EMR Sharing Health Information
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Transcript of EMR Sharing Health Information
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EMRSharing Health Information
By: Gregory-Thomas C. StangerBUS 550 The Contemporary Firm
Spring 2013, Dr. Minder Chen
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Intro• EMR: 1970s• Allow for electronic exchange of patient histories with
other HP• Reduce medical errors• Bring better consistent care• 2005: only 41% US hospitals• Rising Trend in “health consumerism”• $34b in America’s Annual healthcare higher efficiency and
safety• Network effect: Hospitals->Hospitals, HCP->HCP
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Case Study
Canadian Medical Assessment (CMA)20 Cases in primary careObjectives: ID & capture best practices in EMR
Paterson, Grace I. et. Al. Cross-Canada EMR Case Studies: Analysis of Physicians’ Perspectives on Benefits and Barriers (2011). Electronic Journal of Health Informatics. Vol 6(4):e34.
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1. How are EMRs implemented?2. How are EMRs used in clinical practice?3. How can EMR adoption be increased and sustained?
Three primary research questions
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Tools Used
1. EMR System and Use Assessment Survey
2. Interview guide for site visits3. Transcription codes4. Observation guide5. Case study report template
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EMR System and Use Assessment Survey
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http://www.cma.ca/EMRCaseStudies.
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Themes in EMR CSClinic culture and leadership
MotivationEMR capabilities and use
Technical issuesScanning
Workflow and process change-organization impactImplementation strategy
Patient safetyKey success factors and lessons learned
Facilitators of EMR adoptionQuality of care
Costs versus benefitsEfficiency
Lessons learnedFuture plans
Benefits of EMRBarriers to EMR adoption
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The benefits of EMR system functions from the interviews
“Benefits of EMR”
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“Benefits of EMR”
Intrinsic: peace of mind, provisions of better care and patient satisfactionPractice: Reduced physician turnover, saved space, improved morale, practice audit, creation of dataFinancial: As a whole, generally reduce cost
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Fear of change/mistakes Need to scan documents and possibility of introducing errors
from this and/or data entry Lack of speed and reliability Need for expert IT support Start up delays due to need to populate Changes to office configuration Lost productivity Insufficient interoperability- “electronic island” Outdated/restrictive legislation Fee-for-service reimbursement model
“Barriers to EMR Adoption”Addressing: attitude, misconceptions, lost productivity, lack of interoperability, outdated and restricted legislations
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Discussion
Picture #1 Picture #2
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Conclusion of findings
• Social Benefits>Barriers• EMR in medical schools• Reengineer practice and master EMR use
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Conceptual Model toward a Competitive Advantage
Richards, Rhonda J., Prybutol, Victor R., and Ryan, Sherry D. Electronic Medical Records: Tools for Competitive Advantage (2012). International Journal of Quality and Service Sciences. Vol 4 No. 2, pp. 120-136.
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Triggers toward EMREconomic strains
Rising HC costIncreased HC demand
Customers seek increase in quantity and efficiencyPolitical strains
Healthcare as a Right(American Recovery and Reinvestment Act of 2009)
Presidential Initiatives for EMR implementation, 2014Financial incentives, 2011
Financial penalties to HCP, 2014Keep updated systems
Legal StrainsHIPAA rules
Office of the National Coordinator for Health Information technology
Health Information Standards CommitteePrivacy LawsSecurity Laws
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IT Strategy via EMR Standards and Regulation
InteroperabilitySupport Existing technologies
National Health Information Network
Network and Integration(for alignment w/ 3rd pt)
Sharing information to other HCP, payers, and patients
Emerging technologyintegrate emerging technologies adoption
Review of emerging technologiesEarly adoption
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Strategic AlignmentIT linkage with Clinical Administration
Streamlined SchedulingIntegration of Billing
National Health Information NetworkShare clinical dataAvoid Duplications
Trained in Technology
IT linkage with PhysiciansDM, user, admin, purchaser
Commitment to adoption/useBear cost while insurance companies, patients,
and government associations Physicians linkage to clinical administrationPhysician play role in scheduling, doc, bill,
referral, Rx services, storage and data mining for competitive use of information
Implementation vs. need financial benefit
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Patient IS interface with users; web apps: apt., registration, Rx
services and surveys.Decreased ADR, Antibiotics, hospital stay, and cost
Enhanced satisfactionQuality care from database of health information and
DSS->ADR->FDA->Drug safety monitoringGlobal health risk via demographic data
Outcomes leading to competitive advantage
Clinicalcomputerized patient records, document management systems, data warehouses, distribution networks, and
telematics. Allow for speed, reduced errors, and cost savings.
Integration of Dx, treatment codes->faster collectionsPhysicianEfficiency
Access to data, automated Rx, more support
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Competitive Advantage
• Firms compete on the basis of unique resources
• High Quality Care• Satisfaction• Outcome Measurement and
Monitoring (MU)• Affordable Healthcare
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PACIS NEXTGEN REGION V North- User Group Meeting
• Contract Modules• Integrated PIR• Patient Portal• Clinical Viewer• Patient Keeper• PACIS.com
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Risks and Disadvantages of EMR integration
Information transparencyWealth of informationPrivacy-> inadequate quality of careRising cost of EMR
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PrivacyDo privacy protection laws inhibit
technology diffusion of EMR?
Ex: RFID privacy bill in 2004 in Utah House of Representatives, designed to prevent matching RFID data with consumer’s personal information
Miller, Amalia R. And Tucker, Catherine. Privacy Protection and Technology Diffusion: The Case of Electronic Medical Records (February 2009). NET Institute Working Paper No. 07-16.
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PrivacyReduction in medical identity theft
Accomplished by:Issues with data securityIssues with confidentiality
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PrivacyReduction in medical identity theft
Privacy laws can increase network costs or network benefits from EMR adoption.They can improve patient compliance:
“69% of survey respondents state that they are very concerned or somewhat concerned that an EMR system could lead to ‘more sharing of your medical information without your knowledge’”
They can also impose addition network costs:
“It is more expensive to design a system that has the additional flexibility to limit the flow of information by the type of detail in a patient medical record and by the type of external destination, irrespective of how many patients refuse to have their records shared.”
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adopt*ijt =f(NetworkNetBenefitsEMRijt, StandAloneNetBenetfitsEMRit|PrivacyLawit)
Conceptual Model of Hospital EMR Adoption
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Conceptual Model of Hospital EMR Adoption
ICU:Information they collect is only used at the time and not useful when it is transferred
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Network effect
Contingent on:(1)Willingness of patient to provide health
information and have information transferred electronically across HCP
(2)Other HCP can exchange health information
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Tables/Data in Study of Privacy Laws on EMR adoption
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Privacy and EMR Adoption/ Network Effects
“In states without hospital privacy legislation, EMR adoption by one hospital increases the probability of a neighboring hospital adoption by 7% overall using cross-sectional data and by 2% every there years using panel data”
Network effect:No measureable network effect in states with privacy protection legislation.
EMR adoption:“… state privacy protection of hospital medical information is inhibiting EMR adoption by around 11% per three-year period, or 24% overall in states with such laws.”
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T/F
From the Case Study, in states with privacy protection laws the EMR
adoption rate is negative?
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MC
Which of the answers below is NOT a trigger from the conceptual model of
implementing EMR?
A.PoliticalB.EconomicC.PrivateD.LegalE.None of the above
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MC
In states _________ privacy protection laws, there was no measurable effect on
network effect according to the case study.
A.WithoutB.With C.With littleD.None of the above
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THANK YOU!!!