HIM 500 Southern New Hampshire University Healthcare Informatics Discussion

HIM 500 Technology Information Featherfall Medical Center has an existing admission discharge transfer (ADT)/master patient index (MPI) system that was developed in-house and implemented over 20 years ago. By now, all of the original programmers have resigned or retired. The system is cumbersome to manage and update to meet the current needs of the center. This has also led to the compliance, ethical, and governance issues previously stated. An RFP was sent out to two vendors: Intel (SOA Expressway for Healthcare) and Alert (Admission Discharge and Transfer [ADT]). Key portions of the RFP have been summarized to allow for easy comparison. The responses to the functional requirements have also been provided for review. Demonstrations were conducted at the Center, and both systems looked good. The MPI module is preferred on Intel, and the ADT system is preferred on Alert; however, both systems were received favorably. The committee went to see both systems in operation and liked them both. References were checked on both systems. The references for Alert were glowing. All of them said that the system was good and the people were great to work with because they wanted their new company to succeed and grow. However, given their small size, they might lack the resources of a larger company. The references on Intel were excellent as well. The only negative about Intel was that the company is quite large and was sometimes slow to respond to what the company saw as minor problems. The next release of Alert is due out in 6 months and of Intel is due out in 8 months. The Committee has used the following tables to summarize and compare the information that was gathered and is awaiting your recommendation before final decision is reached. System Comparison Topic Intel (SOA Expressway for Healthcare) Alert (Admission Discharge and Transfer [ADT]) Cost of interface Cost of software Cost of hardware Implementation costs Other costs Annual maintenance Training costs Number systems in use in hospitals Length of time in business Stability of company $378,000 $465,000 $375,000 $275,000 $110,000 $75,000 $350,000 364 $238,000 $325,000 $400,000 $175,000 $120,000 $65,000 $264,000 12 30 years Good 3 years Good RFP Response from Intel (SOA Expressway for Healthcare) System Functions Admit patient to ER Admit patient to inpatient status Admit patient to outpatient status Transfer patient from room to room Transfer patient from inpatient to outpatient Transfer patient from outpatient to inpatient Transfer patient from ER to inpatient status Discharge patient from ER Discharge patient from inpatient status Discharge patient from outpatient status Notify housekeeping when patient discharged Notify HIM when patient admitted Meets UHDDS requirements Meets HIPAA requirements Contains required demographics Automated verification of insurance GUI technology User friendly Delete patient from system Multiple levels of security Password protected Audit trail Biometric capable Reads barcodes Edit demographics Edit insurance Allow for 4 insurance providers Prints standards reports at specified periods Ad hoc reporting Admission list Discharge list Transfer list Standard X X X X X Next Release Not Available Custom X X X X X X X X X X X X X X X X X X X X X X X X X X X Looks for potential duplicate medical records Quality edits built into system SQL/Oracle database Runs on Windows 8 Enterprise-wide ready Merge medical record numbers Allows for aliases Maintains old medical record numbers Maintains former names Allows at least 999 patient visits Data dictionary Three-character service field Allows housekeeping to notify admission that room is ready Online no-bed list Sends out announcements to employees/staff Generates list of patients by physician Generates lists of patients by unit Calculates census statistics Performs medical record number queries Performs patient name queries Standardizes, secures, and governs access to master patient records Standardizes, secures, and governs access to master provider indices Standardizes, secures, and governs access to document exchanges Services for building interoperable healthcare networks Authentication and authorization Management and monitoring Transport Layer Security X X X X X X X X X X X X X X X X X X X X X X X X X X X RFP Response from Alert (Admission Discharge and Transfer (ADT)) System Functions Admit patient to ER Admit patient to inpatient status Admit patient to outpatient status Transfer patient from room to room Transfer patient from inpatient to outpatient Transfer patient from outpatient to inpatient Transfer patient from ER to inpatient status Discharge patient from ER Discharge patient from inpatient status Discharge patient from outpatient status Notify housekeeping when patient discharged Notify HIM when patient admitted Meets UHDDS requirements Meets HIPAA requirements Contains required demographics Automated verification of insurance GUI technology User friendly Delete patient from system Multiple levels of security Password protected Audit trail Biometric capable Reads barcodes Edit demographics Edit insurance Allow for 4 insurance providers Prints standards reports at specified periods Ad hoc reporting Admission list Discharge list Standard Next Release Not Available Custom X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Transfer list Looks for potential duplicate medical records Quality edits built into system SQL/Oracle database Runs on Windows 8 Enterprise-wide ready Merge medical record numbers Allows for aliases Maintains old medical record numbers Maintains former names Allows at least 999 patient visits