Four Core It Applications
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Four Core IT Applications Paper
Technology is derived from the Greek word tekne, meaning an art or craft. Logia is an area of study; thus technology is the study or science of crafting. Clinical information technologies are changing the way healthcare is delivered. Networks of delivery systems and health plans are being created by research organizations to support innovation and the advancement of technologies in healthcare. This clinical information technology is leaning towards “prevention-oriented, consumer driven model of healthcare.
Many factors prompt the innovation of new technologies: Consumer demand, clinical accountability, medical advancements, research agendas, population health targets and the capacity and resources for technology development as an industry. Innovation promotes the industry to manufacture high volumes of medical devices and thus market them to the healthcare providers. This “technology push” is sometimes resistant with the “clinical pull” of technology because clinicians as well as physicians often resist the change of new technology due to its value or its impact on day-to-day workflow.
With the increasing access to computers, doctors are now able to look up information on their patients. Half of the physicians either dont have digital health records or the ability to write electronic prescriptions. According to Marie Reed, many physicians still lack access to clinical information technology in their practices despite the substantial growth rate. Barriers to physicians adopting clinical IT include: Start-up and maintenance costs and significant effort and costs of changing workflow to use IT effectively. According to the Center for Studying Health System Change, promoting digital health data may encourage more doctors to go high-tech.
Patient care has become complex due to the widespread use of information technology in routine care. Health care providers as well as nurses must keep track of all pertinent patient information and failure to do so leads to detrimental effect on the patients life. CIS clinical information systems are “large, computerized database management systems that support several types of activities that include physician order entry, result retrieval, documentation and decision support”. CIS is intended to replace medical records department of a hospital or any other medical institution. Physicians and clinicians can safely and quickly access information, order medication and treatments and implement appropriate care. CIS will hopefully improve productivity, increase quality care and reduce costs across the organization.
CIS establishes direct electronic communications with other ancillary systems such as: pharmacy management system, laboratory management system and radiology management system. This allows the CIS to communicate physician orders to these systems and thus deliver status reports and order results back to the provider. Under a goal set by President George W. Bush, all Americans are supposed to have electronic health records by 2014. His administration has funded the U.S. office of the National Coordinator for Health Information Technology, but has relied on the private industry to use information technology in the health sector.
A relationship between patients, providers and third-party payers in health care can affect all aspect of the patients experience due to the complexity of payment mechanisms. The payer rules can affect the patients choice of provider thus “affecting scheduling, registration and intake processes, the delivery and documentation of care and traditional billing procedures”. Payer rules can be fragmented to different institutions causing revenue leakage and dissatisfied and confused patients. It becomes more complicated when the issue of “pay for performance” is brought up. This is an attempt by many payers to define and reward high quality care. This has the provider follow a defined course of care rather than achieving specific results.
The integration of clinical processes with the revenue cycle is becoming a challenge. For example, it would be effective and helpful if when ordering medication for the patient, the physician could be alerted whether the medication is covered by the patients insurance. It will allow the patient to decide whether to pay for the medication out-of-pocket or the physician to order alternative medication. This would assist the physician in complying with payer-specific requirements and thus save time for the physician since the pharmacists usually calls back for an alternative prescription once the patient becomes notified the previous medication is not covered.
The decision making process of the patients care done at the front end of the revenue cycle is critical. Determining insurance coverage, patient financial responsibility and the approach for treatment at the time of scheduling will enhance the efficiency of the revenue cycle. The revenue cycle consists of related processes: Contract negotiation to patient access, patient treatment, billing, remittance and contract performance analysis back to contract negotiation.
Advanced clinical systems have enormous amount of clinical information throughout the patients process of care that it is automatically translated throughout the revenue cycle. Some codes that are generated are automatically captured for the revenue cycle and are usually generated by orders