Background Statement
The case presents the apparent issues within the healthcare system that are related to the inefficient mandatory implementation of the Unified Medical Record System (UMRS). It is vital to understand the current position and value of electronic medical records within the healthcare setting. Glied and Sacarny (2018) state that “the efficiency payoffs from EMRs may only appear after long lags, as hospitals may be slow to learn how to use the platforms effectively” (p. 753). DeAngelis (2019) argues that the usage of EMRs “is often contentious, time-consuming, and expensive” for hospitals due to their lack of optimization (p. 319). In order to implement these systems in an efficient manner, technology providers must communicate with personnel who is going to work with them.
The organization consists of an extensive healthcare system, and the involved sides include the specialists of the hospital, the UMRS committee, Medicare, and the chief information officer (CIO). The role of the CIO is to optimize the usage of technology systems of a healthcare system, as well as serve as a link between technology providers and medical personnel. The primary issue is that the committee that manages the UMRS declined to address problems that make this system unfit for use adequately. Moreover, Medicare has mandated healthcare organizations to change their inner workings to include electronic medical records (EMRs) despite specialists’ complaints.
Specialists voiced their concerns regarding the system’s complexity and difficulty in use and stated that it decreases their productivity and revenues for the healthcare system by a significant amount. The case shows that the UMRS lacks compatibility, is poorly integrated, and is hard to use outside of primary care. However, the committee refused to modify the system in order to make it more suited for specialists. It created a secondary issue with the morale of the workers and falling revenues.
Analysis of the Causes and Effects
The main issue is caused by the lack of communication between the UMRS committee and the affected party – specialists of the hospital. The committee’s refusal to modify its system in order to resolve the conflict shows that the caveats of the application of the system within the hospital were not correctly displayed to them. In this case, the role of the chief administrator would provide better insight into the state of the hospital’s IT systems. I believe that it is crucial to prevent any further escalation of physicians’ discontent since it can grow from a secondary cause into a primary issue with a lack of personnel in the hospital. This role, however, makes a potential resolution that I would choose more subjective.
Moreover, while the implementation of the UMRS is a positive change in itself, it puts an additional strain on the hospital resources, both human and financial. With the mandatory implementation of EHR and the HITECH act, information security adds significant pressure on healthcare organizations (Kuo, 2018). To support such a system, the hospital will need to expand its IT team, further decreasing its cost-efficiency. Kuo (2018) states that “lack of ISM awareness can make all technical solutions ineffective” (p. 370). As a chief information officer within the organization, I might be able to pinpoint potential opportunities for the optimization of the system and evaluate the necessity of additional training of the employees.
Strengths and Weaknesses of the Organization
The primary strength of the hospital in relation to these issues is the fact that it has an already established local electronic health record system. It could serve as a basis for future development toward the UMRS. It signals that the medical personnel of the organization already has the knowledge and experience of working with EHRs. Due to this fact, it is safe to assume that the physicians have trouble with using the UMRS-provided software due to its inefficiency, whether it is an issue with its design or structure.
While the diverse skillsets of medical staff allow the hospital to provide health care at a higher quality, it hinders its ability to use the mandatory system. Therefore, the weaknesses of the hospital lie in its multifunctionality and ineffective communication with the UMRS committee. The variety of specialists who work at the hospital put additional requirements for the system to be used in an efficient manner, however, the organization was unable to achieve this result by contacting the committee. Moreover, some specialists might not be tech-savvy enough, which can be fixed by assigning them to a training program.
Proposed Solutions
As the chief information officer, the first solution I would propose is to exclude specialty practices from the UMRS immediately in order to appease specialists and reduce the financial strain on the healthcare system. It is crucial to keep as many specialists available as possible to provide medical services to patients, which is the primary goal of the healthcare system. To achieve this result, it is necessary to convey this message to Medicare and the UMRS committee to propose this temporary setback to their mandatory enrollment of EMR.
As the CIO, it is my role to resolve any potential conflicts between technology providers and the hospital. Kuo (2018) states that “the goal of EMRS is to improve the traditional workflow of paper-based systems and help health professionals effectively retrieve medical records from different hospitals, thus conserving health and medical resources” (p. 369). The system will be returned to mandatory implementation once it will show a substantial increase in the efficiency of specialists in the current setting in regard to the quality of care without causing a slowdown. Due to its complexity, this technology requires additional training of the stuff, which is crucial for its proper assessment. The main benefit of this approach is the quick resolution of the specialists’ concerns at the cost of lost benefits provided by Medicare from the full implementation of the EMRS.
The second option is to work on the compatibility of data input between the local hospital system of electronic records and the UMRS. Glied and Sacarny (2018) state that “alternative EMR policies may still yield efficiency improvements” (p. 753). It is necessary to discuss with technology providers if it is technically possible to set up the automatic conversion of patient data from the current EHR system that is used by the hospital, assuming that it is adequately suited for use by specialists. If converting EHRs generated by the hospital into the UMRS-friendly data format can be enough to resolve the situation, it would be more cost-efficient in the short term to use this approach. DeAngelis (2019) argues that “EMRs must interface with other EMR systems to facilitate communication between providers” (p. 325). The primary benefits include the satisfaction of both the specialists and Medicare, however, this approach puts an additional strain on the local information technology team as they will be responsible for the compatibility of data and updates of a new conversion system.
References
DeAngelis, J. (2019). Who guards the guardians? Simplifying the discovery of electronic medical records. University of Colorado Law Review, 90(1), 317–364.
Glied, S., & Sacarny, A. (2018). Is the US health care system wasteful and inefficient? A review of the evidence. Journal of Health Politics, Policy & Law, 43(5), 739–765.
Kuo, R.-Z. (2018). EMRS adoption: Exploring the effects of information security management awareness and perceived service quality. Health Policy and Technology, 7(4), 365–373. Web.