Health information exchanges.

For this task, you will read the “EHR Project Management Team” posted below the task
requirements.
Note: Responses to the tasks listed should be completed in an outline format (length of 6
pages), with descriptions given to clarify conceptual understanding.
A. Examine elements of the vendor selection process by doing the following:

  1. Justify how a cost-benefit analysis will help to focus the vendor selection process.
  2. Discuss the difference between a request for information and request for proposal.
    a. Explain why one might be preferred.
    b. Explain why both may be used.
  3. Identify the elements included in writing a request for proposal.
    a. Determine who would be the contact person for gathering information on each element.
  4. Discuss how you would establish a good working relationship with vendors and company
    representatives involved in the selection process for new technology.
    B. List four functional electronic health record (EHR) applications needed by clinical end-
    users in the acute care setting.
  5. Describe how each application may be used.
  6. Identify specific human resources needed in the acute care setting to facilitate
    implementation of new technology, including training needs.
  7. Discuss one strategy that might be used when introducing new technology to enable it to
    interoperate with old technology in the acute care setting.
    C. List three functional applications needed by clinical end-users in the outpatient setting.
  8. Explain how each application may be used.
  9. Identify specific human resources needed in an outpatient setting to facilitate
    implementation of new technology.
    D. Compare two models being used today in health information exchanges.
  10. Describe benefits to developing health information exchanges.
  11. Describe current challenges impacting more widespread implementation of health
    information exchanges.
    E. Explain three factors to be considered by an organization in providing a personal health
    record to patients.

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  1. Identify two businesses or organizations outside of the scenario offering a personal
    health record service.
  2. Identify three qualities of a personal health record which should be determined before its
    adoption.
    F. When you use sources, include all in-text citations and references in APA format.
    Note: When using sources to support ideas and elements in a paper or project, the
    submission MUST include APA formatted in-text citations with a corresponding reference
    list for any direct quotes or paraphrasing. It is not necessary to list sources that were
    consulted if they have not been quoted or paraphrased in the text of the paper or project.
    EHR Project Management Team Scenario
    You have been working for the past several months as a member of a project management
    team in a healthcare organization that made the decision to adopt the electronic health
    record (EHR) throughout its system. The system consists of one 50-bed hospital and several
    outpatient clinics. Organizational leadership has been pleased with the project thus far.
    The EHR Project Management Team has gathered information on organizational needs.
    Focus groups and informational sessions were held at the hospital and in each of the
    outpatient facilities. In addition to the needs identified in employee focus groups, the
    organizational leadership team has identified two elements for the project management
    team to address while developing the request for proposal: selecting the vendor and
    planning for the phases of launching the electronic health record throughout the system.
    The leadership directive is to provide all patients with an option of building a personal
    health record provided by the organization. The second mandate from administration is
    that in planning for the selection of the electronic record and its implementation, the
    organization should consider future initiatives in participating in regional health
    information exchanges. There have been preliminary discussions with an academic
    research hospital and two other healthcare organizations of a size similar to yours. The
    leadership at all four institutions have agreed to pursue this idea with a focus on providing
    higher quality care and convenience to healthcare consumers in the region.
    The focus areas for the EHR Project Management Team are these: select a vendor who can
    accommodate the needs of the hospital and ambulatory care facilities, provide the
    framework for a personal health record for patients, and meet future networking
    capabilities in forming a regional health information exchange.
    The request for proposal needs to list these diverse requirements as critical components of
    the system to be purchased. A cost-benefit analysis must be performed, and the project
    management team leader will meet with all department managers to identify “super-users”
    from each functional area. Financial resources and the allocation of human resources to
    this project are an integral part of its continued success.

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Project management team

A. Examine elements of the vendor selection process by doing the following

  1. Justify how a cost-benefit analysis will help to focus the vendor selection process.
    Cost-benefit analysis (CBA) is the activity of estimating the planned exercise by
    establishing its value on the firm. Generally, cost-benefit analysis determines measures and
    includes all the positive aspects or commonly called benefits. It also determines measures and
    eliminates all the negative aspects or expenses. The disparity between the two factors shows
    whether the planned project is worthwhile. In the vendor selection process, cost-benefit is
    important as it will incorporate all the necessary costs as well as benefits and quantify them
    properly. In addition, cost-benefit analysis is an essential estimation behind all organizational
    decisions; this is because organizational leaders do not want to invest money not unless benefits
    derived from the expense are higher than costs. As organizations attempt to reduce costs and
    increase output, CBA has become a vital tool for assessing a broad range of opportunities like
    purchases, and expansion. Key business decisions facilitated by CBA include implementing new
    procedures, change vendors, purchasing equipment, introducing new technologies (Waegemann,
    2011).
  2. Discuss the difference between a request for information and request for proposal.

