Health IT Test 2 | Complete Solutions Q & A (Verified)

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Health IT Test 2 | Complete Solutions Q & A (Verified) System Acquisition process that occurs from the time the decision is made to select a new system (or replace an existing system) until the time... a contract has been negotiated and signed. Systems development life cycle (SDLC) The process an organization generally goes through in planning, selecting, implementing, and evaluating a health care information system 4 phases of Systems development life cycle (SLDC) 1.) planning and analysis 2.) design 3.) implementation 4.) support and evaluation Project steering committee Committee's function is to plan, organize, coordinate, and manage all aspects of the acquisition process. Usually includes representation from all stakeholders on committee. Chief medical informatics officers (CMIO's) or chief nursing informatics officers (CNIO's) clinicians and nurses with training in informatics are being called on to lead clinical system acquisition Request for Proposal (RFP) provides the vendor with a comprehensive list of system requirements, features, and functions and asks the vendor to indicate whether its product or service meets each need. RFP vs. RFI RFP (Request for Proposal) Includes organizational goals Key selection criteria Specific information Includes financials Normalizes comparisons Great when many vendors have similar products Instruction for vendors Costly Time consuming Up to 200-300 pages Serves as contract between health care provider organization and vendor (can be legally binding) Contender is seriously being considered Statement to current ability of EMR Can better compare systems with this information Includes financial quotes (binding) RFI (Request for Info) General Information Overview of products Less time consuming IT architecture Following the architecture for the organization's information systems, the IT staff members and the organization's vendors implement the core technologies and application software and integrate them to create the information systems Two additional terms are sometimes used either as synonyms for or in describing architecture: platform and infrastructure System Champions key individuals from the clinical and administrative areas that are the focus of the system being acquired, vendor representatives, and IT professionals Just-in-time training occurs several times. Its purpose is to enable users to practice on the system multiple times before go-live Data should be ____________ (complete, accurate, and current) before being converted Cleaned Computerized Physician Order Entry (CPOE) the process of a medical professional entering medication orders or other physician instructions electronically instead of on paper charts. A primary benefit of CPOE is that it can help reduce errors related to poor handwriting or transcription of medication orders Tangible Value of Health IT Increase in revenue Reduction in labor, maintenance, and supply costs Reductions in use of patient care services Fewer errors Faster turnaround times for test results Reductions in elapsed time to get an appointment Quicker admissions process Improvement and access to data Intangible Value of Health IT Intangible value Improved decision making Improved communication Improved collaboration Improved compliance Being more state of the art Being more customer friendly 6 Categories of IT Investment 1. Infrastructure 2. Mandated 3. Cost Reduction 4.Specific New Products/Services 5. Quality Improvement 6. Strategic Initiative Infrastructure Infrastructure enables other investments or applications to be implemented and deliver desired capabilities Examples: data communication networks, workstations, and clinical data repositories. Mandated IS investments may be necessary because of mandated initiatives May involve: Reporting quality data to accrediting organizations Making required changes in billing formats Improving disaster notification systems Cost Reduction IS investments directed to cost reduction are generally highly amenable to ROI and other quantifiable dollar-impact analyses Specific New Products and Services IS delivers the new service and at other times it is itself the product. New services can include: bank cash-management programs, programs that award airline mileage and credit card purchases Quality Improvement Evaluation of quality initiatives is generally done in terms of service parameters that are known or believed to be important determinants of organizational success. Service quality is often necessary to protect current business Major Strategic Initiative Intended to significantly change the competitive position of the organization or redefine the core nature of the enterprise. Most healthcare systems do not undergo an IT-centric transformation Amazon has transformed retailing, Venmo has transformed payments, Netflix has transformed streaming of movies There can be a ROI core or component to analyses of such initiatives because they often involve major reshaping or re-engineering of fundamental organizational processes. IT Project Proposal The proposal requests money and an organizational commitment to devote management attention and staff effort to implementing an information system. The proposal describes why this investment of time, effort, and money is worth it -- the value that will result Net Present Value = (future cash flow that results from investment- initial investment) Future cash is discounted by a standard rate to reflect the fact that a dollar earned one or more years from now is worth less than a dollar one has today If cash generated exceeds the initial investment then :-) Internal Rate of Return Discount rate at which the present value of an investment's future cash flow equals the cost of the investment