The Business Case for Investing in EHR within a Doctor’s Practice

Question

Task: “Greenway Medical Technologies: The Pace-Setting David ofElectronic Health Records”

The above case study outlines the potential value offered by electronic healthcare records (EHR) but also raises a number of issues. The case material is comprehensive but, in essence, focuses on the improving the management of doctors’ offices through the application of information technology and systems. The requirement for this case study is to analyse the IT value issues of EHR so that a business case can be developed for the management of a doctor’s practice.

You are required to analyse the case material provided to you and produce a report to management with the title: The Business Case for Investing in EHR within a Doctor’s Practice. You should identify the issues in the case material that have relevance to a business case and produce a written report from the information available. To understand the issues associated with EHR you should not only rely on the information provided in the case study but also conduct your own research. EHR is very topical and there is much information available through the ECU e-library. A sample journal article relevant to the topic titled “Information Technology Issues in Healthcare: Hospital CEO and CIO Perspectives” is provided with the case material.

You must also consider the ethical and social implications of the implementation of such as system.

The assignment will be completed in two parts:

Part 1: Data collection (worth 30%)

You are required to collect data in respect of EHR and doctors’ practices within Australia.

Firstly obtain an understanding of how General Practice functions, the business context and the key processes. Then select an EHR vendor operating in Australia that supplies EHR system solutions to doctors’ practices. Establish the solutions they provide: functionality of systems, IT architecture, risk and security, costs and benefits, implementation strategy, vendor background information.

It may help you to structure your data collection like this:

The requirements for a doctor’s practice

• What is the business context of a doctor’s practice:
• what is the nature of the business market,
• what challenges do they face,
• what constraints are they under,
• what special regulatory, social and ethical circumstances do they operate in?
• What are areas of breakdown or problems in the practice?
• What processes and services do they perform?
• Who are the key stakeholders, their needs and requirements?
  Software package solutions – vendor and software
• Who is a Vendor offering software solutions?
• What is their background?
• What functions do they offer?
• What is their architecture?
• What equipment do you need?
• What risks are there in implementation?
• What are the costs and benefits of the solutions?
• How will you proceed with the implementation project (roles and responsibilities?)

Answer

1. The Requirements for a Doctor’s Practice
1.1 Analysing the Business Context of Doctor’s Practices
General medical practice helps to provide exhaustive, facilitated and focused whole individual medical services to the patients and their family members within a group. It is important to state that the general physician practices, the practice groups and the important social insurance influences exemplify the developments of a feasible healthcare system. It will be essential for the future practitioners to know that the general medical and clinical practices can be defined by some important characteristics according to the disciplines. These are discussed as follows:

• Care Continuation for the Patients
• Patient Centred Services
• Collaborative clinical activities
• Clinical, ethical and professional standards
• Effective evaluation and monitoring of discipline
• Effective quality management and improvement
• Whole body care of the patients

Patient Centred Services: It is important for the general physicians and practitioners to understand the health requirements and needs of the target customers and patients based on the characteristics of the diseases and illness. It is the ultimate individual experience of the general physicians to detect the reason behind the illness. In addition, the general physicians and practitioners are strongly responsible to give patients relief from the illness and diseases. The needs, desired health consequences and values of the patients always can be considered as the major objective and responsibility of the general physicians and practitioners.

Care Continuation for the Patients: Similar to the detection of the reason behind the illness, the general physicians and practitioners are always responsible for the care and sustainability of the health of the patients. These general physicians and practitioners always need to develop resilience, wellbeing, and good health of the patients through the consideration of the effective doctor-patient relationship (Babichenko et al., 2016). The continuation of the sustainable and care activities by the general physicians and practitioners can be ensured through the enhancement of effective teamwork, resource implications, and adequate services.

Whole body Care of the Patients: The general physicians and practitioners are highly responsible to check the health needs of the patients. Full body check-up can be considered as the major needs of the patients in the case of complex and serious illness. This is acceptable that the majority of the general physicians and practitioners need to advocate, implicate and counsel the enhancement of change management approaches to take care of the care for the patients and the family members.

Collaborative Clinical Activities: The general physicians and practitioners need to adopt the collaborative workplace performance with other members and staffs in the clinic to ensure good discipline, effective care, and successful outcomes. The important clinical information should be flowed ethically and transparently within the team to ensure high-quality services.

Effective Quality Management and Improvement: The general physicians and practitioners are also responsible for maintaining sustainability and quality of the healthcare services in order to assess and monitor the professional abilities. The evaluation of the skill, competency and performance level of the general physicians and practitioners can help them to improve the degree of patient health care services. Overall, it is also essential for the practitioners to evaluate the need for the implication of the change management applications in the healthcare services if needed to improve overall quality of the services. The need of the patients and their family members is highly important in the context of the community services (Dotti et al., 2017). Overall, it is acceptable that the majority of the general physicians and practitioners should focus on effective health care services quality improvement aspects through the consideration of the team working, leadership, planning, data management and information management processes.

