Develop a project plan including project management knowledge areas in.docx

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Develop a project plan including project management knowledge areas in
healthcare
Past resources and information for use if needed Bui, Q., Hansen, S., Liu, M., & Tu, Q. (2018).
The productivity paradox in health information technology. Communications of the ACM,
61(10), 78–85. Glandon, G. L., Smaltz, D. H., & Slovensky, D. J. (2013). Information systems
for healthcare management (8th ed.). Chicago, IL: Health Administration Wang, T., Wang, Y.,
& McLeod, A. (2018, March). Do health information technology investments impact hospital
financial performance and productivity. French, R., & Rees, G. (Eds.). (2016). Leading,
managing and developing people. Kogan Page Publishers. Vinekar, A., Mangalesh, S.,
Jayadev, C., Gilbert, C., Dogra, M., & Shetty, B. (2017). Impact of expansion of telemedicine
screening for retinopathy of prematurity in India. Indian journal of ophthalmology, 65(5),
390. Vranas, K. C., Slatore, C. G., & Kerlin, M. P. (2018). Telemedicine coverage of intensive
care units: a narrative review. Annals of the American Thoracic Society, 15(11), 12561264.
Buvik, A., Bugge, E., Knutsen, G., Småbrekke, A., & Wilsgaard, T. (2016). Quality of care for
remote orthopedic consultations using telemedicine: a randomized controlled trial. BMC
health services research, 16(1), 483. Uscher-Pines, L., Mulcahy, A., Cowling, D., Hunter, G.,
Burns, R., & Mehrotra, A. (2016). Access and quality of care in direct-to-consumer
telemedicine. Telemedicine, and eHealthh, 22(4), 282-287. Visscher, S. L., Naessens, J. M.,
Yawn, B. P., Reinalda, M. S., Anderson, S. S., & Borah, B. J. (2017). Developing a standardized
healthcare cost data warehouse. BMC health services research, 17(1), 396. Jackson, D. E., &
McClean, S. I. (2012). Trends in telemedicine assessment indicate neglect of key criteria for
predicting success. Journal of Health Organization and Management, 26(4), 508-523.
doi:http://dx.doi.org.proxy1.ncu.edu/10.1108/14777261211251553 AlDossary, S., Martin-
Khan, M. G., Bradford, N. K., Armfield, N. R., & Smith, A. C. (2017). The Development of a
Telemedicine Planning Framework Based on Needs Assessment. Journal Of Medical
Systems, 41(5), 74. https://doiorg.proxy1.ncu.edu/10.1007/s10916-017-0709-4
ClickView/VEA (Producer). (2011). ICT project management [Video file]. Films on Demand.
Link Glandon, G. L., Smaltz, D. H., & Slovensky, D. J. (2013). Information systems for
healthcare management (8th ed.). Chicago, IL: Health Administration Link Read Chapter 8:
“Systems Selection and Contract Management” Read Chapter 11: “HIT Project Portfolio
Management” Ho, J. (2010). Project management in health informatics. Studies in Health
Technology and Informatics, 151, 413–424. Kongstvedt, P. R. (Ed.). (2001). The managed
health care handbook. Jones & Bartlett Learning. Smith, A. E., & Swinehart, K. D. (2001).
Integrated systems design for customer focused health care performance measurement: a
strategic service unit approach. International Journal of Health Care Quality Assurance,
14(1), 21-29. Wager, K. A., Lee, F. W., & Glaser, J. P. (2017). Health care information systems:
a practical approach for health care management. John Wiley & Sons. Adler-Milstein, J., &
Huckman, R. S. (2013). The impact of electronic health record use on physician productivity.
The American journal of managed care, 19(10 Spec No), SP34552. Armijo, D., McDonnell, C.,
& Werner, K. (2014). Electronic health record usability: evaluation and use case framework.
AHRQ Publication, (09), 10. Kharrazi, H., Gonzalez, C. P., Lowe, K. B., Huerta, T. R., & Ford, E.
W. (2018). Forecasting the maturation of electronic health record functions among US
hospitals: Retrospective analysis and predictive model. Journal of medical internet research,
20(8), e10458. doi:10.2196/10458 Implementing Change with Health Information Systems
It is nearly cliché that the one constant in life is change; nowhere will you find this truer
than at the interface between information technology and your work as a healthcare
administrator. Technologies will continue to change, and new technologies will emerge, and
problems with existing technologies will be recognized. As a healthcare administrator, not
only will you need to be able to adapt and navigate this change, but in many cases, you will
also be responsible for initiating and driving change. The collected activities to make a
change are called a project. To prepare for your role, you will investigate project
management. Project management is the discipline that investigates and organizes the
many processes involved in successfully initiating, directing, and concluding projects. The
myriad details requiring your attention to successfully implement change have been
enumerated, classified, and organized into knowledge areas. Each knowledge area
addresses a component of an overall project, such as scope, scheduling, costs, risk,
personnel, and quality. Numerous tools, such as Microsoft Project, Airtable, Trello, and
others, have been developed to aid in the navigation of projects. Many of these tools are free
or provide free trials. These tools enable project managers to track scheduling, resources,
progress, budgets, and workloads. You will need to be familiar with the knowledge areas
and available tools to successfully initiate and lead projects. As you explore implementing
change through project management, pay close attention to the components of a project
plan. You will use these components to construct a project plan in your Signature
Assignment. Be sure to review this week’s resources carefully. You are expected to apply the
information from these resources when you prepare your assignments. Health Information
Systems GOENSMHA5006 Summary Clinical information systems include electronic health
records, patient administration systems, and ancillary information systems. The three are
interrelated because of their patient/doctor healthcare information tracking,
admissions/discharge information, and also any testing or medications that would be
related to individual and facility (Wager, Lee, & Glaser, 2017). Operational management
systems include operation improvements, reimbursement systems, and HIPPA compliance.
These systems are all vital to maintaining the facility, its reimbursement to third party
systems, and also must be within HIPPA standards or regulations (Kongstvedt, 2001).
Strategic design support system examples are performance measurement systems, patient
outcome assessments, and data monitoring. All are related for the design and
implementation of quality healthcare settings (Smith & Swinehart, 2001). Electronic
networking and e-health applications have a multitude of systems in place. Three examples
provided are billing, claims, and processing systems, structured delivery systems, and web
services. Each system relies on the other for appropriate billing, processing, and delivery for
the patient as well as the success of the facility (Glandon, Smaltz, & Slovensky, 2013).
References Glandon, G. L., Slovensky, D. J., & Smaltz, D. H. (2014). Information Systems for
Healthcare Management (Vol. Eighth edition). Chicago, IL: Health Administration Press
Kongstvedt, P. R. (Ed.). (2001). The managed health care handbook. Jones & Bartlett
Learning. Smith, A. E., & Swinehart, K. D. (2001). Integrated systems design for customer
focused health care performance measurement: a strategic service unit approach.
International Journal of Health Care Quality Assurance, 14(1), 21-29. Wager, K. A., Lee, F. W.,
& Glaser, J. P. (2017). Health care information systems: a practical approach for health care
management. John Wiley & Sons. Running Head: GOENSMHA5006-2 1 Electronic Health
Record System Stacy Goen MHA5006-2 09/09/2019 Dr. Dale Gooden ELECTRONIC
HEALTH RECORD SYSTEM 2 Electronic health record system Criteria Excellence 60 points
Acceptable 40 points Unacceptable 0 points Stage 1: Laboratory, Test orders/results and
Test orders/results can Online transmission Pharmacy, and pharmacy orders can be
electronically sent of labs/radiology Radiology Results. be electronically to the lab but
multiple results or pharmacy The EHR should be transmitted to lab lab results can only be
orders are not equipped to support technicians. Multiple viewed at the same supported. the
real-time lab test results and time using external transmission of lab other diagnose can be
software. test results, pharmacy viewed without the orders and other need to export to
diagnoses to clinicians external software (Kharrazi, Gonzalez, Lowe, Huerta, & Ford, 2018).
