IT-Possibilities for a hospital setting

1. IT-Possibilities for a hospital setting Presented by Sandra Jones CS 250 Instructor: Winnie Li

2. Costs and Benefits

3. Implementation costs for electronic charting will be significant. • Hardware has to be purchased and installed, this includes wireless routers, and computers • Software and licenses have to be purchased • Staff productivity will decrease during training and for several weeks thereafter Costs and Benefits

4. Ongoing costs include licensing fees, hardware updates and replacements • Even though cost of implementation can be substantial, however, it will be offset by the benefits • Electronic charting allows for more effective communication  clinical pathways can be monitored more effectively Costs and Benefits

5. Transfers between units can be facilitated, possibly reducing empty ICU or step-down unit beds. • Patient records are easily accessible  patients returning to the ER frequently may not have to undergo extensive diagnostic testing if prior results are immediately available Costs and Benefits

6. Additional benefits are faster revenue generation as a result of faster claim generation • Computerized inventory management can help reduce supply costs and improve supply chain management • Patient/staff ratios can be monitored and nurses floated to other units according to staffing needs Costs and Benefits

7. Obstacles to Implementation

8. Changing from a paper system to electronic charting presents a major change to staff routines • To ensure acceptance of change it is VITAL to keep the staff informed and provide adequate training • Staff need to see the computer as a tool, not an obstacle Obstacles to implementation

9. The major resistance will come from staff who feels threatened by new technology. Nurses, physicians, and other staff may feel insecure and consider the change a ‘personal attack’. • Clear guidelines from the administration before and during the go-live phase will help reduce these anxieties • Additionally, a support system comprised of IT-staff, and fellow clinical staff members is essential Obstacles to implementation

10. Security Concerns

11. Providers of healthcare IT-products are aware of the need for strong security measures • The software chosen should be HIPPAA-compliant and carry assurances from the software vendor • The hospital network needs to be secured against intruders Security Concerns

12. The biggest security risk comes from employees not taking proper precautions • Guidelines for passwords need to be established, including length of the passwords, frequency of password changes • Sharing passwords or letting others log in with ones user name should be strongly discouraged • To improve compliance, staff should be informed that the password serves as a signature, and their license may be at risk due to others action under their name Security Concerns

13. Properly implemented and secured an electronic chart protects privacy better than paper charts • A log is kept of who accessed/changed records  this will discourage employees from accessing charts of unassigned patients • The system can be set up to deny access to patients who are not assigned to a specific employee, or deny access to clinical data for the administrative staff Security Concerns

14. Patient Outcomes

15. Improvement of patient outcomes can be achieved, if an electronic system is utilized to its full potential • Staff need to be trained to see the computer as a tool, but also realize its limitations • A computer program can for example analyze trends in a patients vital signs more efficiently than a human, however, a nurse or physician will be needed to determine if an intervention is needed Patient Outcomes

16. Documentation will be legible, this can greatly reduce potentially fatal medication/treatment errors • Within limits, software can monitor compliance with best practices COMPUTERS cannot replace clinical skills • Discharge paperwork will contain the most current information decreases the risk for re-hospitalization and subsequent monetary penalties from insurance companies Patient Outcomes

17. http://www.newyorker.com/reporting/2011/01/24/110124fa_fact_gawande?currentPage=allhttp://www.newyorker.com/reporting/2011/01/24/110124fa_fact_gawande?currentPage=all • https://www.evernote.com/shard/s2/res/5efdc3a3-f9ec-4793-bb73-cebbd8fd1c1b/use+of+EMR+in+US+hospitals+NEJM+march+2009.pdf • http://www.healthit.gov/buzz-blog/electronic-health-and-medical-records/emr-vs-ehr-difference/ For Further Reading