ASSESSMENT BUSINESS CASE
1. Executive summary
Electronic Medical Records System are increasingly becoming a key tool within the field of healthcare provision. EMRs are digital systems involved with recording patient information by their physician for quicker access to the information in a bid to create quality access to healthcare. They are becoming more important in the context of urban healthcare methods since they provide practitioners as well as healthcare organization better cost utilization, efficient access to diagnosis, easy access to medication and treatment plan both on-site and off-site. Categorically, they help hospitals save thousands of dollars per practitioner and more importantly help incapacitated patients save thousands more on average in operations, tests and procedures that are redundant. Summarily the following report outlines the need for the AdvancedMD EMRs which is hybrid system that can be accessed both on site and remotely by the physician and the patient through a remotely hosted information management system. Additionally, can be accessed through the web on a variety of devices and it presents a critical point of focus for better patient care. The system is an elaborate and advance EMR and it is considered the best due to the fact that it provides prescription tracking, advanced scheduling features, its customizable and it can be able to be applied to both small and large scale practices.
Health care is one of the more important evidence-based fields that relies on scientific practices for guidance and decision making (Kloek et al., 2006). Continuous aggregation of data ensures a better and perpetual state of education in which the medical practitioners practicing any form of application continually gain and increase their knowledge on the field. This is for the benefit of comparative effectiveness of medical health-care application, as it and ensures constant knowledge accumulation and transfer. In such a case as is in health care, there is need for proper information management (Yin, 2014). Essentially, health record keeping is the first and most important step to transforming health care in general and ensuring benefits are accrued within the society. The benefits may include effectiveness in the administering of treatment, medical approach to disease treatment that is patient centered, improved patient care, greater communication between the various fields of medicine, greater educational objectives, timeliness of medical treatment and equity within the society. The advent of EHR remains to be quite the better option in medical fields as it served as the first point in transforming the medical fraternity as a whole, being the best alternative system for paper record keeping. Guo, Hermanson and Farnsworth (2016) point out that the system remains to be one of the greatest for its ability to provide adequate and time conscious collaboration between the health care providers, financiers, patients and other important systems, it critically provides ground for better analysis of medical situations, allowing for better decision making that is both efficient and of greater quality.
1.2 Options appraisal
Option 1: AdvancedMD
Option 2: Athena Health
Option 3: CareCloud
AdvancedMD is the recommended EMR system since it’s a hybrid EHR system (meaning it’s both physician hosted and remote hosted) allowing greater access in incare treatment and remote treatment. Additionally, a variety of benefit come with it that include comprehensive and legible records, clinical decision support inclusive with safety alerts, and remote access to records. These benefits may translate to improved quality of care and increased patient safety which all together achieve the first priority obligation of a healthcare facility which is to offer the best care to the patient. According to Neal (2011), a good EHR system overall reduces professional liability claims since they insist on offering greater attention potential liability risk associated with record management as well as centering their effectiveness on quality care.
1.3 Costs and benefits
● Provide accurate, complete, and updated patient information at any point of care
● Enable safer and more reliable care and prescription
● Streamline coding and billing (insurance claims)
● Help healthcare providers give more accurate diagnosis of the patient
● Reduce medical errors
● Allow practitioners improve productivity and achieve a work-life balance
● Improve hospital efficiency and quality
● Reduce cost by decreasing paperwork
● Reduce duplicate testing due to lack of adequate patient information
● Improve secured sharing of information between patient and their physicians/ practitioners of clinicians.
Fixed Cost (subscription cost) Variable Cost (Maintenance costs) Total Cost
AdvacedMD $729 Per provider per month $120 $849 per month
($10188 annually) Per provider
Athena Health $8400 Per provider annually $140 $8540 Per provider
Care Cloud $279 single pricing plan for all users Per Month $3348 Per Annum
*Per Provider implies per physicians with access to system *Prices in USD
Project Name: Source EMR system (Electronic Medical Record System)
Project Sponsor/ Executive:
In healthcare management systems government place an important (statutory mandate) that healthcare systems (both corporate and clinical) need to place more emphasis on the quality of the service being offered rather than concentrate on profits (Sandy, 2019). This is because quality services led to better patient management and an improvement on quality of service implies that most of the patient needs are catered for. Electronic Health/ Medical Record system is an important tool that allow physicians to maintain a larger portion of their time on patients rather than fulfilling their administrative duties (Marquez, 2017). This is an important tool that our small regional hospital requires for the benefit of the hospital as well as the well-being of their patients.
