The pro of staying the way we are
is it is already in place, and we have been functioning as it is.
There is no need for significant
resources other than the maintenance needed for fixes and software updates.
A con would be that
if the systems become no longer certified or the interfaces cannot keep up with each other's
changes and can no longer be compatible.
This will result in a new system.
A pro to moving to
an all-in-one system is to have all information in one place, providing safety, efficiency, and ease
in reporting.
A con is the cost and upfront labor in standing up a new system.
The recommendation would be to move to a single health information management
system.
EHRs were initially created for easy access to health information across the spectrum
(Sninsky, 2008).
Having one system also reduces medical errors due to the accuracy and
transparency of medical information.
It also reduces duplicative testing and the delay of care,
having instant and accurate information available (CMS, 2023).
The streamlined workflows that
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come with using one system help ensure all elements are documented and captured to be
extracted and reported on for meaningful use and other programs.
Meeting the measures can
result in significant incentives that could pay for the new system in a few years (Schilling, n.d).
In a study conducted across multiple organizations, adopting a single health information
system showed significant benefits.
Lab testing decreased by 18%, radiology exams decreased
by 6.3%, transcription cost reduced by 74.6%, medical errors decreased by 38.9%, and
medication errors decreased by 55.2 %.
Clinical decision support scores significantly increased,
and admissions and death significantly decreased (Uslu, 2021).
Conclusion
A robust health information system is essential for patient care, clinical outcomes, and
reporting.
Having information stored in a single place is essential for patient safety, decision
support, quality of care, efficiency, and ease of reporting to programs such as meaningful use.
Sustaining a quality health information management system will ensure that we continue moving
forward with technology and can handle all the nuances of healthcare.
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References:
Boerner, D. (2015). What APIs bring to EMR/EHR interoperability.
Health Management
Technology, 36
(10), 22. http://library.capella.edu/login?qurl=https%3A%2F
%2Fwww.proquest.com%2Ftrade-journals%2Fwhat-apis-bring-emr-ehr-interoperability
%2Fdocview%2F1744624878%2Fse-2%3Faccountid%3D27965
Centers For Medicare & Medicaid Services. (n.d.)
Stage 3 Program Requirements for Providers
Attesting to their State’s Medicaid Promoting Interoperability (PI) Programs. Retrieved
June 13, 2023, from
https://www.cms.gov/Regulations-and-
Guidance/Legislation/EHRIncentivePrograms/Stage3Medicaid_Require
Schilling, B. (n.d.) The Federal Government Has Put Billions Into Promoting Electronic Health
Record User: How Is It Going?
The Commonwealth Fund.
Retrieved June 11, 2023, from
https://www.commonwealthfund.org/publications/newsletter-article/federal-government-
has-put-billions-promoting-electronic-health
Sninsky, C. (2008). Developing universal electronic medical records.
Gastroenterology &
Hepatology
,
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(3), 193–195.
Uslu, A., Stausberg, J. (2021). Value Of the Electronic Medical Record.
J Med Internet Res,
23(12). https://doi.org/10.2196/26323
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