The difference between request for information (RFI) and request for proposal (RFP) is
important to make decisions when they want to outsource. Therefore, RFI provides necessary
information required for choosing a supply while RFP provides a vendor or a supply of what is
the company is looking for to help in price and quality. Unlike RFP, RFI is wide and does not
require financial conversions. In this case, RFP is preferred because it reflects the strategy as
well as long term or short tem organization objective, giving detailed insight on which suppliers

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use to provide perspective. Therefore, the organization should provide the supplier with all the
basic project details (Marhula, 2011). On the contrary, both RFI and RFP are needed because
they seek detailed information, estimates and offerings. Additionally, they seek detailed
questions regarding performance measures, items vendors are suggesting, organizational
requirements, technical aspect that assist in later negotiations.

  1. Identify the elements included in writing a request for proposal.

 Products suppliers are proposing – procurement officer
 Organization requirements – production manager
 Information – information technology specialist
 Ideas – Performance measures-production manager
 Technical details and training – IT specialist
 Selection procedure – procurement officer
 Addressee selected carefully – production manager
 Information on how to reply – IT specialist
 Contact person incase issues arise – procurement officer

  1. Discuss how you would establish a good working relationship with vendors and
    company representatives involved in the selection process for new technology.

Like other forms of relations, vendor relationships are developed on communication, respect and
trust. At the beginning of a new relationship, the involved parties should clearly express
themselves to reach joint understanding of the needs and outcomes. Consequently, company

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leaders must provide vendors all relevant information associated to the project. Giving the
vendor an opportunity to understand the company requirements and its objective will present
insights in the selection of the new technology. In meetings, vendors should be given an
opportunity to familiarize with all the company events and workers involved in the new
technology (Smith et al. 2008). Communication with workers, will present vendors with a clearer
understanding of what the company does and how. Understanding of how is less evident and can
be attained when the vendor integrates with the company workers. Whereas it’s the vendor’s role
to be familiar with the company needs and objectives, the company should reciprocate by being
familiar with vendor’s needs as well as objectives. Understanding a range of vendor’s service is
as well important.

B. List four functional electronic health record (EHR) applications needed by clinical end-
users in the acute care setting.
There are four functional electronic health record (EHR) applications needed by clinical end-
users in the acute care setting:
Electronic health record (EHR) is a longitudinal e-platform with patient health data. Incorporate
in this data are demography of patients, laboratory information, immunization radiology records
previous health history and vital signs. Some of the functional benefits related to EHR are its
ability to access computerized reports and removal of low penmanship that has traditionally
overwhelmed medical records. EHR applications can include several abilities; however certain
functionalities have great significance on quality health care and minimize costs. These
functionalities are:

 CDS -Clinical decision support tools

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 CPOE-computerized physician order entry applications
 HIE-health information exchange

CDS tools help providers in decision making related to care of patients. Key
functionalities of CDS are providing updated data on drugs, assessing patients’ sensitivity to
drugs, notifications for medication and other possible patient complications signaled by the
computer. Following the development of health knowledge, these functionalities present a basis
for provision of quality care in an effective way.

CPOE applications help providers to input orders (such as lab test, physical therapy,
drugs) in a computerized system. Automation of this procedure reduces the risks of health errors.
In addition, it makes ordering procedure effective since nurses and pharmacists do not require
clarification or look for missing data from incomplete or even indecipherable orders. HIE
facilitates sharing of patients data among various organization leading to effective care delivery.
Allowing synchronized exchange of patient data, HIE can minimize expensive and uncalled-for
tests ordered since a provider has no access to health records in another provider’s place.
Generally, patients have their health records kept in several locations where they get healthcare
services including primary care practitioner, emergency departments, hospitals and so forth.
With time, much information accumulates in several locations, HIE facilitates the sharing of this
data through electronic health records that can in turn lead to cost-effectiveness and quality care
delivery.