Being a Senior Manager in a private hospital that also serves as a regional one, the size of the operations and the number of patients is bound to increase. This could be unsustainable in the event that there are no adequate avenues to cater for information management. Introduction of an adequate EMR is also a regulatory obligation and a tool that will bring more efficiency and sustainability to the office. The traditional methods of information management are majorly decentralized. This is because there are no way of linking variety of necessary information into one elaborate and extensive list in order to create an accurate contextual file that would be able to explain the current problem. Research indicates that the Problem Oriented-Medical-Records (PORM) required the medical practitioner concerned with patient admission to be constantly involved in the five key processes (Sandy, 2019):
1. Database entry,
2. Creation of a complete problem listing,
3. Initial planning of treatment after evaluating patient’s behavior,
4. Keep records of daily progress
5. Create an elaborate and comprehensive discharge sheet.
This was a very limiting process that further limited the physicians from concentrating on the patient’s care but rather on the administrative functions of creating records for patient’s condition and health care procedures. Research identifies the implication of such a traditional method was that information was scattered and not adequately managed or even controlled from a central facility; creating a greater challenge for most of the medical institutions to learn and create greater context to medical problems (UoS 2018). Acquiring a Electronic Medical/ Health record system that is up to date on, will be both efficient and helpful in cutting down operations cost, guaranteeing maximum care is given to the patients and overall providing adequate information management that is both compliant with hospital and jurisdiction regulations.
The EHR consequently helps medical providers manage patient information by offering satisfactory, latest, and comprehensive information about the patients. It additionally, gives quick access to medical records, creates a hierarchy of access; in which the patient is in charge of his or her information. This ensures a secured access to information in which the clinician, insurers and the patient manage the information at the patient’s discretion. As such, the EHR, creates better context into a disease for relatively accurate diagnosis of information, and a reduction in medical errors (Sandy, 2019). This in turn trickles down to better prescription, that is safe and reliable which can also be reflected into the billing of the patient’s medical services. Since the documentation is reliable, the EHR, allows for a productive work and work-life balance for the medical practitioners (Govindarajan, 2019). This is key in ensuring their commitment to the tasks assigned. It ultimately serves to reduce the cost of medical care and creates a more secured and certain health care environment.
2.2 Problem statement
Main aim of the project is to acquire a well-functioning, efficient and easy to incorporate EMR for functions of patient information management. Acquisition of a working EMR software comes at a critical time when there is an increased need for clinical and corporate governance to offer quality healthcare to the patients as well as maintain up to date information on their conditions as a means to create adequate awareness and become inclusive in offering quality care to the hospital’s patient. The advent of the EHR is key in bringing control back to the physicians in matters administration and control of treatment procedures.
Key factors that promote EMR’s success within the medical fields are based on the fact that the technology allows for the minimization of errors within record keeping criteria. UoS (2018) identifies that handwritten documents and a decentralized record keeping system is full of misspellings, illegible words and often confused terminologies which are limiting in the context of offering quality care to the patient. It allowed medical centers to maximize on cost efficiency and by allowing EMR’s the ability to share and manage medical information from a central location. This linked more professional opinions together, increased the period of medical administration which was ultimately cost effective. UoS (2018) researchers opine that information exchange through electronic medical records is almost instantaneous, it also reduces the risks of information mismanagement and access of information by third parties, or misplacement of information. Management of medical records is a critical area as personally identifiable information (such as patient care information, medical history, allergies and even previous treatment that an individual was subjected) is information considered persona and as such protected under the law in Australia. This is information that is provided by the patient to their physician and works to help in their treatment. The patient maintains control on who can access the information, and its in the hospital’s interest to maintain a higher degree of confidentiality with regard to these information. A good EMR system will be critical in offering this service, maintaining integrity of the information, allow easier coordination of treatment and essentially helpful in providing quality treatment and patient care.
2.3 Strategic objectives
Strategic Objectives Measure
Improve Patient access to the physician and decrease number of time physician leaves examination room during patient visit Administrative control
Increase quality and quantity of patient education on their health Clinical control
Decrease number of calls to the lab or other department for lab results and follow up by the doctor Clinical control
Increase number of patients who receive preventive health controls measures overly preventing unwanted conditions Clinical control
Increase doctor patient communication and contact / follow up through reminders especially for age etc. Administrative control
2.4 Project objectives
Data is increasingly becoming a key commodity, even in healthcare for their ability to shed light on critical trends, that are likely to affect policy implementation process. Research into the various product data types that can be gained from EMRs include (Ehrenstein, et al., 2019):
Procedures: Such as clinical procedures, surgeries, radiology, pathology and laboratory practices. This could be included in the Healthcare Procedure Coding Systems and allow for an increased attention in patients primary care.
