The business report will deal with HIMSS and its importance in health care sector. It will demonstrate that how HIMSS will be helpful in the implementation of electronic medical record system. The author will discuss the critical success factor of this scheme. The report will contain the detailed analysis of the current situation of the health informatics in Metro Hospital. Based on this analysis the practices required to implement efficient information management system will be discussed. Further, the report will present the HIMSS EMR Adoption Model and its implementation plan. The author will brief project governance and its alignment with state and national eHealth programs. Risk factors and the likelihood of success will be stated in brief. Finally, based on the analysis and discussion conclusion will be drawn.
HIMSS is a U.S. based organization, and it stands for Healthcare Information and Management Systems Society (Brown et al., 2012). Its ultimate goal is to establish a proper system for managing healthcare related information. To implement electronic health records, a hospital must acquire HIMSS Level 7 recognition (Custis et al., 2016). When a hospital receives a score of 7 from HIMSS, it implies that it has well adopted the Electronic Medical Records Model (EMR). It also indicates that the organization uses optimal management systems and Information Technology (Craven et al., 2015).
Physicians, insurance companies, and other medical professionals maintain the medical records of patients in digital format instead of the traditional paper-based method. It includes patient’s history and other health information. These records are called EMR (Shah et al., 2016). The EMR system helps in easy retrieval of the clinical records and efficient navigation with patients (Brown et al., 2012). This report will thus function as the roadmap for Metro Hospital to achieve HIMSS level & EMR.
Vision for the Electronic Medical Records
The vision of this report is to improve the service system and management of the Metro Hospital so that it can attain HIMSS level 7 by the year 2025. The report will act as the roadmap for serving this purpose.
By adopting the EMR model, a hospital will thus help in improving the client services and its efficiency by decreasing medical errors (Fossum & Moe, 2013). It will enhance its result management. The improved results will be proliferated with the quick access to the contemporary practices. Further, this project will offer orderly and layered onscreen presentation. It will present coding concepts clearly and other medical information through browsing (Dixon et al., 2013).
For attaining HIMSS level 7 by the year 2025, the first step for the hospital is to participate in the “Annual HIMSS Analytics Study” and receive the EMRAM Score.
The implemented EMR system
After implementing the vision of adopting the EMR model, the hospitals will be able to provide integrated clinical information (Ong, 2014). It will help medical professors in speeding up their services while decreasing the medical errors. It will have increased revenue cycle as it will significantly reduce the operations costs (Xue et al., 2012). The implemented EMR system will integrate the medical data in the comprehensive format including such as weight, age, medication and allergies, laboratory tests, radiology images, medical history, billing information, demographics, vital signs and immunization status (Warner et al., 2012). This process will increase the number of clients served each day. This process of electronic documentation will improve billing system (Shah et al., 2016).
Since the EMR will not include any paper work, the chance of documentation error will decrease to a great extent. Therefore, EMR system will offer the hospital a better environment with the seamless flow of information (Wang et al., 2013). In this digital progress, the way of care delivered is entirely transformed. With EMR, information can be retrieved anywhere and anytime. It will improve the communication system of Metro Hospital with other departments (oncology, ophthalmology, maternity, etc.) in the healthcare network through this electronic transaction. This will enable coordination in decision making and care provided. It will allow improved patient diagnostics and health outcomes (Fossum & Moe, 2013).
Critical success factors- The first and the foremost step for implementing EMR model is to convert the traditional paper based system into electronic automated environment (Ong, 2014). Before implementation, the staff, physicians, and other medical professionals should be well adapted with the latest technology and must be aware of real time quality information (Ong, 2014). The other critical factor is that the hospital must increase its capital resources for increased expectations (Murray & Wright, 2014).
It is necessary for the hospital to develop good staff capacity. It will help to cope up with the cultural changes and emerging needs of the organization. It will ensure customer and staff satisfaction (Valdez et al., 2015). The critical success factor for this hospital lies in the team commitment. The hospital must design the effective plan for sustainable changes, implement efficiently, and improve the methodology (Paton, 2014). To ensure that all the departments have incorporated best practices, these sustainable processes must be redesigned and regularly measured (Dixon et al., 2013).
