Chapter 24: Case study 1 Western Heights Hospital (WHH) is a 1125-bed, 5-hospitalacademic healthcare system servicing central and western Massachusetts.
Answer the questions associated with those case studies in a cohesive, APA-formatted paper. Must be three to four double-spaced pages in length (not including title and references pages) and formatted according to APA style. Must use at least two scholarly or credible sources. Chapter 24: Case study 1 “Western Heights Hospital (WHH) is a 1125-bed, 5-hospitalacademic healthcare system servicing central and western Massachusetts.
WHH is the only designated Level I Trauma Center for adults and children in the area and is home to New England’s first hospital-based air ambulance and the region’s only Level III Neonatal Intensive Care Center. WHH launched a 5-year strategic plan with a fundamental goal of a system-wide move from a predominately paper environment to an electronic one.
Phase I included implementation of an EHR system consisting of order entry for all laboratory, radiology, and patient care orders. Additionally, clinical documentation was implemented, including admission assessments and all nursing flow sheets.
The nursing informatics counsel, a 25-member group of nurses representing all disciplines, developed the clinical content. The clinical content was custom built using both free text and structured data entry fields within the application.” “Three months after go-live, hospital leadership is reporting that it is unable to report on various state and federally man-dated quality measures.
These measures track healthcare quality based on national standards, are compared to nationally accepted benchmarks, and are used to plan ways to improve quality.
Leadership has communicated that the reports generated by the system are incomplete and are putting the hospital at financial risk due to lower reimbursement rates. Clinicians are eager and excited to continue to develop content in the application.
However, the project’s program manager is proposing a stabilization and optimization approach and does not want to go forward with content development until the issue of reporting has been assessed and addressed”
• Assuming that you are the clinical content manager leading reporting efforts, recommend the approach you would take to address the reporting problem.
• Describe how the effort of changing preadmission testing data collection from paper to the Electronic Health Record System (EHR) can be approached. • Using Patient Safety and Quality Research Design (PSQRD) methodology, identifying area of quality improvement in the hospital setting, recommend a process plan and identify the expected outcomes.
Chapter 25: Case study “A 50-member multispecialty medical practice has decided to implement a new EHR system. The practice chooses the new EHR system based on both clinical functionality and the practice management and billing functionality that is demonstrated specifically because the EHR sales representative repeatedly states that the new EHR can reduce patient visit times (thus increasing the number of patients a provider can see in a day) and increase reimbursement to the practice by helping the practice “correctly code “to the highest E/M (evaluation and management) code available.
While the healthcare providers and practice administrators are impressed with the new EHR, the new system will cost$2,000,000 for the EHR software and$250,000 for the associated hardware, plus yearly maintenance fees of$125,000. These costs exceed the practice’s budget. One day, while meeting with the vice president of a community hospital, the practice administrator mentions this issue and how the practice will have to delay purchasing an EHR due to the budget constraints.
The VP states that the hospital will be happy to cover85% costs for the new EHR system if the practice agrees to (1)consider their hospital first before sending a patient to any other potential competitors including not just ER or inpatient admission but outpatient diagnostic services and hospital-owned specialty practices, (2) include the hospital’s logo on patient education materials printed from the system, (3)use the hospital’s template for designing data entry pages for practitioners, and (4) use the hospital’s template for the patient portal in the design of their patient porta”
• Discuss whether the proposed course of action would be permissible under current fraud and abuse regulations.
• Explain common issues related to the use of EHR and healthcare fraud. • Discuss how the proposed EHR could potentially facilitate healthcare fraud. Must be three to four double-spaced pages in length (not including title and references pages) and formatted according to APA style. Must use at least two scholarly or credible sources.