Clinical, Ethical and Professional Standards: The effective and transparent professional standards generally help the general physicians and practitioners regarding the development of the essential framework for the improvement of the decision making process under a complex situation. This is also essential to consider the ethical standards to maintain transparency and governance in the overall healthcare system (Lakhoua et al., 2016). The general physicians and practitioners also need to become ethically responsible regarding utilisation of the public resources. Minimum utilisation and maximum output can help in better strategy development and implementation process, which can result in caring and high-quality patient care services.

Effective Evaluation and Monitoring of Discipline: The general physicians and practitioners are highly responsible for ethical, transparent, valuable, and high-quality patient and health care services. It is also important to discuss that the quality of the healthcare services cannot be maintained without the monitoring and evaluation of the discipline of the practices (refai et al., 2016). Discipline and professional standards in mentorship, teaching, and research & development process should be considered to overcome the disciplinary issues for the healthcare system

1.2 Challenges that are facing by Greenway Medical
The general medical service industry has developed concretely over the last years. The physicians in Australia are the first point of contact in the medical system that provides direct treatment to the patients. The service industry has been characterized through low market share concentration as well as degree of fragmentation. The particular industry has made up small-scale business, which is closely tied to the requirements of community. According to the report of Australian Bureau of Statistics, there is nearly half of general physicians operate as the sole proprietorships as well as less than 2.0% of the general practices employ 20 or more employees

1.3 special regulatory, social and ethical circumstances that are operating at Greenway Medical
Greenway Medical presently a positively settled conviction in medical industry of Australia that legal and ethical considerations are irreplaceable to remedial practice in the preparing for the care of the patient. With the advances in therapeutic sciences and creating many-sided quality of the authentic structure in current society and growing consideration, regarding human rights and changing great models of the gathering all around, masters and other wellbeing mindfulness workers alike are frequently received in troublesome challenges in various viewpoints rising up out of systematic practice.

1.4 Identification of Areas of Breakdown in Practices
Within the doctor’s practice in the healthcare industry, the following are the key areas of breakdown -

Communication: This is the major area of breakdown in doctor’s practices. Faulty communication making the system error and it is taking time to resolve the actual issue.

Cost: It is identified that IT system in medical practices is becoming a soar. Therefore, maintenance cost is very hurdle for implementing HER within doctor’s practices.

1.5 Processes and Services that Doctor Performing
Overall, the general physicians and practitioners is acting collaboratively with nurses, counsellors, and other important staffs to deliver integrated and accessible patients care. Aspects should lead, co-ordinate and support the flexibly constructed clinical teams (Bosman et al., 2016). This will help a clinic to contribute effectively to the external clinical group members. Both the internal as well as external team members is acting collaboratively to ensure effective patient-centred services.

1.6 Key Stakeholders, Their Needs and Requirement in Greenway Medical
1.6.1 External Stakeholders: Suppliers, Patient and Financial Community: These are the key stakeholders that plays important role in running the business of Greenway Medical. Suppliers supplies the external instrument including medicine.

1.6.2 Internal Stakeholders
Doctor and Nurses: These are the internal stakeholders that helps in serving the patiaent with care.

2. Solution of Software Package [Vendor and Software]
Insta HMS can be considered as a popular and efficient vendor software program, which is also considered as the integrated software application. It generally enhances the billing, appointment and other types of clinical management activities quite effectively.

2.1 Vendor Background Information

• Insta HMS software application is a clinical service providing software application. The company was established in the year 2008. This is also important to discuss that almost 300 practices have been considered by the Australian practitioners.
• The company is headquartered in Brisbane. The branches of the company are spread all over the Australia in several popular cities. The branches are developed in Perth, Sydney, Adelaide and Melbourne (Tarkanyi et al., 2017).
• Insta HMS is selected as the sixth top most vendors by NEHTA. NEHTA is popular as the handling and implication of eHealth services in the clinical organisations across Australia.
• This specific medical software application is effectively backed by several important stakeholders in the healthcare service providing industry since last 70 years due to efficiency, quality management and higher degree of technological advancement.

2.2 Features and Function
The features and functions are described in the tabular format as follows

2.3 IT Architecture

• It is important to state that Insta HMS generally use the efficient client-server technology-oriented applications during the time of the network processing process, which enhances effective speed of the network.
• This particular software application has established own server for better communication and overcome the challenges regarding dependency on other third-party vendors (Wang et al., 2017).
• This particular software application is also considered as an independent platform, which operates on both Macintosh and Windows.
• Insta HMS is generally developed on the basis of industrial-strength database. It helps to improve the degree of quality and efficiency of the overall activities.

