Scenario 1: Combining data in an EMR system
A large healthcare enterprise in the Mid-Atlantic region that was created by a merger owns two acute care hospitals, a rehabilitation center, an outpatient surgical center, and three long-term care facilities. Each of these institutions uses a different EMR system. Admitting privileges extend to 550 physicians who have office systems that interface with at least one of the acute care EMR systems.
The vision is to create an environment to support communication, care coordination, and data sharing across the organization in preparation for a regional EHR system. The organization also wants to move quickly in order to take advantage of the incentives offered by the government and meet mandatory requirements.
Executives have decided to focus on the acute care facilities first and use lessons learned there to integrate the other centers at a later time. Hospital A uses certified EHR applications and has implemented ancillary systems, CPOE, and clinical documentation whereas Hospital B has a highly customized, beloved old mainframe computer that is outdated and no longer supported by the vendor. Instead of selecting a new system for both hospitals, the software programs used in Hospital A will be implemented in Hospital B.
- There are many types of barriers that can interfere with the implementation of a unified EMR system. Give an example of at least three barriers types that exist and could cause issues given the scenario above.
Scenario 2: PHR Implementation
An academic medical center in the western U.S. recently adopted a commercial EHR and plans to adopt and integrate a PHR with its EHR. The hospital CEO drafts a vision statement designed around improving how their patients experience health care.
The CEO convenes a meeting of the chief technology officer, the chief nursing informatics officer, the chief medical officer, and a liaison from the EHR vendor to develop a strategic plan for the PHR. This meeting includes a specific list of functionalities, a timeline for their implementation, and considerations regarding the effects of the PHR on current workflows and revenue streams.
- Imagine that you are the chief technology officer for the hospital. What PHR functionalities will you recommend be implemented first? Why?