To save time in the manual filling of charts and their retrieval, the physical environment must be renovated and remodeled (Paton, 2014). To have an optimal workflow, the satellite area must be decommissioned. The other critical factor is the maintaining the confidentiality of patient’s health information (Nambisan et al., 2015). Also, implementing EMR will enable Metro to link with international patients (Wang et al., 2013). With improved coordination, it will be easy for patients in other states to involve in academic research or participate in clinical trials (Mastellos et al., 2015).
Analyzing the current situation and aspects critical to support EMR
Currently, Metro Hospital must work hard towards attaining technological tools, enhancing the safety and quality of health services. Strategic management of electronic information will enable HIMSS EMR Adoption Model by 2025. Analysis of current situation of Metro Hospital includes if the organization can serve a large number of patients. Currently, in the hospital the system of services is entirely paper based, Therefore, changing this into computerized version (electronic transition) is the crucial factor. All its clinical information must be digitalized (Valdez et al., 2015). The hospital currently implementing the care facilities and other operations are ineffective. Therefore, it must use its functionality in a provision of safe, efficient and effective care services for its patients (Hersh, 2014).
This analysis in part is required to determine the contemporary status of Informatics in Metro Hospital. It is necessary to measure if Metro can incur the cost of adopting the electronic Medical records system (Murray & Wright, 2014). It is essential to assess if the process in the first step exceeds the estimated budget. If so then the cost must be adjusted for subsequent stages despite the auditing event (Dixon et al., 2013). The analysis also includes the review of EMR in fulfilling its purpose and assesses the frame of time (Valdez et al., 2015).
Analysis of current situation of Metro Hospital includes assessment of hospital’s component deployment and understanding of the short-term goals of the organization. The study showed that the hospital has good connections with medical professionals, which are not linked electronically (Fossum & Moe, 2013). Therefore, these exercises must be fulfilled first. The method of searching the electronic records manually must be replaced with the computer search. Metro needs to practice decreasing the time spent on manual process and serving the patients and save its resources (Valdez et al., 2015). These measures will determine the “factor of benefit” in implementing EMR (Nambisan et al., 2015).
The Metro hospital team should be aware of the management practices newly implemented to run EMR. Regulatory bodies must set guidelines and legislations for taking patient's consent before the accession and saving their information in EHRs/EMRs (Custis et al., 2016). There must be stringent rules for maintaining the confidentiality of the patient's records and there shall be no integrity issues (Brown et al., 2012).
Roadmap for achieving HIMSS level 7 by 2025
To achieve HIMSS level 7 by 2025, there are several stages to be followed by the Metro hospital. In stage 0- the hospital must install radiology, laboratory, and pharmacy department systems, as already there is some clinical automation present (Valdez et al., 2015). In stage one, Metro must be ensured that these ancillary systems store the data into “Clinical Data Repository” including those of imaging systems for quick retrieval by the medical staff (Fossum & Moe, 2013). In this stage, all the three systems will be installed and next to it “Controlled Medical Vocabulary Clinical Data Repository” and the “CDSS inference” engine will "Document Imaging". In this second stage, clinical documentation is must while the electronic Medication Administration Record care plan charting and nursing notes are integrated and implemented with the CDR and are scored with extra points (Brown et al., 2012). At the initial level, it is also necessary to build the support system to check order entry errors in pharmacy services (Murray & Wright, 2014). During the third stage, the medical personnel confined to the radiology department should have the accession to hospital’s intranet (Valdez et al., 2015).
In the fourth stage, any medical professional of Metro hospital using the “Computerized Physician/Practitioner Order Entry” will be updated with CDR (Paton, 2014). During the fifth stage; Patient care services require close administration, bar coding, and Radio Frequency Identification (Dixon et al., 2013). It will improve the quality and safety of care services. Sixthly, there will be the complete documentation of one of the hospital department. The clinical actions of the physicians and used protocols will be verified for its "compliance and variance alerts” (Schirmer et al., 2013).