Stage 2: Clinical All orders and results here is a single oracle There is no single Data
Repository can be stored in a to view patients repository and (CDR). single cache where
records. However, clinicians have to log The EHR should have clinicians can log in clinicians
cannot into several systems ELECTRONIC HEALTH RECORD SYSTEM one clinical data and
view all details. 3 access the entire repertory where all patient’s data without test orders,
lab results, viewing multiple and other orders are clinicians of the written and stored
patient. to patient details. (Glandon, Slovensky, & Smaltz, 2014). Stage 3: Nursing All
nursing orders, Nursing Nursing Documentation and past, present, and documentation is
documentation is not Security. future assessments, supported online but supported. EHR
should be able to tasks, can be they cannot be support any nursing recorded. Nursing
reconciled and documentation. documentation is systematically be Documentation
supported online. retrieved without an includes notifications Includes admission external
software and and reminders on such processing, patient as allergies, info, and care.
prescriptions use, or Documentation protocols (Glandon, typically performed Slovensky, &
Smaltz, by nursing is on-line 2014). such as: admission processing, H&P, care hardware.
ELECTRONIC HEALTH RECORD SYSTEM 4 documentation, nursing orders & tasks related to
RX & procedure, e-MAR, discharge planning etc. Stage 4: Physician’s orders can Physician
orders can Computerized Computerized be entered be transmitted physician order entry
Physician Order electronically and the electronically to not supported. Entry (CPOE). The
instructions of the nurses, pharmacists EHR should be also to practitioners sent and
laboratory but support automated online to the nurses or nurses cannot send physician
order entry. appropriate back their response This includes any designation (Kharrazi online
without use of tests or measures that et.al, 2018). an external software will direct the
facility to the specified or precise location (Glandon, Slovensky, & Smaltz, 2014). and
hardware. ELECTRONIC HEALTH RECORD SYSTEM 5 Stage 5: Closed-loop The medication
The medication Radiology exams and Medication process can be stored process may be
stored PACs are not Administration. in PAC and can be in PAC as well as supported. The
electronic health accessed by accessed offline at system can support practitioners over the
healthcare facilities. the storage of internet (Kharrazi However, the processes of et.al, 2018).
Also, the information may not medications medication processes be accessed through
administered can be accessed Internet services. (Glandon, Slovensky, offline at the hospital.
& Smaltz, 2014). This is important for the safety of the patient as well as for the facility.
ELECTRONIC HEALTH RECORD SYSTEM 6 Stage 6 A physician or A doctor can send an A
closed loop ERH Technology clinician can submit, order to a pharmacist medication is not
Enabled order and send the only but not to a lab supported. Medication, Blood information
to the technician, Products, And pharmacy. The proper radiologist, personnel can then
psychotherapist or Administration; verify it and dispense other clinicians. Risk Reporting;
the medication Full CDS properly. Human Milk The technology needs to support closed-loop
medication administration (Glandon, Slovensky, & Smaltz, 2014). ELECTRONIC HEALTH
RECORD SYSTEM 7 Stage 7 Medical Transcribers Physician No documentation Physician
should be well versed Documentation available. Documentation in medical should be
supported Clinician technology. The by outsourced Documentation system should be
services. Online provides the correct structured for any services are supported verbiage for
language barriers with but interfere with transcription (Adler- editors for any language
barriers. Milstein & Huckman complications. 2013). Services should be correlated within
the healthcare facility and appropriate services. Stage 0 EHR Not EHR Not EHR Not
Implemented Implemented Implemented Conclusion The implementation of EHR has
improved productivity and performance in the healthcare realm has improved productivity
to the clinician, patient, and family member. The overall process saves time as well as relays
specifics that may not be obtained in condi tions when family members are absent or do not
exist. ELECTRONIC HEALTH RECORD SYSTEM 8 Medical practitioners can easily and
quickly access patients’ records as well as share them with other staff involved in the
treatment (Adler-Milstein & Huckman 2013). Criteria is a crucial aspect in EHR’s and when
viewing multiple patient records. The EHR process has a high usability factor which, lowers
the stress factor of all parties involved. Any information found from the EHR may minimize
possible complications to the patient such as allergies, past illnesses, or other circumstances
important to the patients well-being (Armijo, McDonnell & Werner, 2014). ELECTRONIC
HEALTH RECORD SYSTEM 9 References Adler-Milstein, J., & Huckman, R. S. (2013). The
impact of electronic health record use on physician productivity. The American journal of
managed care, 19(10 Spec No), SP34552. Armijo, D., McDonnell, C., & Werner, K. (2014).
Electronic health record usability: evaluation and use case framework. AHRQ Publication,
(09), 10. Glandon, G. L., Slovensky, D. J., & Smaltz, D. H. (2014). Information systems for
healthcare management (Vol. Eighth edition). Chicago, IL: Health Administration Press.
Kharrazi, H., Gonzalez, C. P., Lowe, K. B., Huerta, T. R., & Ford, E. W. (2018). Forecasting the
maturation of electronic health record functions among US hospitals: Retrospective analysis
and predictive model. Journal of medical internet research, 20(8), e10458.
doi:10.2196/10458 Running Head: GOENSMHA5006-4 1 SQL Queries Stacy Goen
MHA5006-4 09/22/2019 Dr. Dale Gooden 2 GOENSMHA5006-4 A query that recreates list
of distinct patients. SELECT DISTINCT dob, FROM patients JOIN encounters ON
patients.patient_id=encounters.patient_id WHERE encounters.start_datetime>=20-01-01
Patients Table Patient_id Name Date of Birth 001 Stacy Watts Jan 04 1992 002 Cindy Lou
Jan 04 1992 003 Bailey Blue July 26 1980 Encounters Table Encounter_id Patient_id
Procedure_id Start_dateTime End_dateTime 1001 001 2002 01-04-2019 01-04-2019
0900hrs 1100hrs 01-04-2019 01-04-2019 1400hrs 1800hrs 02-12-2019 02-12-2019
1000hrs 1430hrs 1002 1003 001 003 2003 2004 GOENSMHA5006-4 The query SELECT
dob FROM patient JOIN encounters ON patients.patient_id=encounters.patient_id Returns a
single row of each patient date of birth Date of Birth Jan 04 1992 Jan 04 1992 July 26 1980
However, when SELECT DISTINCT is applied in the following query, we end up with the
following: SELECT DISTINCT dob, FROM patients JOIN encounters ON
patients.patient_id=encounters.patient_id WHERE encounters.start_datetime>=20-01-01 3
GOENSMHA5006-4 We end up with: Date of Birth Jan 04 1992 July 26 1980 List the names
of patients for each procedure type (by billing code). The output should list the billing code
first, followed by the patient name. Sort by billing code first, then patient name. SELECT
billing_code, FROM procedure JOIN patient ON
procedure.procedure_id=patient.procedure_id ORDER BY billing_code ASC ORDER BY
patient_name ASC table_name: procedure. List the distinct procedure labels for a provider
with the specialty of “dermatologist”. SELECT DISTINCT specialty, FROM providers WHERE
specialty. “dermatologist” 4 GOENSMHA5006-4 /* the explanation for the first question is
elaborate enough to enable one to follow through question three*/ Produce a count of
procedure types for each provider specialty. SELECT specialty COUNT (*), procedure_count
FROM providers INNER JOIN provider.procedure ON procedure_id = provider_id GROUP BY
Procedure_types ORDER BY Procedure_count ASC; List the names and addresses of all
patients who have had an encounter with a provider licensed in California SELECT
encounter_id, patient_id, provider_id FROM encounters INNER JOIN patients ON
encounters.encounters_id=patients.encounters_id INNER JOIN providers ON
encounters.encounters_id=providers.encounters_id WHERE
providers.licensed_CALIFORNIA /* The INNER JOIN as the keyword in this case selects all
rows from the three tables (patients, encounters and providers). Since there is a match
among the columns provided by the selected primary keys (encounters_id, patients_id and
providers_id), all columns from each of the three 5 GOENSMHA5006-4 tables can be
referenced. If there are records in the “encounters” table that do not have matches in
“patients or providers”, these encounters will not be shown*/ 6 • Impact of an Expanded
Telemedicine Program – POWERPOINT OUTLINE • • • • • Overview Telemedicine-clinical
application of giving care at a distance Primary driving force- enhancing access to medical
services in the rural areas Telemedicine-boosted the quality of local care leading to better
patient satisfaction Wide variety of services and applications that use email, video and
different types of telecommunications technology • Factors in Reimbursement of
Telemedicine Services • Medicare Rules and Telehealth Services • Billing Services •
Origination of Billing Site/Facility Services • Fees, Deductibles, and Third Party
Reimbursements • Factors in Reimbursement of Telemedicine Services • Reimbursement of
telehealth services given for non-Medicare patient is dependent on the jurisdiction • Lack of
uniformity in state health guidance such as area of site of service-non reimbursements •
Strict rules set by CMS on telemedicine reimbursement based on the rural location of the
patient • Other factors-originating site and synchronized services • New/Enhanced Health
Information Capabilities for Reimbursements • Health information and capabilities needed
to ensure reimbursement of telemedicine services include; • Distant site practitioners have
to be; • Physicians • Nurse practitioners • Physician assistant • Nurse midwives • Clinical
nurse specialist • New/Enhanced Health Information Capabilities for Reimbursements •
Limitations on the type of technology applied in the delivery of care. • Specific telemedicine
applications • Patients must be located in Health Professional Shortage Areas (HSPA) away
from Metropolitan Statistical Area (MSA) • Patient location-rural census tract, or a county
that is not within an MSA. • Originating site requirements-restricted to specific sites which
include hospitals, provider offices, critical access health facilities etc. • Current Information
Systems Capabilities Assessment • Originating site tool-checks site eligibility •
Reimbursement restrictions-based on geographical locations • Assessment done based on
originating site requirements • Current Information Systems Capabilities Assessment
Additional Services • • • • • • • • • • • • • • • • • • • • • • • • Services Provided to Existing
Telehealth Services Accuracy of Description Based on CPT Code Commercial Available
Alternatives Store and Forward solutions The Remote Patient Monitoring (RPM) Real-time
Telehealth Commercial Available Alternatives Mayo Clinic tele-stroke program The
Antenatal and Neonatal Guidelines, Education and Learning System program in University
of Arkansas for Medical Tele-dermatology by the Children’s Hospital of Pittsburgh of UPMC
Documents to guide Transition in Offering Expanded Telemedicine Services Provider
licensure and credentials The State Medical Board created telemedicine laws Organizations-
review of the third-party payer contracts to ensure the telemedicine service have been
captured Necessitates reimbursements Documents to guide Transition in Offering
Expanded Telemedicine Services Documentation for Prescriptions References AHIMA.