Laboratory Results: Ehrenstein et al (2019) identifies that the current best source of lab data is from information systems that are used by standalone labs that are not incorporated into the EHRs and as such, costly and not easily sourced. EHRs provide practitioners across a wide range of hospital with capabilities of sharing important non personal information central to understanding conditions.
Vital signs: this is data that greatly improves diagnosis ability of healthcare practitioners. It includes aspects such as height, weight BMI, pulse rate, blood pressure, and respiratory rates and temperatures- LOINC codes allow for quicker diagnosis.
Surveys: This is data collected from self-reported questionnaire and interviews that are stored within EMRs for a variety of purposes. They shed light on risk factors, behaviors socioeconomic status of a patient that will give practitioners background into the conditions.
Social data: This is information that provide underlying social context and is likely to provide practitioners and understanding into certain development among a demographic of people.
Other important products include Utilization Costs, Diagnoses, Patient Identifier, Demographics and Medications.
2.5 Related projects
Clinical and Financial Integrated system is a similar project that is interdependent to the EMRs as it falls under the healthcare digital technology investment areas. It is a project that ideally provides digital consumers a connection to healthcare services offered by the hospital. Fitz and Shaikh (2018) identify that such a product commits healthcare providers to integrated planning process, as well as allowing them to gain an upper hand in understanding current technological trends that dominate the field of healthcare.
3. Options analysis
1. Option 1: AdvancedMD
2. Option 2: Athena Health
3. Option 3: CareCloud
3.1 Preferred option
AdvancedMD is the best choice of all the options. Its dashboard is overall very user friendly with combination of basic and advanced features for EMRs.
+1 (800) 825-0224
Athena Health –
Direct: +1 732-873-5133
● Well outlined detail scheduling interface
● Tracks descriptions
● Elastic and can fit any size or operation ● Easy to learn and use.
● Web based as such compatible with many devices
● Easy to customize
● Excellent customer service ● Modern Interface
● Easy and updated tracking of patient flow
● Tweaked to match regular healthcare regulations
● Requires more time to learn to be able to use it efficiently ● Limited to smaller practices no large sizes available (noty appropriate for expansion)
● Entirely web based as such more vulnerable to attacks. ● Simple interface
● Suitable for small practices only
The issue procurement strategy for this project will be related to cost reduction, risk management, optimization of processes as well as global sourcing and quality management. The main aim of the EMR is to ensure greater patient care by offering quality services a reason why all the above strategies are necessary in outlining the EMRs procurement. Risk management consultation, onsite risk management, training and education into regulatory frameworks and policies as well collaboration with other stakeholders will be necessary. The EMRs is a high involvement purchase as such there will be an elaborate process into its acquisition. After the appropriate research has been conducted there is a need to involve a risk management company in order to outline the various forms of compliances that will be required in its use by the practitioners and other stakeholders with access to the information.
5. Project strategy
Event / Milestone Deliverable Date
(or elapsed time from start of project)
Problem recognition: Identify the difference between current state and desired state that triggers one to act, these states can be internally or externally triggered June 12th 2021
Information search: what products can solve our problem (AdvancedMD has already been identified). First, we use internal information which is our knowledge. Then external information is ranked into commercial/ marketer controlled: e.g. adverts it can also be public within the internet or books and personal information search from family and friends June 15th 2021
is the third aspect in the model. We compare between the three different products. And establish how different companies solve our problems July 1st 2021
Actual purchase: after we have identified the most suitable company to guide us in subsequently achieving the desired model state. July 10th 2021
Purchase evaluation: This is the last stage this model. It is when we decide whether we have been satisfied and establishing whether we can repeat the purchase if a future problem is identified. If we are happy with the product we can try another product and service ad maintain trust in the brand. July 23rd 2021
Post Purchase evaluation Evaluation of the EMR will be made based on performance appraisal and general feedback from the hospital and the stakeholders will deliberate whether the product was satisfactory or unsatisfactory. This information is necessary to outline whether their product use was accurate or inaccurate. Users will create claims and expectations into a product that is realistic and can lead to satisfaction. August 30th 2021
6. Costs – benefit analysis
There is a wide range of cost benefits that can be accrued from introducing EMRs into the general field of practitioners. Summarily research indicates that the EMRs works to improve patient safety, support delivery of effective and efficient patient care, facilitate better management of chronic illnesses in patient, provide efficient schedules and timelines within the hospital and promote limited waste in laboratory tests etc (Clancy 2003). But all these factors are the easily identifiable aspects benefits of an EMR systems. Research indicates that in the US, introduction of EMRs saved the hospital $84,300 per provider in a period of over 5 years (Wang et al., 2003). These benefits were gained from improved utilization of various procedures, avoidance of double or triple doing them each time a patient came to the exam room, savings from drug expenditures, decreased billing error and better capture of charges across the board. Since quality care is the overall concern in any healthcare facility, it is indicated that majority of patient save between $8400 to $140,000 (Wang et al., 2003). This showed a generally cost-effective advantage on both the healthcare organization and the patients.
