Scenario
Big Sky Health System, the largest healthcare system in a predominantly rural state, has just bought Windy City Hospital from Health Management Partners (HMP). As part of the purchase agreement, Big Sky agreed to a three-year transitional services agreement from HMP, which allows that Windy City Hospital will continue to use their EMR and includes a clause allowing Big Sky to cancel the agreement with 90 days’ notice. Windy City has been using Meditech, whereas Big Sky uses Cerner for its EMR systems. Per the agreement, HMP will provide some technical support for their system, but their customer service does not have a positive reputation.
At the time of the purchase, Big Sky had hoped to utilize this agreement by transitioning Windy City to Cerner at the end of the three-year period. This timeline was ideal for Big Sky, as they also have plans to implement a new revenue cycle software around the same time. By syncing the two technology updates, it was hoped that the projects could be managed in concordance and thereby avoid multiple, separate initiatives.
However, after purchasing Windy City, the compliance and audit team began a fuller investigation into the Meditech system. All claims were to be audited for accuracy before billing. In addition, all bills were held for auditing purposes to ensure accuracy. More than $10 million in claims have been placed on hold, with the number increasing. During the audit period, it was discovered that Windy City did not place much emphasis on charge capture and accuracy, creating major gaps and a highly manual charging process. For example, nurses were manually charging for medications when dispensing to patients, resulting in many mischarges.
The compliance and audit team’s final report stresses that it is vital to automate the charge process and allow the auditors to exit this billing process. At this point, the options seem to be either 1) rebuild many sections of Meditech or 2) accelerate the transition of Windy City to Cerner ahead of the original three-year schedule.
Directions
As the chief information officer of Big Sky, you are responsible for considering these two options and developing an EMR transition proposal for the executive leadership team.
- You should include an executive summary at the beginning of your proposal report. However, it is generally recommended that summaries be created last in the sequence of developing a report, so that you can pull from the body of your report to highlight the most important information for the executive leadership team.
- Then, articulate your proposal for addressing the EMR issues identified by the audit. Indicate the option that you think is optimal for Big Sky Health System in this situation. In other words, would you attempt to fix the existing EMR system or transition to Cerner more quickly?
- Next, defend your proposal using the details provided in the scenario and your knowledge of automation and integration technologies and techniques that can increase efficiency in healthcare. Be sure to do the following:
- Analyze the impact of your proposal in terms of its potential value for Big Sky. In other words, to what extent does your proposal reflect a strategic approach to accomplishing the goal of further automating EMR processes? Support your claims with evidence from the health information management literature.
- Explain how your proposal would likely impact both the short-term and long-term productivity and efficiency of your organization. Support your claims with evidence from the health information management literature.
- Finally, discuss the high-level implementation considerations implied by your proposal. For example, if you are proposing to fix the existing system, how would you go about requisitioning and managing the rebuild? If you want to accelerate the transition, how would you secure the additional resources needed to transfer all of the existing records? Specifically, be sure to address all of the following considerations:
- Explain the advantages and disadvantages of outsourcing within healthcare organizations with an emphasis on impacts to efficiency.
- Describe the legal and ethical considerations that Big Sky must address for contracting work as they relate to your proposal.
- Describe how you would go about developing an RFP for the work required to implement your proposal. In your description, be sure to illustrate the negotiation skills that could be used in securing and managing contracts and contracted work.
What to submit
EMR Transition Proposal
Your proposal report should include your recommendations, rationale, and implementation considerations for addressing the EMR issues resulting from your organization’s acquisition of Windy City Hospital. It should be formatted as a Word document ranging from 1,000 to 1,500 words in length and cite any references.
Sources
Kathleen M. LaTour, & Shirley Eichenwald. (2013). Health Information Management: Concepts, Principles, and Practice, Fourth Edition: Vol. 4th ed. AHIMA Press. pages 84–99 of Chapter 4
Kathleen M. LaTour, & Shirley Eichenwald. (2013). Health Information Management: Concepts, Principles, and Practice, Fourth Edition: Vol. 4th ed. AHIMA Press. Chapter 14
Kathleen M. LaTour, & Shirley Eichenwald. (2013). Health Information Management: Concepts, Principles, and Practice, Fourth Edition: Vol. 4th ed. AHIMA Press. Chapter 16, PP 449-452. Chapter 29 PP 869-871.
Johnson, K. B., & Ehrenfeld, J. M. (2018). An EPIC Switch: Preparing for an Electronic Health Record Transition at Vanderbilt University Medical Center. Journal of Medical Systems, 42(1), 1.
Richins, S.M. (2015). Emerging Technologies in Healthcare (1st ed.). Productivity Press. Chapter 3, Chapter 6.
Kathleen M. LaTour, & Shirley Eichenwald. (2013). Health Information Management: Concepts, Principles, and Practice, Fourth Edition: Vol. 4th ed. AHIMA Press. Chapter 5 PP 125-128
Larch, Sara M,M.S.H.A., F.A.C.M.P.E. (2012). Three Payer Strategies to Increase Revenue. The Journal of Medical Practice Management : MPM, 27(5), 268-71.
Kelahan, L. C., Kalaria, A. D., & Filice, R. W. (2017). PathBot: A Radiology-Pathology Correlation Dashboard. Journal of Digital Imaging, 30(6), 681-686.
Kathleen M. LaTour, & Shirley Eichenwald. (2013). Health Information Management: Concepts, Principles, and Practice, Fourth Edition: Vol. 4th ed. AHIMA Press. Chapter 26 PP 818-832.
Ruiz Morilla, M. D., Sans, M., Casasa, A., & Giménez, N. (2017). Implementing technology in healthcare: insights from physicians. BMC Medical Informatics and Decision Making, 17(1), 92.
Kathleen M. LaTour, & Shirley Eichenwald. (2013). Health Information Management: Concepts, Principles, and Practice, Fourth Edition: Vol. 4th ed. AHIMA Press. Chapter 12 PP 308-327, Chapter 13 PP 343-350, 350-354, 356-361.