(2017). Telemedicine Toolkit, American Health Information Management Association.
Retrieved from https://healthsectorcouncil.org/wpcontent/uploads/2018/08/AHIMA-
Telemedicine-Toolkit.pdf Angels.uams.edu/clinical-telemedicine/, (2019). Retrieved from
https://angels.uams.edu/clinical-telemedicine/ Center for Connected Health Policy (CCHP).
(2019). Telehealth Reimbursement. Retrieved from
https://www.cchpca.org/sites/default/files/201903/TELEHEALTH%20REIMBURSEMENT
%202019%20FINAL.pdf Fathi, J.T., Modin, H.E and Scott, J.D. (2017). “Nurses Advancing
Telehealth Services in the Era of Healthcare Reform” OJIN: The Online Journal of Issues in
Nursing Vol. 22, No. 2, Manuscript 2. DOI: 10.3912/OJIN.Vol22No02Man02 Glandon, G. L.,
Slovensky, D. J., & Smaltz, D. H. (2014). Information Systems for Healthcare Management
(Vol. Eighth edition). Chicago, IL: Health Administration Press. Nesbitt, T. S., Hilty, D. M.,
Kuenneth, C. A., & Siefkin, A. (2000). Development of a telemedicine program: a review of
1,000 videoconferencing consultations. The Western journal of medicine, 173(3), 169–174.
doi:10.1136/ewjm.173.3.169-a Running head: GOENSMHA5006-5 1 Telemedicine Memo
Stacy Goen MHA5006-5 09/30/2019 Dr. Dale Gooden 2 GOENSMHA5006-5 Memo To:
Prospective Engineering Majors From: Stacy Goen, CIO Date: September 30, 2019 Subject:
Telemedicine Expansion Introduction The following memo is an evaluation of costs, quality,
and access to telemedicine services. The information will be used as a tool to integrate these
services into our healthcare facility. Currently, health care providers are introducing
information technology to provided affordable services to their clients as well as important
medical information. The health providers use the technology to remotely deliver health
care services such as consultation and diagnosis. Also, the providers can assess, diagnose,
and treat the patient using common technology such as smartphones and video
conferencing without the need of an in-person visit by the patient. In a summary by Uscher-
Pines, Mulcahy, Cowling, Hunter, Burns, and Mehrotra, (2016), better healthcare providers
use telemedicine to offer quality and affordable care that is congruent to the Affordable
Care Act. Healthcare Costs Before the organization leadership implements telemedicine, it is
important to consider healthcare costs, quality, and access to telemedicine services. By
considering the healthcare costs, the organization leadership will determine the viability of
the implementation of the telemedicine program used in its daily operations. Billing
services are the main challenge that deters healthcare providers from implementing
telemedicine in their services. (Visscher, Naessens, Yawn, Reinalda, Anderson, & Borah,
2017) summarizes the organizations need to 3 GOENSMHA5006-5 verify the clients when
he is insured by contacting the insurer. Secondly, the program viability has to be considered
in obtaining the appropriate CPT codes and GT modifier appropriate for the telemedicine
services. The organization should develop a standardized healthcare cost data warehouse.
The healthcare data warehouse has a set of reference files as well as SAS software version
9.4. Therefore, the organization can access all professional costing fee schedules that are
located in a file having HCPCS and CPT – 4 codes. Quality The quality is another essential
factor that the healthcare organization should consider before the implementation of
telemedicine services. Buvik, Bugge, Knutsen, Småbrekke, and Wilsgaard, (2016), engaged
in a random control test to orthopedic patients with one group using in-person visits and
the other using real-time videoconferencing. The results indicated that there was no
significant difference between the two groups (Buvik, Bugge, Knutsen, Småbrekke, &
Wilsgaard, 2016). Access to Telemedicine Services The organizational leadership must
consider the accessibility of the telemedicine services before it adopts telemedicine in the
organization. Healthcare management and leadership will need to consider the accessibility
of the telemedicine services both by the patients and itself as well. Some of the factors for
consideration included economic, geographic, architectural, and social barriers. As
identified by Uscher-Pines et al., (2016), the telemedicine services are more applicable to
the underserved health regions. Similarly, the organizations need to educate the patients
and train the nurses or personnel who will work the closest with the remote patients. 4
GOENSMHA5006-5 Conclusion In conclusion, based on the above information, the
organization can implement an Electronic Medical Record system. The system can be
applied to store the patient’s information that includes medical history and treatment
history for an extended time. Similarly, it can allow the exchange of the patient information
with the multiple practitioners, thus making it easier for the physician to communicate with
the trained remote nurse. 5 GOENSMHA5006-5 References Buvik, A., Bugge, E., Knutsen, G.,
Småbrekke, A., & Wilsgaard, T. (2016). Quality of care for remote orthopedic consultations
using telemedicine: a randomized controlled trial. BMC health services research, 16(1), 483.
Uscher-Pines, L., Mulcahy, A., Cowling, D., Hunter, G., Burns, R., & Mehrotra, A. (2016).
Access and quality of care in direct-to-consumer telemedicine. Telemedicine, and eHealthh,
22(4), 282-287. Visscher, S. L., Naessens, J. M., Yawn, B. P., Reinalda, M. S., Anderson, S. S., &
Borah, B. J. (2017). Developing a standardized healthcare cost data warehouse. BMC health
services research, 17(1), 396. Running Head: GOENSMHA5006-6-2A 1 Telemedicine
Organizational Chart Stacy Goen MHA5006-6-2 Dr. Dale Gooden 10/09/2019 2
Telemedicne Organizational Summary In healthcare organization, on of the major
consideration is to define the responsibilities of each personel to ensure the workflow and
administration of duties is as expected. An organizational chart will detail these
responsibilities as well as provide a chain of command. The organizational chart provided in
GOENSMHA5006-6-6B will detail the process of a telemedicine expansion program.
Expanding telemedicine services to each role in the organizational chart will ease how work
is done and avoid any confusion from the top management (Vinekar, Mangalesh, Jayadev,
Gilbert, Dogra, & Shetty, 2017). Senior Management The organization of personnel in a
telemedicine expansion program in providing healthcare information services will include
managers, senior managers, and networking or EHRs. The major user groups are clinical
providers, clinical administrators, strategic leadership, medical billers, and medical coders.
