Hi, This is some additional detailed instruction for the C816 task: C816 is an applications course and as such presents certain key concepts and evaluates the students mastery by present
Hi,
This is some additional detailed instruction for the C816 task:
C816 is an applications course and as such presents certain key concepts and evaluates the student’s mastery by presenting a problem to which the student must successfully apply those concepts. In a general sense this course covers health information technology systems development in the context. Please note the bolding of the word apply. The most common mistake students make in this task is recapitulating the concepts and not applying them to the scenario. Success in C816 in general, and in its single performance assessment specifically, lies in using the concepts in the reading to explain in concrete terms how the events in the scenario will come to fruition.
The student is advised to follow the rubric. The student should present their responses to each prompt (section or bullet point) of the rubric so as to meet the expectations listed in the right-most column of the rubric. After completing the draft, self-score the draft against the rubric as if role-playing the evaluator who will grade it. Your self-score should indicate you have demonstrated competency or high competency per the rubric. Anywhere the draft falls short, the student should revise to meet the competency or high competency standard.
The scenario presented is a hospital with a hybrid electronic medical record system deployed in its emergency department. The student should consult the direction and rubric for details. However, the providers in the emergency department (physicians, clinicians, nurses, etc.,) document patient encounters using both paper-based and electronic means, because the universal use of laptops or workstations on wheels was deemed unfeasible. The result is a chart for patients in the ED which is partially electronic and partially on paper.
The above situation produces what is known as a hybrid record, a concept with which all students should be familiar from previous courses. The student may wish to refresh her/his memory as to the limitations of such a record, but the primary problem presented in the scenario is that the distributed nature of the patient information across electronic and physical media complicates timely chart completion.
Imagine a patient, Joan A, who presents to the emergency department with vague symptoms that could be anything from a heart attack to anxiety, asthma or a pulmonary embolism. To complicate matters further, the unfortunate Ms. Joan is a diabetic and is on seven medications she takes daily, including a diuretic, Glucophage and something she cannot identify beyond a pink tablet she refers to as a ‘heart pill.” Doubtless ferreting out what could be at the bottom of the chest pain, anxiety, confusion and recent collapse at work which brought her to Anywhere Memorial Hospital ED would require that the patient be examined and tested by any number of well-meaning clinical treatment staff who would be recording their findings and impressions—some on paper, some electronically and perhaps some by dictation to be transcribed onto paper or into some electronic form. Now presume that Joan spends six hours in the ED, is stabilized, found to have nothing requiring hospitalization and is released with instructions to follow up with her family physician Elise Kumar. Unfortunately two days later, on her way to her appointment with Dr. Kumar Joan has another episode of some kind, blacks out while driving, crashes her car and reappears at the Anywhere Memorial ED in the company of a policewoman and two EMTS alternately attending to the woman and scratching their heads. One of the first tasks is to review Joan’s previous ED visit, but with the work of over a dozen people who saw her scattered across paper and electronic platforms, reconstructing an actionable picture of this patient in short order would be a challenge.
Even so, Ms. Joan cuts a wide swath. She has been in and out of the ED and back again in less than 48 hours, totaled her car and in the process damaged public and private property—a light pole and a taco truck unluckily parked where her car jumped the curb. Insurance companies and attorneys have become involved, including Joan’s health insurer and her own attorney. The former questions why they should subsidize another ED visit so soon after the first and the latter is livid she was discharged so quickly the first time. Joan’s attorney has called the hospital threatening a malpractice suit and has subpoenaed her ED records. Everyone wants complete and accurate information on Joan’s medical issues, they want it now, they want nothing missing or there will be hell to pay and that information must come from a record parsed across different media. This is but one example of the challenge of a hybrid medical record.
Returning the scenario in C816, you are tasked with devising a plan to move all documentation to the new electronic EMR. To do this, you need to:
- Identify the problems of continuing a hybrid record system (such as what results from the misadventures of Joan A above)
- Describe how the transition to a completely electronic medical record will address the problems of a hybrid system. Be specific here. How will it help the hospital in the scenario?
- Describe how the roles of the staff will change and be improved. Also, if there will be a downside, discuss that as well.
- Be inclusive—the change to an all-electronic system will not just change the habits and workflow of clinicians, physicians and nurses. Others will be affected, including but not limited to lab techs, HIMS, Billing, IT, etc. The more stakeholders you include the better evaluation is likely to receive your work.
- The student might consider devoting a paragraph to each stakeholder, discussing the changes, the plusses and the minuses, if any
- Identify two HIM professionals who will be involved in and who may even spearhead this conversion project. Discuss their roles in the SDLC, the system development life cycle. The student may approach this in any way she/he sees fit, but we recommend devoting at least one paragraph to each stage of the SDLC and in that paragraph discussing the role of the two HIMs identified. Alternatively and likely just as valid, the student could devote one section of the performance assessment to each of the HIMs. In the section for HIM #1 devote a paragraph for that HIM’s role in each stage of the SDLC. Then, in the section for HIM#2 write paragraphs for each stage of the SDLC and how that HIM will contribute.
The SDLC (systems development Life Cycle) has six stages. It can be iterative. Iterative means the cycle can repeat as needed, though always in the same order. However, for the purposes of this assignment the cycle can be considered to be just one cycle through the following 6 processes beginning with process #1, identify need.
SDLC
- Identify Need
- Specify requirements
- Design or Acquire
- Develop or Implement
- Maintain
- Monitor Results
Hello,
Attached are the instructions of my task for the C816. I was the one who contacted you yesterday regarding the writing assistance.
Remember, on this course, it is crucial that you follow the gridded RUBRICS for each of the Tasks and not the written instructions.