What rate of return am I going to get on this investment? Valuation of Health IT Proposal Organizations may score proposals according to how much value it promises to deliver in each of the following areas: Revenue impact Cost reduction quality of work life Quality of care Patient or customer satisfaction Regulatory compliance Potential learning value The Investment-Performance Relationship Spending more on IT is no guarantee that the organization will be better off. No direct correlation between spending and outcomes Factors other than the appropriateness of the tool to the task also influence the relationship between IT investment and organizational performance. Digital Maturity Digital intensity- the extent to which the company had invested in technology-enabled initiatives to change how the company operates. Examples.) advanced analytics, social media, digital design of products Transformation management intensity- extent of leadership capabilities necessary to drive digital transformation throughout the company. Examples.) vision, governance, and ability to change culture HCIS Standards Multiple dimensions of standards to ensure health care information systems are operating correctly. Transporting standards standards needed for basic communication across the internet or other network Data interchange and messaging standard standards for structuring the content of messages communicated across the network Content standards standards that describe required data elements for a particular function, such as the EHR or clinical summary Vocabulary/terminology standards standards for naming or classifying the actual data Health IT Standard Categories 1.) Ad hoc 2.) De facto 3.) Government mandate 4.) Consensus Ad hoc when a group of interested people or organizations agree on standard specs without any formal adoption process De facto a vendor or other commercial enterprise controls such a large segment of the market and its product becomes the recognized norm Government mandate government mandates new standards, i.e. HIPAA Consensus representatives from various interested groups come together to reach a formal agreement on specifications International Organization for Standardization (ISO) Members are national standards bodies from many different countries around the world. Oversees international approval of standards development. American National Standards Institute (ANSI) accredits standards development organizations (SDOs) from a wide range of industries, including health care. Publishes tens of thousands of standards Standards Developing Organizations (SDOs) Must be accredited by ANSI, develop standards in accordance with ANSI criteria. Approximately 200 accredited SDOs that make up 90% of standards. Profiling bodies use existing standards to create comprehensive implementation guides. Two examples of profiling bodies are the Integrating the Healthcare Enterprise (IHE) and the ONC Designated standard maintenance organizations (DSMO) have the responsibility for the development, maintenance, and modification of relevant electronic data interchange standards. Electronic Data Interchange (EDI) HIPAA transaction standards apply to every entity's EDI. SCRIPT standard for e-prescriptions Interoperability Standards Advisory published by ONC, outlines the ONC-identified "best available" standards and implementation specifications for clinical IT interoperability. ASTM International Accredited SDO Has published over 12,000 standards Standards include medical device standards and health information standards Health information standards managed by committee E31 HL7 International ANSI-Accredited SDO Provides framework and standards for the exchange, integration, sharing, and retrieval of electronic health information that supports clinicial practice and the management, delivery and evaluation of health services. HL7 standards related to interoperability: Clinical Document Architecture (CDA) Continuity of care document (CCD) Clinical context object workgroup (CCOW) HL7 also publishes functional EHR and PHR specifications Integrating the Healthcare Enterprise (IHE) Developed a series of profiles to guide health care documentation sharing These profiles are not standards, but include specific guidance for how existing standards can be implemented to meet clinical needs. SNOMED Systematized Nomenclature of Medicine- computer database of medical terms, providing codes, terms, synonyms, and definitions which cover care delivery. CDT Code on Dental Procedures and Nomenclature National Drug Codes NDC, product identifier for all drugs Logical Observation Identifiers Names and Codes LOINC, Facilitates the electronic transmission of laboratory results to hospitals, physicians, third-party payers, and other users of laboratory data Clinical Vaccines Administered CVX RxNorm Normalized naming system for generic and brand name drugs and as a tool for supporting semantic interoperation between drug terminologies and pharmacy knowledge-based systems. Unified Medical Language System UMLS; facilitate the development of computer systems that behave as if they 'understand' the meaning of the language of biomedicine and health Digital Imaging and Communications in Medicine Standards DICOM; Need for a standard for the electronic transfer of images between devices manufactured by different vendors. Continuity of Care Document (CCD) Standard for the electronic exchange of patient summary information, so-called transportable patient care information. CCD standard is not solely a content standard; it includes elements of a data exchange standard. Fast Health Interoperability Resources (FHIR) Has potential to accelerate health IT interoperability, offers tools like data exchange mechanisms to improve interoperability [Show More]

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