Senior managers will be important within the services to guide the employees or direct
other supervisors who in turn will manage the works. The senior manager will have the
responsibility of providing guidance and ensure clarity on the goals and objectives the
organization is seeking to achieve (French & Rees, 2016). Managers Managers will have the
responsibility for controlling the operations, supervising, predicting of the future
aspirations and make decisions on what the company needs to change to function
cohesively. Management need to possess strong leadership skills. The managers are then
task with assigning employees who are well skilled in managing information systems
among other functions that may be useful to the program. 3 EHRs EHRs are navigated with
responsibilities such as managing history of clients and medication lists (Vranas, Slatore, &
Kerlin, 2018). Clinical providers will be able to will offer treatment needs to the clients.
Clinical administrators will have the responsibility of admitting new clients and supervise
clinical providers. Strategic leaders can plan on how the organization will meet the goals
and objectives of the program. Medical administration will follow claims of the providers to
ensure they have been paid, while medical coders determine the procedures to be
performed and any diagnosis required. The providers should be well drive and ensure
satisfaction of the clients. 4 References French, R., & Rees, G. (Eds.). (2016). Leading,
managing and developing people. Kogan Page Publishers. Vinekar, A., Mangalesh, S.,
Jayadev, C., Gilbert, C., Dogra, M., & Shetty, B. (2017). Impact of expansion of telemedicine
screening for retinopathy of prematurity in India. Indian journal of ophthalmology, 65(5),
390. Vranas, K. C., Slatore, C. G., & Kerlin, M. P. (2018). Telemedicine coverage of intensive
care units: a narrative review. Annals of the American Thoracic Society, 15(11), 1256-1264.
Senior Management Technology Officer Program Direct Communication Officer Program
Advisor Data Manager System Manager Program Director Leadership Program Director
BSN Management Medical Service Director Clinical Administrators Medical Billers
Circulating Nurses Information Officer Program Director RN Medical Coders Surgical Tech
Operations Team Knowledge Manager Billing Manager Privacy Officer Customer Service
Manager Supervisors Authority Manager Relationship Manager Information Security
Manager Strategic Leaders HR Managers Discipline Officers Compensation Manager
Inventory Controller Activity Coordinators Event Planners EHRS Clinical Providers Medical
Service Director Protocol Manager Controllers Manage Care Planners Critical Care Assist
Medical Record Manager Staff registered nurses Nurse Leaders Surgical Service Recorders
Result Managers Circulating Nurses Entity Authorizers Nursing Assistants Shift Assistance
Supervisors Database Manager Running Head: GOENSMHA5006-7 1 Telemedicine
Expansion Action Plan Stacy Goen MHA5006-7 10/13/2019 Dr. Dale Gooden
GOENSMHA5006-7 2 Introduction The digital era has changed the fundamental dynamics of
healthcare facilities, clinicians, and patient care. Individuals have gradually embraced the
changes and technology is being used widely in the healthcare system (El-Miedany, 2017).
The use of telemedicine is increasing and innovators are developing better customer-
friendly programs that address patient management. The future of healthcare is rapidly
progressing to technology-related processes and thus, institutions are pressed to invest in
telemedicine to offer universal services. Providing adequate healthcare in rural areas is a
global challenge. In the earlier phases of telemedicine, the likely solution was to offer
remote access to services. Many proposals, however, failed to reach the execution stage due
to inadequate planning. The evaluation should combine the needs of society as well as
clinical requirements (AlDossary, Martin-Khan, Bradford, Armfield, & Smith, 2017). In the
next few pages, I will introduce an action plan designed for the expansion of an existing
telemedicine program for a local healthcare institution. The plan consists of nine steps that
should be strictly followed to ensure its effectiveness in the facility. Health Information
Technology (HIT) HIT is a vital resource for institutional performance as it offers accurate
and credible records for patients and practitioners. Enabling HIT improves patient care by
enhancing doctor-patient interactions and eliminating errors such as misdiagnosis or
prescription errors. Additionally, the technology boosts the accessibility of disease
management and prevention programs (Bui, Hansen, Liu, & Tu, 2018). HIT systems
encompass electronic medical records, information exchange channels, and computerized
provider order entry. Implementing HIT and other telemedicine technologies, however,
requires a proper project evaluation to ensure it is feasible and beneficial for patients.
GOENSMHA5006-7 3 Telemedicine Expansion The expansion program will focus on four
main areas that will act as the foundation for the telemedicine system; a. Remote assistance
– Remote assistance encompasses consultation services for diagnosis, follow-up and
treatment (Glandon, Slovensky, & Smaltz, 2013). Communication between practitioners will
also be included as it enhances coordination and improves performance. The telemedicine
expansion will also include telemonitoring services that will mobilize the community
towards the effective management of health issues. The technology will also reduce
inpatient care, which, promotes organizational efficiency. b. Organizational patient
management – Institutional management is vital to the success of telemedicine strategies.
This section includes clinical laboratory procedures, telepathology, and digital management
of records (Glandon, Slovensky, & Smaltz, 2013). c. Professional learning – A telemedicine
system also offers online learning for practitioners. It provides guidelines, strategies,
resources that promote consistent improvement, and professionalism (Glandon, Slovensky,
& Smaltz, 2013). d. Building research networks – The institution has to create an interface
that allows the sharing and retrieval of healthcare evidence. Practitioners share best
practices and information through the systems (Glandon, Slovensky, & Smaltz, 2013).
GOENSMHA5006-7 4 Action Plan Step Activities Personnel Information Additional Time
Responsibilities Requirements Resources Frame Defining Departmental analysis of A
coordination team Service Professional 3-4 Institutional Needs requirements. will be
formed. It delivery data. research and weeks Analysis of patient will include Patient
benchmarking requirements. departmental feedback on reports from other Evaluation of
technology representatives, the program. institutions. requirements. stakeholder
Organization Organizational Sustainability analysis. representatives issues. culture.
(patients, workers, Organizational shareholders). books. Conceptualizing After defining
institutional Assessing patient Practitioner Reports on best the Care Delivery and patient
needs, an requirements. reports. practices Method interactive care delivery Defining best
Patient evidence. model will be defined. practice. feedback. Practitioner Defining care
Departmental focus groups. policy. reports. 2 weeks Conducting a feasibility test.
Technology and Identifying technology gaps. Departmental IT reports. Organizational
Funding Budgeting. analysis of IT. Inventory financial reports. Financial planning. IT
budgeting. records. Identifying required Cost analysis equipment. Feasibility tests. Risk
analysis. 3 weeks GOENSMHA5006-7 5 Identifying Legal Data protection. Research to be
Facility World Healthcare Requirements Privacy and confidentiality. conducted by the
compliance Organization Liability for information. legal department. documents and (WHO)
directives reports. on public health. Licensing. 2 weeks Government acts and provisions.
Testing Equipment Installing equipment. Inspection. User manuals. External training and
Training Establishing policies. Attending training Directives programs. Personnel Defining
employee roles. and drills. from the IT Inter- Performing work drills. Learning the
department. organizational Evaluating employee systems. Information performance.
Evaluate equipment sharing Defining a chain of command. performance. IT 1 week dept,
mgmt, and personnel. Patient Testing A 2-week implementation of Documenting Patient
health Reports on best the program. activities. records. practices. Participant Patient
observation. interviews. Includes Organizational management. policies. 2 weeks
GOENSMHA5006-7 6 Evaluating Test Assessing the success of the Examining session
Session Patient focal Results program. recordings. recordings. groups. Identifying technical
Conducting patient Patient Practitioner focal problems. interviews. healthcare groups.
Change management. Issuing records. Evaluating technology use. questionnaires.
Interviews. Evaluating results Billing against project records. objectives. Launching the
Implementing the entire Following protocols Organizational Telemedicine Program
program. and policies. policies. directive manuals. Full patient engagement. Maintaining
activity Implementing Health records. Information Technology. Digitizing records.
Assessment of acceptance. Issuing evaluation Questionnaire Focal groups. and personnel
questionnaires. and interview Community satisfaction Conducting patient responses.
interviews. Evaluating patient and employee interviews. Patient follow-up. Provided by
management. 3 months 2 months GOENSMHA5006-7 7 Action Plan Diagram
GOENSMHA5006-7 8 References AlDossary, S., Martin-Khan, M. G., Bradford, N. K., Armfield,
N. R., & Smith, A. C. (2017). The development of a telemedicine planning framework based
on needs assessment. Journal of Medical Systems, 41(5), 74. doi:10.1007/s10916-017-
0709-4 Bui, Q. “., Hansen, S., Liu, M., & Tu, Q., (2018). The productivity paradox in health
information technology. Communications of the ACM, 78-85. Glandon, G. L., Slovensky, D. J.,
& Smaltz, D. H. (2013). Information systems for healthcare management, Eighth Edition
(Vol. Eighth edition). Chicago, IL: Health Administration Press. El-Miedany, Y. (2017).