2.4 Risks and Security
Apart from the advantages, there are different types of the security and risk issues. These issues are developed below.

2.5 Security Issues

• In terms of the inefficient and tedious functioning, the record keeping activities can be affected. These challenges can affect the care activities, services providing activities and good health of the patients.
• According to the reports of HRSA, different types of natural disaster can cause the challenges like data loss, record loss etc.

2.6 Financial Risks

• The cost of the EHR system is more than hundred dollars and the consumption cost may be reached to the thousands of dollars. It may affect the financial stability of the clinics.
• After the installation of these services, borrower may get effective results after huge time period. It also may affect the financial stability of the firms (Wenzel et al., 2017).

2.7 Technical Risks
Under limit server challenges, inefficient data transmission challenges, remote scope related challenges as well as the extreme repetition absence can cause technical errors, which can affect the sustainability of the overall outcome.

2.8 Costs of EHR
It is important to accept that the cost of the Insta HMS software applications may go to 750 Australian dollar on yearly basis. On the other hand, the cost of the hardware systems also can be considered. The hardware applications include printers, scanners, peripheral devices, graphic cards and computers. It can go to 1000 Australian Dollars. In addition, the data backup cost also can be considered. The cloud reinforcement system can cost almost 12 Australian Dollars on monthly basis.

2.9 Benefits of EHR
There are several benefits of EHR, which are discussed below.

• It helps to provide appropriate and trustworthy information to the clients.
• It acts like a time efficient model, which records, keeps, and present data in a time efficient manner.
• It also helps in the prescription of the reliable and safe medical oriented and clinical oriented services.
• It also helps the users and clients to save the security and privacy of the data and information.
• It helps to reduce overall operation management cost through the consideration of the reduced paperwork.

2.10 Implementation of EHR
The implication process of the EHR system can be completed through the consideration and application of the following six steps.

• The assessment pjhase generally helps the clients and users to assess the required steps and elements, which should be installed to improve the quality of the healthcare services through adequate leadership and managerial approacjhes.
• In planning phase, the users and clients need to ensure effective planning regarding the intended workflow of the processes and activities. It also includes the development and creation of the unique ideas to improve the efficiency of the overall system. It also helps to develop a contingency plan.
• In selection phase, the users are responsible to select the most cost and time efficient plan through the consideration of the best utilisation of the high quality resources.
• In the implication phase, training, pilot testing, chart abstraction plan, and data migration activities should be ensured.
• In the evaluation plan, the improvement of the quality, stakeholder engagement, collaboration process, and the privacy and security application process is evaluated.
• In the improvement phase, application, care, leadership, ethics, professional standards, and goal development approaches should be considered for better improvement.

References
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Bosman, A. J., Mylanus, E. A., Hol, M. K., & Snik, A. F. (2016). Wireless and acoustic hearing with bone-anchored hearing devices. International journal of audiology, 55(7), 419-424.

Dotti, A., Wenzel, H., Elvira, D., Genser, K., Yarba, J., Carminati, F., ... & Ribon, A. (2017, October). Software aspects of the Geant4 validation repository. In Journal of Physics: Conference Series (Vol. 898, No. 4, p. 042030). IOP Publishing.

Lakhoua, N., Khanchel, F., Laifi, S., & Khazemi, S. (2016). SYSTEM ANALYSIS OF MEDICAL EQUIPMENTS FOR HEALTHCARE MANAGEMENT. Annals of the Faculty of Engineering Hunedoara, 14(4), 17.

Refai, A., Merouani, H. F., & Aouras, H. (2016). Maintenance of a Bayesian network: application using medical diagnosis. Evolving Systems, 7(3), 187-196.

Tárkányi, F., Hermanne, A., Ditrói, F., & Takács, S. (2017). Activation cross section data of proton induced nuclear reactions on lanthanum in the 34–65 MeV energy range and application for production of medical radionuclides. Journal of Radioanalytical and Nuclear Chemistry, 312(3), 691-704.

Wang, G. S., Roosevelt, G., Fagan, K., & Hoppe, J. (2017). Pediatric Emergency Physician Knowledge and Utilization of Prescription Drug Monitoring Program. Clinical pediatrics, 56(1), 80-82.

Wenzel, H., Folger, G., Konstantinov, D., Pokorski, W., Carminati, F., Ribon, A., ... & Genser, K. (2017). DoSSiER: Database of scientific simulation and experimental results (No. FERMILAB-CONF-16-508-CD). SISSA.