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C. List three functional applications needed by clinical end-users in the outpatient setting..
There are three functional applications needed by clinical end-users in the outpatient
setting:
Integrated communication support: this are devices that have a positive impact on
proficiency in terms of communication teams on duty, working towards enhancing continuity of
patient concern in the event of a changeover in several healthcare departments (Haynes &
Walker, 1987). Administrative data: access to administrative information, admission, discharge
and transfer records, operation timetable; patient basic information, room assignments for
tracking patient movement for permitting precise generation and delivery of medical alerts as
well as reminders.
Clinical decision support: Alerts that stem from updated information from the electronic
medical registers from EBP or evidence based practice rules or more composite technological
intelligence systems for screening and usually provided when the physician evaluates the
patient’s health condition before contemplating an ordering decision. However, to be successful
in implementing new technology within an outpatient arrangement, technical pundits are needed
to rollout the system by coding the most befitting application software and also ensure that
necessary hardware components are in place. The practitioner is obviously expected on board,
including accountants and network support, just in case the system malfunctions (Waegemann,
2011).

D. Compare two models being used today in health information exchanges.

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Two models commonly being used today in health information exchanges include
patient-centered and patient-controlled. These are information exchange platforms that allow
providers to share patients’ information in a granular manner. Additionally, these models enlist
open source involvement and support patients’ privacy needs. It is believed that these models
help health providers to verify, input, and update medical information leading to accountability,
valuable collaboration of physician and their patients.

  1. Describe benefits to developing health information exchanges.
    Developing a health information exchange leads to quality service delivery as well as
    safety of patients. There are several benefits to developing health information exchanges. This
    implies that, it is done at the right time, right manner and to the right individual. Additionally,
    health information exchange facilitates sharing of patient health data contributing to
    effectiveness, patient safety and efficiency in healthcare provision. ting to effectiveness, patient
    safety and efficiency in healthcare provision.
  2. Describe current challenges impacting more widespread implementation of health
    information exchanges.
    Health information exchanges, come with high monetary costs in the line of rollout and
    implementation, maintenance costs in terms of software and hardware that must be replaced time
    and again, support fees, end user training, loss of revenue related to transitory loss of
    productivity, and reduced revenue, present a disincentive for health facilities and practitioner to
    embrace and rollout an EHR (Smith et al. 2008). Moreover, EHR systems are marred with a lot
    of mishaps that tend to hamper work-flows for medics resulting in to transitory losses in output.
    Productivity loss emanates from end-users trying to master a new system and culminate into loss

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of earnings. Lastly, EHR systems require technical expertise in the event of a breakdown, so
when technical supports are not available, EHR systems can be disastrous. On the other hand,
data security and privacy of patients will be compromised because of intense and increased
scrutiny by both U.S government as well as healthcare centers. Incorporation of legacy
structures with current health information infrastructures might be a nightmare for entities that
are not willing to let go their huge IT outlays. In cases where EHR systems might be viewed as
counterintuitive, health practitioner may appeared opposed to technological change (Haynes &
Walker, 1987).

E. Explain three factors to be considered by an organization in providing a personal health
record to patients.

There are three factors to be considered by an organization in providing a personal health
record to patients:
Data: these are facts that are gathered, analyzed shared and kept in various electronic
tools. These data can be imaging results, radiology, laboratory tests, past health history, health
complications, and medication pattern among others. Thus, it is important for health providers to
store these data safe for future reference.

Infrastructure is another aspect to be considered. In case, infrastructure is a computer
application that generates or transfers medical data like websites, and software. Applications:
comprises of information transfer, analytical as well as material delivery abilities of a network,
like scheduling of appointments, disease awareness content, support systems for patients, and
renewal of drug (Smith et al. 2008).

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  1. Identify two businesses or organizations outside of the scenario offering a personal
    health record service.

There are businesses or organizations in this case they include: HIPAA, and Mediplus.

  1. Identify three qualities of a personal health record which should be determined before its
    adoption.

There are three qualities of a personal health record which should be determined before
its adoption. Paper-based: Reliability in terms of easy of access without a computer or involved
hardware. Versatility is also an issue to consider. In addition electronic device-based should have
printing functionalities, backup features, encrypting, data importation features, and data sharing.
Lastly, web-based that is easy to integrate with other providers.

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References

Hunt DL, Haynes RB, Hanna SE, Smith K (2008). Effects of computer-based clinical decision
support systems on physician performance and patient outcomes: a systematic review.
JAMA 21; 280 (15):1339-46.