Telehealth and telemedicine: how the digital era is changing standard health care. Smart
Homecare Technology and TeleHealth, 43-51.

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Develop a project plan including project management knowledge areas in.docx

  • 1. Develop a project plan including project management knowledge areas in healthcare Past resources and information for use if needed Bui, Q., Hansen, S., Liu, M., & Tu, Q. (2018). The productivity paradox in health information technology. Communications of the ACM, 61(10), 78–85. Glandon, G. L., Smaltz, D. H., & Slovensky, D. J. (2013). Information systems for healthcare management (8th ed.). Chicago, IL: Health Administration Wang, T., Wang, Y., & McLeod, A. (2018, March). Do health information technology investments impact hospital financial performance and productivity. French, R., & Rees, G. (Eds.). (2016). Leading, managing and developing people. Kogan Page Publishers. Vinekar, A., Mangalesh, S., Jayadev, C., Gilbert, C., Dogra, M., & Shetty, B. (2017). Impact of expansion of telemedicine screening for retinopathy of prematurity in India. Indian journal of ophthalmology, 65(5), 390. Vranas, K. C., Slatore, C. G., & Kerlin, M. P. (2018). Telemedicine coverage of intensive care units: a narrative review. Annals of the American Thoracic Society, 15(11), 12561264. Buvik, A., Bugge, E., Knutsen, G., Småbrekke, A., & Wilsgaard, T. (2016). Quality of care for remote orthopedic consultations using telemedicine: a randomized controlled trial. BMC health services research, 16(1), 483. Uscher-Pines, L., Mulcahy, A., Cowling, D., Hunter, G., Burns, R., & Mehrotra, A. (2016). Access and quality of care in direct-to-consumer telemedicine. Telemedicine, and eHealthh, 22(4), 282-287. Visscher, S. L., Naessens, J. M., Yawn, B. P., Reinalda, M. S., Anderson, S. S., & Borah, B. J. (2017). Developing a standardized healthcare cost data warehouse. BMC health services research, 17(1), 396. Jackson, D. E., & McClean, S. I. (2012). Trends in telemedicine assessment indicate neglect of key criteria for predicting success. Journal of Health Organization and Management, 26(4), 508-523. doi:http://dx.doi.org.proxy1.ncu.edu/10.1108/14777261211251553 AlDossary, S., Martin- Khan, M. G., Bradford, N. K., Armfield, N. R., & Smith, A. C. (2017). The Development of a Telemedicine Planning Framework Based on Needs Assessment. Journal Of Medical Systems, 41(5), 74. https://doiorg.proxy1.ncu.edu/10.1007/s10916-017-0709-4 ClickView/VEA (Producer). (2011). ICT project management [Video file]. Films on Demand. Link Glandon, G. L., Smaltz, D. H., & Slovensky, D. J. (2013). Information systems for healthcare management (8th ed.). Chicago, IL: Health Administration Link Read Chapter 8: “Systems Selection and Contract Management” Read Chapter 11: “HIT Project Portfolio Management” Ho, J. (2010). Project management in health informatics. Studies in Health Technology and Informatics, 151, 413–424. Kongstvedt, P. R. (Ed.). (2001). The managed health care handbook. Jones & Bartlett Learning. Smith, A. E., & Swinehart, K. D. (2001).
  • 2. Integrated systems design for customer focused health care performance measurement: a strategic service unit approach. International Journal of Health Care Quality Assurance, 14(1), 21-29. Wager, K. A., Lee, F. W., & Glaser, J. P. (2017). Health care information systems: a practical approach for health care management. John Wiley & Sons. Adler-Milstein, J., & Huckman, R. S. (2013). The impact of electronic health record use on physician productivity. The American journal of managed care, 19(10 Spec No), SP34552. Armijo, D., McDonnell, C., & Werner, K. (2014). Electronic health record usability: evaluation and use case framework. AHRQ Publication, (09), 10. Kharrazi, H., Gonzalez, C. P., Lowe, K. B., Huerta, T. R., & Ford, E. W. (2018). Forecasting the maturation of electronic health record functions among US hospitals: Retrospective analysis and predictive model. Journal of medical internet research, 20(8), e10458. doi:10.2196/10458 Implementing Change with Health Information Systems It is nearly cliché that the one constant in life is change; nowhere will you find this truer than at the interface between information technology and your work as a healthcare administrator. Technologies will continue to change, and new technologies will emerge, and problems with existing technologies will be recognized. As a healthcare administrator, not only will you need to be able to adapt and navigate this change, but in many cases, you will also be responsible for initiating and driving change. The collected activities to make a change are called a project. To prepare for your role, you will investigate project management. Project management is the discipline that investigates and organizes the many processes involved in successfully initiating, directing, and concluding projects. The myriad details requiring your attention to successfully implement change have been enumerated, classified, and organized into knowledge areas. Each knowledge area addresses a component of an overall project, such as scope, scheduling, costs, risk, personnel, and quality. Numerous tools, such as Microsoft Project, Airtable, Trello, and others, have been developed to aid in the navigation of projects. Many of these tools are free or provide free trials. These tools enable project managers to track scheduling, resources, progress, budgets, and workloads. You will need to be familiar with the knowledge areas and available tools to successfully initiate and lead projects. As you explore implementing change through project management, pay close attention to the components of a project plan. You will use these components to construct a project plan in your Signature Assignment. Be sure to review this week’s resources carefully. You are expected to apply the information from these resources when you prepare your assignments. Health Information Systems GOENSMHA5006 Summary Clinical information systems include electronic health records, patient administration systems, and ancillary information systems. The three are interrelated because of their patient/doctor healthcare information tracking, admissions/discharge information, and also any testing or medications that would be related to individual and facility (Wager, Lee, & Glaser, 2017). Operational management systems include operation improvements, reimbursement systems, and HIPPA compliance. These systems are all vital to maintaining the facility, its reimbursement to third party systems, and also must be within HIPPA standards or regulations (Kongstvedt, 2001). Strategic design support system examples are performance measurement systems, patient outcome assessments, and data monitoring. All are related for the design and implementation of quality healthcare settings (Smith & Swinehart, 2001). Electronic
  • 3. networking and e-health applications have a multitude of systems in place. Three examples provided are billing, claims, and processing systems, structured delivery systems, and web services. Each system relies on the other for appropriate billing, processing, and delivery for the patient as well as the success of the facility (Glandon, Smaltz, & Slovensky, 2013). References Glandon, G. L., Slovensky, D. J., & Smaltz, D. H. (2014). Information Systems for Healthcare Management (Vol. Eighth edition). Chicago, IL: Health Administration Press Kongstvedt, P. R. (Ed.). (2001). The managed health care handbook. Jones & Bartlett Learning. Smith, A. E., & Swinehart, K. D. (2001). Integrated systems design for customer focused health care performance measurement: a strategic service unit approach. International Journal of Health Care Quality Assurance, 14(1), 21-29. Wager, K. A., Lee, F. W., & Glaser, J. P. (2017). Health care information systems: a practical approach for health care management. John Wiley & Sons. Running Head: GOENSMHA5006-2 1 Electronic Health Record System Stacy Goen MHA5006-2 09/09/2019 Dr. Dale Gooden ELECTRONIC HEALTH RECORD SYSTEM 2 Electronic health record system Criteria Excellence 60 points Acceptable 40 points Unacceptable 0 points Stage 1: Laboratory, Test orders/results and Test orders/results can Online transmission Pharmacy, and pharmacy orders can be electronically sent of labs/radiology Radiology Results. be electronically to the lab but multiple results or pharmacy The EHR should be transmitted to lab lab results can only be orders are not equipped to support technicians. Multiple viewed at the same supported. the real-time lab test results and time using external transmission of lab other diagnose can be software. test results, pharmacy viewed without the orders and other need to export to diagnoses to clinicians external software (Kharrazi, Gonzalez, Lowe, Huerta, & Ford, 2018). Stage 2: Clinical All orders and results here is a single oracle There is no single Data Repository can be stored in a to view patients repository and (CDR). single cache where records. However, clinicians have to log The EHR should have clinicians can log in clinicians cannot into several systems ELECTRONIC HEALTH RECORD SYSTEM one clinical data and view all details. 3 access the entire repertory where all patient’s data without test orders, lab results, viewing multiple and other orders are clinicians of the written and stored patient. to patient details. (Glandon, Slovensky, & Smaltz, 2014). Stage 3: Nursing All nursing orders, Nursing Nursing Documentation and past, present, and documentation is documentation is not Security. future assessments, supported online but supported. EHR should be able to tasks, can be they cannot be support any nursing recorded. Nursing reconciled and documentation. documentation is systematically be Documentation supported online. retrieved without an includes notifications Includes admission external software and and reminders on such processing, patient as allergies, info, and care. prescriptions use, or Documentation protocols (Glandon, typically performed Slovensky, & Smaltz, by nursing is on-line 2014). such as: admission processing, H&P, care hardware. ELECTRONIC HEALTH RECORD SYSTEM 4 documentation, nursing orders & tasks related to RX & procedure, e-MAR, discharge planning etc. Stage 4: Physician’s orders can Physician orders can Computerized Computerized be entered be transmitted physician order entry Physician Order electronically and the electronically to not supported. Entry (CPOE). The instructions of the nurses, pharmacists EHR should be also to practitioners sent and laboratory but support automated online to the nurses or nurses cannot send physician