Finally, it’s the “GO live!” situation by 2025, where it is ensured that the hospital has established the EMR environment. The hospital at this stage is paperless, and the transactions are electronic based. There will be a proper dissemination of information among different departments and medical staff. At this stage, the HCO will support the actual HER (Koch, 2013).
At the executive level, there should be an implementation of a strategic plan. According to (Brown et al., 2012) “A governance structure should also be build to facilitate decision making, accountability, prioritization and management which include a user-focused comprehensive plan which deals with informing people how to handle change”. Therefore, there should be a governance structure along with the working committee that will facilitate the management, prioritization, decision making and accountability (Yawen et al., 2016). To embark this long journey to reach the destination of “level 7 by 2025” the business process requires stretching its goals and balancing the needs (Mastellos et al., 2015).
The processing in the executive engagement may take three years, and that of the process measurement may comprise of two years. Establishment of the IT infrastructure consumes another two years. The whole executive team should be supportive and committed towards the goal (Valdez et al., 2015). The hospital must demonstrate the data agility before the implementation. Metro must take preventive actions before the stakeholders get disengaged and the whole project comes to a stall. Metro must foresee the incremental benefits arising with the implementation of EMR. To become fully digital, the entire process must take around ten years of time (Nambisan et al., 2015).
The implementation plan for the Metro Hospital will include:
- Purpose, current analysis of hospital, overview of management
- Implementation schedule
- Security and privacy system during implementation
- IT resources, documentation and required personnel
- Training of personnel, monitoring of performance, and evaluation
- configuration management interface and site requirement details (Bissett et al., 2016)
Additional resources for the implementation of EMR are: “Citrix technology” for accession by users in the hospital and other remote areas through wireless technology such as smartphones, tablets (Xue et al., 2012). The hospital requires proper allocation of funds and minimize overspending of funds and resources (Hersh & Valerius, 2013).
To achieve the “fully digital status” by 2025, there are series of stages to be passed by the hospital. There are many hurdles to be overcome during the implementation journey. One of the critical steps is the proper planning of HER and its acquisition (Fossum & Moe, 2013). The assessment and evaluation of medical process follow this critical step. "E-communication patient providers and portals" will help in supporting the documentation (Wang et al., 2013). The final implementation of the EMR/EHR will make the electronic system for Metro legal by 2025. Thus, the goal of attaining the automatic status will be accomplished by the establishment of EMR successfully along with the incorporation of automation and Information Technology (Valdez et al., 2015). Therefore, there will be increased improvement in care delivered to the patients (Custis et al., 2016).
Once fully EHR system is implemented Metro hospital will become a place with improved applications, documentation by automation and coding resulting in speedy billing services. This will decrease the medical errors as it will improve the collaboration process between the patients and physicians (Mastellos et al., 2015). It increases the opportunities for students willing to participate in clinical trials and other academic research (Hung et al., 2013). As a result of a big channel that Metro hospital has, with well-qualified practitioners, further implementing EMR provide the hospital with the global environment. It can easily connect with its international patients who will also get feasibility to shop the procedures (Nambisan et al., 2015).
This is an essential step during an implementation of HIMSS EMR Adoption Model by 2025. Two committees will govern this whole process in Metro hospital. One is the “IT Committee" and other is "departments affected by the EMR-EHR”. Clinical staff and other members engaged in this process directly or indirectly must abide by the rules and guidelines and aware of their individual responsibilities (Craven et al., 2015). All the members will be involved in the decision-making. According to Schirmer et al., (2013), “Governance arrangements should include all the agency lines of accountability and reporting coupled with the relevant executive committees and agency boards in the hospital”.
The governance of the project will ensure that all the services in an attempt of HIMSS EMR Adoption Model are delivered. To assess the success of the implementation project separate governing bodies of Metro must well collaborate with each other. Regular conferences will be held in Metro to check the progress, address the emerging problems and update the whole project (Yawen et al., 2016).