7. Project management and control
7.1 Business case
For the process that involves the purchase of the AdvancedMD EMRs and its implementation and overall supervision and training of the staff the IT department and the Financial Committee will take charge in the implementation of the EMR system as well as overseeing its application and use. The finance committee will be concerned with budgeting, financial planning, financial reporting, creation and monitoring of internal modes of controls, and creation of policies of accountability. Their responsibilities will also include the development of the annual operating budget reports, trend reports and this will be in conjunction with the staff. This will be developed in conjunction with staff members, where I will work with them to develop desired reports that are detailed, regular (up to date), adhere to deadlines. This is because financial reports are required to be holistic and broad in their range. Performance appraisal will be key in identifying the different variation.
In Australia, the Australian Digital Health Agency usually regulates the e-health record which it considers an online electronic summary of one’s key health information. They provide adequate regulations to enhance clinical workflow capabilities that consequently enable healthcare providers to easily and readily identify, group and provide relevant tests and results to patients. In the context of the private hospital, the Information technology will be charged with the capabilities of managing the project. This will be overseen by the Senior Manager. The finance committee which has the general oversight on the project implementation will be tasked with creating reports and keeping the corporate and clinical governance informed on the progress of the project. The finance committee will approve budgets, provide organization- wide monitoring for adherence to budgetary supplements, articulate long-range financial goals, and approve funding strategies (Edmund, Rmaia and Prakash, 2009). Within the finance committees, reporting is a critical tool in creating accountability. In addition to the development of the annual budget, I will be required to develop useful and readable reports.
7.3 Risk management
Being an evidence-based practice, variance and trend risk assessment will be the best tool in place to control and evaluate project performance. Yin (2014) identifies Variance analysis as a risk analysis tool that is quantitative and used to review difference between what the project managers though would have happened against what has actually taken place. Trend analysis in similar regards reviews the trend of the object item over a period of time (before and after). Variance and trends usually are compatible and as such data can be collected in regular intervals and a comprehensive spreadsheet on the EMRs working be outlined and a comprehensive report outlined.
7.4 Progress monitoring
Performance appraisal of all employees central to the EMR system will be critical in monitoring and comparing achievement of the tool relative to the baseline plan. Gesme and Wiseman (2011) identify that in any healthcare establishment the corporate and the clinical sections are codependent. A performance appraisal will thus consider the job description of all the employees central to the EMR system and based on the function they serve around the system form maintenance of the system, to those who log in information to the procuring department etc. The main aim of a performance appraisal is nested on practice improvement and adaptability of their general practice relative to the EMR system. Practice improvement is a form of performance management complex healthcare organizations introduce so in order to monitor and encourage their employees to achieve the best practical training for their specific roles (Hughes 2008).
In this case the EMR Categorically, researchers identify that performance management remains to be action based central to the performance measure and reporting (Leggat, 2009). Appraisal of performance as a tool of employee monitoring and comparing with the baseline plan will be directed at improving employee behavior, interaction and motivation with the EMR system. In this regard performance appraisal will ensure objectivity in review of each employee relative to the system in place. Chandra and Frank (2004) pointy out that performance review as a measure for monitoring will evaluate employee performance improvements and outline critical measures to be taken to maintain or improve employee performance. The appraisal will consider their roles in their professional capacity to the system and compare how they have improved or deviated from the baseline plan.
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