  • 4. order entry. appropriate back their response This includes any designation (Kharrazi online without use of tests or measures that et.al, 2018). an external software will direct the facility to the specified or precise location (Glandon, Slovensky, & Smaltz, 2014). and hardware. ELECTRONIC HEALTH RECORD SYSTEM 5 Stage 5: Closed-loop The medication The medication Radiology exams and Medication process can be stored process may be stored PACs are not Administration. in PAC and can be in PAC as well as supported. The electronic health accessed by accessed offline at system can support practitioners over the healthcare facilities. the storage of internet (Kharrazi However, the processes of et.al, 2018). Also, the information may not medications medication processes be accessed through administered can be accessed Internet services. (Glandon, Slovensky, offline at the hospital. & Smaltz, 2014). This is important for the safety of the patient as well as for the facility. ELECTRONIC HEALTH RECORD SYSTEM 6 Stage 6 A physician or A doctor can send an A closed loop ERH Technology clinician can submit, order to a pharmacist medication is not Enabled order and send the only but not to a lab supported. Medication, Blood information to the technician, Products, And pharmacy. The proper radiologist, personnel can then psychotherapist or Administration; verify it and dispense other clinicians. Risk Reporting; the medication Full CDS properly. Human Milk The technology needs to support closed-loop medication administration (Glandon, Slovensky, & Smaltz, 2014). ELECTRONIC HEALTH RECORD SYSTEM 7 Stage 7 Medical Transcribers Physician No documentation Physician should be well versed Documentation available. Documentation in medical should be supported Clinician technology. The by outsourced Documentation system should be services. Online provides the correct structured for any services are supported verbiage for language barriers with but interfere with transcription (Adler- editors for any language barriers. Milstein & Huckman complications. 2013). Services should be correlated within the healthcare facility and appropriate services. Stage 0 EHR Not EHR Not EHR Not Implemented Implemented Implemented Conclusion The implementation of EHR has improved productivity and performance in the healthcare realm has improved productivity to the clinician, patient, and family member. The overall process saves time as well as relays specifics that may not be obtained in condi tions when family members are absent or do not exist. ELECTRONIC HEALTH RECORD SYSTEM 8 Medical practitioners can easily and quickly access patients’ records as well as share them with other staff involved in the treatment (Adler-Milstein & Huckman 2013). Criteria is a crucial aspect in EHR’s and when viewing multiple patient records. The EHR process has a high usability factor which, lowers the stress factor of all parties involved. Any information found from the EHR may minimize possible complications to the patient such as allergies, past illnesses, or other circumstances important to the patients well-being (Armijo, McDonnell & Werner, 2014). ELECTRONIC HEALTH RECORD SYSTEM 9 References Adler-Milstein, J., & Huckman, R. S. (2013). The impact of electronic health record use on physician productivity. The American journal of managed care, 19(10 Spec No), SP34552. Armijo, D., McDonnell, C., & Werner, K. (2014). Electronic health record usability: evaluation and use case framework. AHRQ Publication, (09), 10. Glandon, G. L., Slovensky, D. J., & Smaltz, D. H. (2014). Information systems for healthcare management (Vol. Eighth edition). Chicago, IL: Health Administration Press. Kharrazi, H., Gonzalez, C. P., Lowe, K. B., Huerta, T. R., & Ford, E. W. (2018). Forecasting the
  • 5. maturation of electronic health record functions among US hospitals: Retrospective analysis and predictive model. Journal of medical internet research, 20(8), e10458. doi:10.2196/10458 Running Head: GOENSMHA5006-4 1 SQL Queries Stacy Goen MHA5006-4 09/22/2019 Dr. Dale Gooden 2 GOENSMHA5006-4 A query that recreates list of distinct patients. SELECT DISTINCT dob, FROM patients JOIN encounters ON patients.patient_id=encounters.patient_id WHERE encounters.start_datetime>=20-01-01 Patients Table Patient_id Name Date of Birth 001 Stacy Watts Jan 04 1992 002 Cindy Lou Jan 04 1992 003 Bailey Blue July 26 1980 Encounters Table Encounter_id Patient_id Procedure_id Start_dateTime End_dateTime 1001 001 2002 01-04-2019 01-04-2019 0900hrs 1100hrs 01-04-2019 01-04-2019 1400hrs 1800hrs 02-12-2019 02-12-2019 1000hrs 1430hrs 1002 1003 001 003 2003 2004 GOENSMHA5006-4 The query SELECT dob FROM patient JOIN encounters ON patients.patient_id=encounters.patient_id Returns a single row of each patient date of birth Date of Birth Jan 04 1992 Jan 04 1992 July 26 1980 However, when SELECT DISTINCT is applied in the following query, we end up with the following: SELECT DISTINCT dob, FROM patients JOIN encounters ON patients.patient_id=encounters.patient_id WHERE encounters.start_datetime>=20-01-01 3 GOENSMHA5006-4 We end up with: Date of Birth Jan 04 1992 July 26 1980 List the names of patients for each procedure type (by billing code). The output should list the billing code first, followed by the patient name. Sort by billing code first, then patient name. SELECT billing_code, FROM procedure JOIN patient ON procedure.procedure_id=patient.procedure_id ORDER BY billing_code ASC ORDER BY patient_name ASC table_name: procedure. List the distinct procedure labels for a provider with the specialty of “dermatologist”. SELECT DISTINCT specialty, FROM providers WHERE specialty. “dermatologist” 4 GOENSMHA5006-4 /* the explanation for the first question is elaborate enough to enable one to follow through question three*/ Produce a count of procedure types for each provider specialty. SELECT specialty COUNT (*), procedure_count FROM providers INNER JOIN provider.procedure ON procedure_id = provider_id GROUP BY Procedure_types ORDER BY Procedure_count ASC; List the names and addresses of all patients who have had an encounter with a provider licensed in California SELECT encounter_id, patient_id, provider_id FROM encounters INNER JOIN patients ON encounters.encounters_id=patients.encounters_id INNER JOIN providers ON encounters.encounters_id=providers.encounters_id WHERE providers.licensed_CALIFORNIA /* The INNER JOIN as the keyword in this case selects all rows from the three tables (patients, encounters and providers). Since there is a match among the columns provided by the selected primary keys (encounters_id, patients_id and providers_id), all columns from each of the three 5 GOENSMHA5006-4 tables can be referenced. If there are records in the “encounters” table that do not have matches in “patients or providers”, these encounters will not be shown*/ 6 • Impact of an Expanded Telemedicine Program – POWERPOINT OUTLINE • • • • • Overview Telemedicine-clinical application of giving care at a distance Primary driving force- enhancing access to medical services in the rural areas Telemedicine-boosted the quality of local care leading to better patient satisfaction Wide variety of services and applications that use email, video and different types of telecommunications technology • Factors in Reimbursement of
  • 6. Telemedicine Services • Medicare Rules and Telehealth Services • Billing Services • Origination of Billing Site/Facility Services • Fees, Deductibles, and Third Party Reimbursements • Factors in Reimbursement of Telemedicine Services • Reimbursement of telehealth services given for non-Medicare patient is dependent on the jurisdiction • Lack of uniformity in state health guidance such as area of site of service-non reimbursements • Strict rules set by CMS on telemedicine reimbursement based on the rural location of the patient • Other factors-originating site and synchronized services • New/Enhanced Health Information Capabilities for Reimbursements • Health information and capabilities needed to ensure reimbursement of telemedicine services include; • Distant site practitioners have to be; • Physicians • Nurse practitioners • Physician assistant • Nurse midwives • Clinical nurse specialist • New/Enhanced Health Information Capabilities for Reimbursements • Limitations on the type of technology applied in the delivery of care. • Specific telemedicine applications • Patients must be located in Health Professional Shortage Areas (HSPA) away from Metropolitan Statistical Area (MSA) • Patient location-rural census tract, or a county that is not within an MSA. • Originating site requirements-restricted to specific sites which include hospitals, provider offices, critical access health facilities etc. • Current Information Systems Capabilities Assessment • Originating site tool-checks site eligibility • Reimbursement