Likelihood of success and identification of risk
I believe that Metro hospital will be successful in achieving HIMSS EMR Adoption Model level 7 by 2025. It is due to the staff committed towards the organizational goals. There will be some hindrance initially, due to the difficulty faced by the practitioners in being accustomed to the use of “health information technology” (Murray & Wright, 2014).
The other risk factors are the maladaptive behavior of insiders and lack of policy awareness. The health information may be leaked to the third parties by increasing cybercrime (hacking, electronic mail phishing, and social media) (Hung et al., 2013). It may turn disastrous for the hospital’s reputation. Therefore, the hospital must be prepared with “data recovery policies and weak disaster recovery plans” (Mastellos et al., 2015).
The use of benchmark metrics is necessary for obtaining more than comparative information by the usability ratings. For every scenario, the clinical environment for the end users must be assessed. Further, the users “actual performances against the perceived ideal performance” will be compared to generate a target score to upgrade the user requirements. This will enhance the present performance of EMR system (Nambisan et al., 2015).
For adopting the model of HIMSS EMR by 2025, Metro needs to be assessed for its barriers and risk factors. The ability to bring about significant change or transformation from manual method to electronic based clinical transactions will provide the hospital with the range of benefits and opportunities (Hung et al., 2013). The changes will be reflected at both population level and individual level. The success rate of “EMR-EHR” will correlate with the input given by the departments engaged in the process as well as on the quality of care (Paton, 2014).
It is recommended that the committees governing the implementations of the EMR should be respected for their contribution. It is through them that the ideas, criticisms, suggestions are provided by the stakeholders (Murray & Wright, 2014). There should be timely monitoring and evaluation of the strategies used in adopting the EMR-HER system to make sure that expectations are met, and the improved healthcare practices are upheld (Craven et al., 2015). It is suggested that the hospital must demonstrate the data agility before the implementation. Metro must take preventive actions before the stakeholders get disengaged and the whole project comes to a stall. Metro must foresee the incremental benefits arising with the implementation of EMR.
Based on the above discussion it can be inferred that, adopting the EMR model, a hospital will thus help in improving the client services and its efficiency by decreasing medical errors (Fossum & Moe, 2013). It will enhance its result management. The improved results will be proliferated with the quick access to the contemporary practices.
The business report has dealt with HIMSS and its importance in health care sector. It demonstrated how HIMSS would be helpful in the implementation of electronic medical record system. The report has clearly stated the critical success factor of this scheme. The report detailed the analysis of the current situation of the health informatics in Metro Hospital. Based on this analysis the practices required to implement efficient information management system were easy to discuss. Further, the report has given a systematic presentation of HIMSS EMR Adoption Model and its implementation plan. The author discussed project governance and its alignment with state and national eHealth programs. Conclusively, the report has given me a clear concept on what is EMR and its importance in the health sector and how difficult it is in real to adopt such model in the hospital.
Bissett, K., Cadena, J., Khan, M., Kuhlman, C. J., Lewis, B., & Telionis, P. A. (2016, February). An integrated agent-based approach for modeling disease spread in large populations to support health informatics. In 2016 IEEE-EMBS International Conference on Biomedical and Health Informatics (BHI) (pp. 629-632). IEEE.
Brown, G. D., Patrick, T. B., & Pasupathy, K. S. (2012). Health informatics: a systems perspective. Health Administration Press.
Craven, C. K., Doebbeling, B., Furniss, D., Holden, R. J., Lau, F., & Novak, L. L. (2015). Evidence-based Health Informatics Frameworks for Applied Use. Studies in health technology and informatics, 222, 77-89.
Custis, L. M., Hawkins, S. Y., & Thomason, T. R. (2016). An innovative capstone health care informatics clinical residency: Interprofessional team collaboration. Health informatics journal, 1460458215627188.
Dixon, B. E., Pina, J., Kharrazi, H., Gharghabi, F., & Richards, J. (2015). What’s Past Is Prologue: A Scoping Review of Recent Public Health and Global Health Informatics Literature. Online journal of public health informatics, 7(2).