Please follow those RUBRIC instructions through the attached Organization of Task NPN1 for C816 for more explanations.
Systems Development Life Cycle
,
Healthcare System Application
C816 – NOM1 Version 3
C816 Healthcare System Applications, NOM1, Version 3
Competencies:
Competency 7035.1.1: Health Information Systems and Business Process The graduate explains how information systems affect business processes within the healthcare industry.
Competency 7035.1.2: Systems Development The graduate analyzes the different methods of system development for the purpose of recommending an appropriate method for a project.
Competency 7035.1.3: Health Information Systems Management and Security The graduate analyzes the role of management in health information systems and the necessity for security and contingency plans.
Competency 7035.1.4: Healthcare IT Support The graduate justifies the need for information technology support and ways to manage the support processes in healthcare organizations.
C816 Healthcare System Applications, NOM1, Version 3
C816 is an applications course and as such presents certain key concepts and evaluates the student’s mastery by presenting a problem to which the student must successfully apply those concepts.
In a general sense this course covers health information technology systems development in the context. Please note the bolding of the word apply.
The most common mistake students make in this task is recapitulating the concepts and not applying them to the scenario.
Success in C816 in general, and in its single performance assessment specifically, lies in using the concepts in the reading to explain in concrete terms how the events in the scenario will come to fruition.
The student is advised to follow the RUBRIC and not the partial outline in the “Requirements” section of the Task Overview.
C816 Healthcare System Applications, NOM1, Version 3
Scenario:
The stakeholders at Anywhere Memorial Hospital have gathered to discuss their system-wide electronic health record needs. They currently have an 8-year-old hybrid EHR and would like to transition into a fully digitized record. Some of the legacy providers expressed their desire to keep some of the records on paper with the initial EHR implementation. Legacy physicians still wanted to use paper at the bedside because dragging around a COW (computer on wheels) was not their idea of good patient care. This required full-time employees (FTEs) in the HIM department that were responsible for gathering and scanning these records into the system.
Scenario – Continued:
The problem of delinquent medical records from these providers still existed because they didn't always get them completed promptly. There was also a delay when the document scanning system was down. Providers and healthcare professionals on the floor who depended on the images for patient care wouldn’t have access to the paper so HIM staff would sometimes have to find the paper documentation and take it back to the floor. This resulted in lost documents and misplaced patient records.
Scenario – Continued:
Now, there is a new CEO and Medical Director who are both major supporters of a fully digitized record. This would require providers to enter patient information directly into the system. This would cut down on the number of paper records being scanned into the system. There would be no need for dedicated staff to retrieve and scan documents into the system. The younger physicians are thrilled at the idea of a record that they can see in real-time to provide patient care. Legacy physicians are not happy about the change but realize that change is inevitable.
Scenario – Continued:
The Medical Staffing Office and Medical Director have identified a Physician Champion to advocate the record transition and collaborate with the implementation team in creating a training plan for all providers. The CEO and Medical Director have assured them that they will have scribes available to assist with clinical documentation entry into the new system.
The main reason for this transition includes reducing the long turnaround times for completed medical records which greatly impacts the revenue cycle, the manual tracking of deficiencies which is subject to human error, and the disorganization of records which could lead to ineffective outcomes if all information isn't presented.
Scenario – Continued:
. The fully digitized record can automate deficiency tracking, can alert staff when records aren’t completed on time and will keep records organized for easy access. The digitized record also means that there is no need for destruction policies for the paper records in the department.
You are the HIM Director. You are responsible for working with IT to streamline the processes to sundown the hybrid record and implement the new digitized record. You will need to consider the needs of the facility, the staff, and what events are included in the System Development Life Cycle (SDLC) for the project. You are also tasked with creating job descriptions for the new roles associated with the new digitized system and working with the systems analyst to create a training plan for new and existing employees.
Scenario – Continued:
No longer will you depend on people with a cart going to each floor for pickups. You won’t need staff manually assigning deficiencies to scanned paper charts to be completed in the hybrid record. Now you will need staff who have a keen eye for detail that can find errors in the system and reroute them to be corrected. This is a big job!
A.1. Issues in the Hybrid Record
Health Information Management: Concepts, Principles, and Practice, 6th Edition by Oachs and Watters
Chapter 12, Health Information Technologies, beginning on page 101 online.
The submission accurately describes the issues with clinical documentation in the hybrid record in the scenario.
A.2. Fully Digital and Hybrid Records
Health Information Management: Concepts, Principles, and Practice, 6th Edition by Oachs and Watters
Chapter 12, Health Information Technologies, beginning on page 429 online.
The submission accurately explains how a fully digital record will both address and solve the issues caused by the hybrid record in the scenario
A.3. Staffing and the Transition to a Fully Digital Record
Health Information Management: Concepts, Principles, and Practice, 6th Edition by Oachs and Watters
Chapter 13, Health Information Systems Strategic Planning, beginning on page 435 online.
The submission appropriately describe how the roles of existing staff members in the HIM department as described in the scenario will change with the transition from a hybrid record to a fully digital record, and the changes are accurate.
A.4. Roles of HIM Professional
Health Information Management: Concepts, Principles, and Practice, 6th Edition by Oachs and Watters
Chapter 13, Health Information Systems Strategic Planning, beginning on page 429 online.
The submission accurately explains the revised roles and responsibilities of 2 HIM professionals in the SDLC for the implementation project described in the scenario, and all of the explained revised roles and responsibilities are appropriate for both professionals.
COURSE INSTRUCTORS FOR C816
Junius Logan, MD
Direct phone – 385-428-7846
Diana L Gardner, MBA-HM, RHIA, FACMPE, CPC-Ret., MCCT, PMEC
Direct phone – 385-428-4694
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