restrictions-based on geographical locations • Assessment done based on originating site requirements • Current Information Systems Capabilities Assessment Additional Services • • • • • • • • • • • • • • • • • • • • • • • • Services Provided to Existing Telehealth Services Accuracy of Description Based on CPT Code Commercial Available Alternatives Store and Forward solutions The Remote Patient Monitoring (RPM) Real-time Telehealth Commercial Available Alternatives Mayo Clinic tele-stroke program The Antenatal and Neonatal Guidelines, Education and Learning System program in University of Arkansas for Medical Tele-dermatology by the Children’s Hospital of Pittsburgh of UPMC Documents to guide Transition in Offering Expanded Telemedicine Services Provider licensure and credentials The State Medical Board created telemedicine laws Organizations- review of the third-party payer contracts to ensure the telemedicine service have been captured Necessitates reimbursements Documents to guide Transition in Offering Expanded Telemedicine Services Documentation for Prescriptions References AHIMA. (2017). Telemedicine Toolkit, American Health Information Management Association. Retrieved from https://healthsectorcouncil.org/wpcontent/uploads/2018/08/AHIMA- Telemedicine-Toolkit.pdf Angels.uams.edu/clinical-telemedicine/, (2019). Retrieved from https://angels.uams.edu/clinical-telemedicine/ Center for Connected Health Policy (CCHP). (2019). Telehealth Reimbursement. Retrieved from https://www.cchpca.org/sites/default/files/201903/TELEHEALTH%20REIMBURSEMENT %202019%20FINAL.pdf Fathi, J.T., Modin, H.E and Scott, J.D. (2017). “Nurses Advancing Telehealth Services in the Era of Healthcare Reform” OJIN: The Online Journal of Issues in Nursing Vol. 22, No. 2, Manuscript 2. DOI: 10.3912/OJIN.Vol22No02Man02 Glandon, G. L., Slovensky, D. J., & Smaltz, D. H. (2014). Information Systems for Healthcare Management (Vol. Eighth edition). Chicago, IL: Health Administration Press. Nesbitt, T. S., Hilty, D. M., Kuenneth, C. A., & Siefkin, A. (2000). Development of a telemedicine program: a review of 1,000 videoconferencing consultations. The Western journal of medicine, 173(3), 169–174.
  • 7. doi:10.1136/ewjm.173.3.169-a Running head: GOENSMHA5006-5 1 Telemedicine Memo Stacy Goen MHA5006-5 09/30/2019 Dr. Dale Gooden 2 GOENSMHA5006-5 Memo To: Prospective Engineering Majors From: Stacy Goen, CIO Date: September 30, 2019 Subject: Telemedicine Expansion Introduction The following memo is an evaluation of costs, quality, and access to telemedicine services. The information will be used as a tool to integrate these services into our healthcare facility. Currently, health care providers are introducing information technology to provided affordable services to their clients as well as important medical information. The health providers use the technology to remotely deliver health care services such as consultation and diagnosis. Also, the providers can assess, diagnose, and treat the patient using common technology such as smartphones and video conferencing without the need of an in-person visit by the patient. In a summary by Uscher- Pines, Mulcahy, Cowling, Hunter, Burns, and Mehrotra, (2016), better healthcare providers use telemedicine to offer quality and affordable care that is congruent to the Affordable Care Act. Healthcare Costs Before the organization leadership implements telemedicine, it is important to consider healthcare costs, quality, and access to telemedicine services. By considering the healthcare costs, the organization leadership will determine the viability of the implementation of the telemedicine program used in its daily operations. Billing services are the main challenge that deters healthcare providers from implementing telemedicine in their services. (Visscher, Naessens, Yawn, Reinalda, Anderson, & Borah, 2017) summarizes the organizations need to 3 GOENSMHA5006-5 verify the clients when he is insured by contacting the insurer. Secondly, the program viability has to be considered in obtaining the appropriate CPT codes and GT modifier appropriate for the telemedicine services. The organization should develop a standardized healthcare cost data warehouse. The healthcare data warehouse has a set of reference files as well as SAS software version 9.4. Therefore, the organization can access all professional costing fee schedules that are located in a file having HCPCS and CPT – 4 codes. Quality The quality is another essential factor that the healthcare organization should consider before the implementation of telemedicine services. Buvik, Bugge, Knutsen, Småbrekke, and Wilsgaard, (2016), engaged in a random control test to orthopedic patients with one group using in-person visits and the other using real-time videoconferencing. The results indicated that there was no significant difference between the two groups (Buvik, Bugge, Knutsen, Småbrekke, & Wilsgaard, 2016). Access to Telemedicine Services The organizational leadership must consider the accessibility of the telemedicine services before it adopts telemedicine in the organization. Healthcare management and leadership will need to consider the accessibility of the telemedicine services both by the patients and itself as well. Some of the factors for consideration included economic, geographic, architectural, and social barriers. As identified by Uscher-Pines et al., (2016), the telemedicine services are more applicable to the underserved health regions. Similarly, the organizations need to educate the patients and train the nurses or personnel who will work the closest with the remote patients. 4 GOENSMHA5006-5 Conclusion In conclusion, based on the above information, the organization can implement an Electronic Medical Record system. The system can be applied to store the patient’s information that includes medical history and treatment history for an extended time. Similarly, it can allow the exchange of the patient information
  • 8. with the multiple practitioners, thus making it easier for the physician to communicate with the trained remote nurse. 5 GOENSMHA5006-5 References Buvik, A., Bugge, E., Knutsen, G., Småbrekke, A., & Wilsgaard, T. (2016). Quality of care for remote orthopedic consultations using telemedicine: a randomized controlled trial. BMC health services research, 16(1), 483. Uscher-Pines, L., Mulcahy, A., Cowling, D., Hunter, G., Burns, R., & Mehrotra, A. (2016). Access and quality of care in direct-to-consumer telemedicine. Telemedicine, and eHealthh, 22(4), 282-287. Visscher, S. L., Naessens, J. M., Yawn, B. P., Reinalda, M. S., Anderson, S. S., & Borah, B. J. (2017). Developing a standardized healthcare cost data warehouse. BMC health services research, 17(1), 396. Running Head: GOENSMHA5006-6-2A 1 Telemedicine Organizational Chart Stacy Goen MHA5006-6-2 Dr. Dale Gooden 10/09/2019 2 Telemedicne Organizational Summary In healthcare organization, on of the major consideration is to define the responsibilities of each personel to ensure the workflow and administration of duties is as expected. An organizational chart will detail these responsibilities as well as provide a chain of command. The organizational chart provided in GOENSMHA5006-6-6B will detail the process of a telemedicine expansion program. Expanding telemedicine services to each role in the organizational chart will ease how work is done and avoid any confusion from the top management (Vinekar, Mangalesh, Jayadev, Gilbert, Dogra, & Shetty, 2017). Senior Management The organization of personnel in a telemedicine expansion program in providing healthcare information services will include managers, senior managers, and networking or EHRs. The major user groups are clinical providers, clinical administrators, strategic leadership, medical billers, and medical coders. Senior managers will be important within the services to guide the employees or direct other supervisors who in turn will manage the works. The senior manager will have the responsibility of providing guidance and ensure clarity on the goals and objectives the organization is seeking to achieve (French & Rees, 2016). Managers Managers will have the responsibility for controlling the operations, supervising, predicting of the future aspirations and make decisions on what the company needs to change to function cohesively. Management need to possess strong leadership skills. The managers are then task with assigning employees who are well skilled in managing information systems among other functions that may be useful to the program. 3 EHRs EHRs are navigated with responsibilities such as managing history of clients and medication lists (Vranas, Slatore, & Kerlin, 2018). Clinical providers will be able to will offer treatment needs to the clients. Clinical administrators will have the responsibility of admitting new clients and supervise clinical providers. Strategic leaders can plan on how the organization will meet the goals and objectives of the program. Medical administration will follow claims of the providers to ensure they have been paid, while medical coders determine the procedures to be performed and any diagnosis required. The providers should be well drive and ensure satisfaction of the clients. 4 References French, R., & Rees, G. (Eds.). (2016). Leading, managing and developing people. Kogan Page Publishers. Vinekar, A., Mangalesh, S., Jayadev, C., Gilbert, C., Dogra, M., & Shetty, B. (2017). Impact of expansion of telemedicine screening for retinopathy of prematurity in India. Indian journal of ophthalmology, 65(5), 390. Vranas, K. C., Slatore, C. G., & Kerlin, M. P. (2018). Telemedicine coverage of intensive care units: a narrative review. Annals of the American Thoracic Society, 15(11), 1256-1264.