Dixon, B. E., Turner, A. M., Pina, J., Kharrazi, H., & Richards, J. (2013). Public and Global Health Informatics Year in Review. In AMIA.
Fossum, M., & Moe, C. E. (2013, August). Masterand# 8217; s Program in Health Informatics at University of Agder. In Scandinavian Conference on Health Informatics 2013; Copenhagen; Denmark; August 20; 2013 (No. 091, pp. 87-88). Link?ping University Electronic Press.
Gibson, C. J., Dixon, B. E., & Abrams, K. (2015). Convergent evolution of health information management and health informatics. Applied clinical informatics, 6(1), 163-184.
Hersh, W. B., & Valerius, J. (2013). A tale of two professions health information management and biomedical/health informatics converge at OHSU. Journal of the American Health Information Management Association, 84(10), 37-41.
Hersh, W. R. (2014). Context and Value of Biomedical and Health Informatics. In Public Health Informatics and Information Systems (pp. 37-46). Springer London.
Hung, M., Conrad, J., Hon, S. D., Cheng, C., Franklin, J. D., & Tang, P. (2013). Uncovering patterns of technology use in consumer health informatics. Wiley Interdisciplinary Reviews: Computational Statistics, 5(6), 432-447.
Koch, S. (2013). Achieving holistic health for the individual through person-centered collaborative care supported by informatics. Healthcare informatics research, 19(1), 3-8.
Mastellos, N., Car, J., Majeed, A., & Aylin, P. (2015). INNOVATION IN HEALTH INFORMATICS. Journal of Innovation in Health Informatics Vol,22(1).
Murray, P. J., & Wright, G. (2014). Towards a Research Agenda for Web 2.0 and Social Media in Health and Informatics. Ghanaian Population. Debrah O, Srofenyo E, Aryee NA, Quaye IK............. 77, 89.
Nambisan, P., Luo, Z., Kapoor, A., Patrick, T. B., & Cisler, R. A. (2015, January). Social Media, Big Data, and Public Health Informatics: Ruminating Behavior of Depression Revealed through Twitter. In System Sciences (HICSS), 2015 48th Hawaii International Conference on (pp. 2906-2913). IEEE.
Ong, K. (2014). Health Informatics Defined. Physician Informatics Community.
Paton, C. (2014). Massive open online course for health informatics education. Healthcare informatics research, 20(2), 81-87.
Schirmer, P., Winston, C., Ryono, R., Lucero-Obusan, C., Oda, G., & Holodniy, M. (2013). Online Journal of Public Health Informatics, Vol 5, No 1 (2013). Online Journal of Public Health Informatics, 5(1).
Shah, G. H., Leider, J. P., Castrucci, B. C., Williams, K. S., & Luo, H. (2016). Characteristics of Local Health Departments Associated with Implementation of Electronic Health Records and Other Informatics Systems. Public Health Reports, 131(2).
Valdez, R. S., Holden, R. J., Novak, L. L., & Veinot, T. C. (2015). Technical infrastructure implications of the patient work framework. Journal of the American Medical Informatics Association, 22(e1), e213-e215.
Wang, Y., Wu, Y., Wilson, R. F., Bleich, S., Cheskin, L., Weston, C., ... & Segal, J. (2013). Childhood obesity prevention programs: comparative effectiveness review and meta-analysis.
Warner, H. R., Sorenson, D. K., & Bouhaddou, O. (2012). Knowledge engineering in health informatics. Springer Science & Business Media.
Xue, L., Yen, C. C., Chang, L., Chan, H. C., Tai, B. C., Tan, S. B., ... & Choolani, M. (2012). An exploratory study of ageing women's perception on access to health informatics via a mobile phone-based intervention.International journal of medical informatics, 81(9), 637-648.
Yawen, Y., Nakamura, M., & Nakashima, N. (2016). Designing Health Data Management Systems: Learning From Prominent Worldwide Applications.Journal of Health & Medical Informatics, 2016.