  • 9. Senior Management Technology Officer Program Direct Communication Officer Program Advisor Data Manager System Manager Program Director Leadership Program Director BSN Management Medical Service Director Clinical Administrators Medical Billers Circulating Nurses Information Officer Program Director RN Medical Coders Surgical Tech Operations Team Knowledge Manager Billing Manager Privacy Officer Customer Service Manager Supervisors Authority Manager Relationship Manager Information Security Manager Strategic Leaders HR Managers Discipline Officers Compensation Manager Inventory Controller Activity Coordinators Event Planners EHRS Clinical Providers Medical Service Director Protocol Manager Controllers Manage Care Planners Critical Care Assist Medical Record Manager Staff registered nurses Nurse Leaders Surgical Service Recorders Result Managers Circulating Nurses Entity Authorizers Nursing Assistants Shift Assistance Supervisors Database Manager Running Head: GOENSMHA5006-7 1 Telemedicine Expansion Action Plan Stacy Goen MHA5006-7 10/13/2019 Dr. Dale Gooden GOENSMHA5006-7 2 Introduction The digital era has changed the fundamental dynamics of healthcare facilities, clinicians, and patient care. Individuals have gradually embraced the changes and technology is being used widely in the healthcare system (El-Miedany, 2017). The use of telemedicine is increasing and innovators are developing better customer- friendly programs that address patient management. The future of healthcare is rapidly progressing to technology-related processes and thus, institutions are pressed to invest in telemedicine to offer universal services. Providing adequate healthcare in rural areas is a global challenge. In the earlier phases of telemedicine, the likely solution was to offer remote access to services. Many proposals, however, failed to reach the execution stage due to inadequate planning. The evaluation should combine the needs of society as well as clinical requirements (AlDossary, Martin-Khan, Bradford, Armfield, & Smith, 2017). In the next few pages, I will introduce an action plan designed for the expansion of an existing telemedicine program for a local healthcare institution. The plan consists of nine steps that should be strictly followed to ensure its effectiveness in the facility. Health Information Technology (HIT) HIT is a vital resource for institutional performance as it offers accurate and credible records for patients and practitioners. Enabling HIT improves patient care by enhancing doctor-patient interactions and eliminating errors such as misdiagnosis or prescription errors. Additionally, the technology boosts the accessibility of disease management and prevention programs (Bui, Hansen, Liu, & Tu, 2018). HIT systems encompass electronic medical records, information exchange channels, and computerized provider order entry. Implementing HIT and other telemedicine technologies, however, requires a proper project evaluation to ensure it is feasible and beneficial for patients. GOENSMHA5006-7 3 Telemedicine Expansion The expansion program will focus on four main areas that will act as the foundation for the telemedicine system; a. Remote assistance – Remote assistance encompasses consultation services for diagnosis, follow-up and treatment (Glandon, Slovensky, & Smaltz, 2013). Communication between practitioners will also be included as it enhances coordination and improves performance. The telemedicine expansion will also include telemonitoring services that will mobilize the community towards the effective management of health issues. The technology will also reduce inpatient care, which, promotes organizational efficiency. b. Organizational patient
  • 10. management – Institutional management is vital to the success of telemedicine strategies. This section includes clinical laboratory procedures, telepathology, and digital management of records (Glandon, Slovensky, & Smaltz, 2013). c. Professional learning – A telemedicine system also offers online learning for practitioners. It provides guidelines, strategies, resources that promote consistent improvement, and professionalism (Glandon, Slovensky, & Smaltz, 2013). d. Building research networks – The institution has to create an interface that allows the sharing and retrieval of healthcare evidence. Practitioners share best practices and information through the systems (Glandon, Slovensky, & Smaltz, 2013). GOENSMHA5006-7 4 Action Plan Step Activities Personnel Information Additional Time Responsibilities Requirements Resources Frame Defining Departmental analysis of A coordination team Service Professional 3-4 Institutional Needs requirements. will be formed. It delivery data. research and weeks Analysis of patient will include Patient benchmarking requirements. departmental feedback on reports from other Evaluation of technology representatives, the program. institutions. requirements. stakeholder Organization Organizational Sustainability analysis. representatives issues. culture. (patients, workers, Organizational shareholders). books. Conceptualizing After defining institutional Assessing patient Practitioner Reports on best the Care Delivery and patient needs, an requirements. reports. practices Method interactive care delivery Defining best Patient evidence. model will be defined. practice. feedback. Practitioner Defining care Departmental focus groups. policy. reports. 2 weeks Conducting a feasibility test. Technology and Identifying technology gaps. Departmental IT reports. Organizational Funding Budgeting. analysis of IT. Inventory financial reports. Financial planning. IT budgeting. records. Identifying required Cost analysis equipment. Feasibility tests. Risk analysis. 3 weeks GOENSMHA5006-7 5 Identifying Legal Data protection. Research to be Facility World Healthcare Requirements Privacy and confidentiality. conducted by the compliance Organization Liability for information. legal department. documents and (WHO) directives reports. on public health. Licensing. 2 weeks Government acts and provisions. Testing Equipment Installing equipment. Inspection. User manuals. External training and Training Establishing policies. Attending training Directives programs. Personnel Defining employee roles. and drills. from the IT Inter- Performing work drills. Learning the department. organizational Evaluating employee systems. Information performance. Evaluate equipment sharing Defining a chain of command. performance. IT 1 week dept, mgmt, and personnel. Patient Testing A 2-week implementation of Documenting Patient health Reports on best the program. activities. records. practices. Participant Patient observation. interviews. Includes Organizational management. policies. 2 weeks GOENSMHA5006-7 6 Evaluating Test Assessing the success of the Examining session Session Patient focal Results program. recordings. recordings. groups. Identifying technical Conducting patient Patient Practitioner focal problems. interviews. healthcare groups. Change management. Issuing records. Evaluating technology use. questionnaires. Interviews. Evaluating results Billing against project records. objectives. Launching the Implementing the entire Following protocols Organizational Telemedicine Program program. and policies. policies. directive manuals. Full patient engagement. Maintaining activity Implementing Health records. Information Technology. Digitizing records.
  • 11. Assessment of acceptance. Issuing evaluation Questionnaire Focal groups. and personnel questionnaires. and interview Community satisfaction Conducting patient responses. interviews. Evaluating patient and employee interviews. Patient follow-up. Provided by management. 3 months 2 months GOENSMHA5006-7 7 Action Plan Diagram GOENSMHA5006-7 8 References AlDossary, S., Martin-Khan, M. G., Bradford, N. K., Armfield, N. R., & Smith, A. C. (2017). The development of a telemedicine planning framework based on needs assessment. Journal of Medical Systems, 41(5), 74. doi:10.1007/s10916-017- 0709-4 Bui, Q. “., Hansen, S., Liu, M., & Tu, Q., (2018). The productivity paradox in health information technology. Communications of the ACM, 78-85. Glandon, G. L., Slovensky, D. J., & Smaltz, D. H. (2013). Information systems for healthcare management, Eighth Edition (Vol. Eighth edition). Chicago, IL: Health Administration Press. El-Miedany, Y. (2017). Telehealth and telemedicine: how the digital era is changing standard health care. Smart Homecare Technology and TeleHealth, 43-51.