Data dictionary Three-character service field Allows housekeeping to notify admission that room is ready Online no-bed list Sends out announcements to employees/staff Generates list of patients by physician Generates lists of patients by unit Calculates census statistics Performs medical record number queries Performs patient name queries Standardizes, secures, and governs access to master patient records Standardizes, secures, and governs access to master provider indices Standardizes, secures, and governs access to document exchanges Services for building interoperable healthcare networks Authentication and authorization Management and monitoring Transport Layer Security X X X X X X X X X X X X X X X X X X X X X X X X X X X X HIM 500 Sample Evaluation Matrix This is a completed version: Vendor Evaluation Matrix Instructions: Score each vendor on a scale from 1 (poor) to 5 (excellent) on each of your prioritized items. Total up your ratings for each vendor to help make your comparisons. Write the names of the vendors you are comparing in the watermark space provided in vendor columns. Use the blank rows at the end of the worksheet to ask your own questions. Functionality/Usability Charting Can the system accommodate (and potentially improve) my workflow? Can I easily build and/or customize “off-theshelf” templates? Does the system offer a variety of data entry options, e.g., dictation, voice recognition, structured notes, etc.? Can I make subsequent edits and addendums to clinical documentation? Does the system alert me about unfinished portions of the clinical documentation and can I bypass it if necessary? Can I access other such clinical information as previous labs, progress notes, etc. from a patient’s “electronic chart” while charting? Vendor A Vendor B 26 41 HIGH 3 5 4 MED 3 4 2 MED 2 4 3 HIGH 4 5 4 HIGH 3 4 3 HIGH 3 5 4 Priority Vendor C 31 Does the system allow me to multi-task, e.g., create task, order lab, etc. while charting? Does the system allow me to forward patient information to staff, other physicians, etc. via email, electronic faxing, messaging, etc.? Does the system ensure that only authorized clinicians can sign clinical documentation? Prescriptions Can I complete a prescription within a few clicks? Can I look up medication information, and is this information valuable? How extensive (and how sensitive) is the system’s interactions-checking capability, e.g., drug-drug, drug-allergy, drug-food? How accurate is the system in identifying drug-condition warnings, e.g., pregnancy? Can I refill a medication within a few clicks? Can previous sigs be viewed from the refill screen? Can the system handle multiple drug formularies? Can the system send prescriptions electronically to pharmacies in my local market? Lab and Results Management Can I complete a lab order within a few clicks? Can the system send lab orders electronically to laboratories, hospitals, etc. in my local market? Can I pull up and review lab results within a few clicks? Can the system receive lab results electronically from laboratories, hospitals, etc. in my local market? LOW 3 5 4 MED 3 4 3 HIGH 2 5 4 21 28 24 HIGH 3 3 4 MED 2 4 4 MED 3 5 4 LOW 3 5 3 MED 3 4 3 LOW 3 4 2 MED 4 3 4 21 27 24 HIGH 2 3 4 HIGH 4 4 3 HIGH 3 4 4 HIGH 3 3 4 Does the system notify me of abnormal lab results and provide normal ranges? Can the system show me trending of results over time? Can I create and/or customize “off-the-shelf” order sets? Decision Support Does the system utilize clinical information from all parts of the chart to provide decision support? Does the system alert me when patient data indicates that intervention is recommended? Can I access medical literature, clinical guidelines, etc.? Disease and Population Management Assuming good data entry for all patients, can I query the system and identify patients that have a particular condition, are on a certain medication, etc.? Does the system track patients for follow-up and send out reminders? Can I create ad-hoc reports, or am I limited to ones provided off-the-shelf? Can I customize these reports? Does reporting module handle “and/or” queries together? Health Record Management Can I look up a patient by a number of different criteria, e.g., name, MRN, SSN, etc.? Does the system provide a summary view of a patient’s health status? Does the system handle other such clinical documents as X-rays, reports, etc.? MED 3 4 3 MED 3 4 3 LOW 3 5 3 9 11 11 MED 3 3 4 MED 3 5 4 LOW 3 3 3 8 16 13 MED 2 4 3 LOW 2 5 3 LOW 3 4 4 MED 3 3 3 16 24 18 MED 3 5 4 LOW 4 5 3 MED 3 5 3 Does the system allow me to maintain patient lists, e.g., problems, allergies, medications, etc.? Can I organize patient information within the system in a similar way to my paper charts? Clinical Tasking and Messaging Can I access and manage various tasks, e.g., sign progress notes, review labs, etc. within a few clicks? Can I task or message someone else in the practice and do it with a few clicks? Does system alert me of overdue tasks and urgent lab results? How disruptive are the alerts, are they customizable, and can they be overridden? Can I manage tasks and messages from a computer other than my own? Financial Considerations Roughly how much could the system cost my clinic? Can you offer an Application Service Provider (ASP) option, purchase option, or monthly subscription option? Roughly how much do the software licenses cost? About how much will ongoing maintenance and upgrades cost? How often will a support person(s) be available once the system goes “LIVE” in case of any system difficulty? How are the licenses issued? Concurrent user versus per practitioner? TOTAL SCORE MED 3 5 4 LOW 3 4 4 14 22 17 HIGH 2 5 3 MED 2 4 3 LOW 3 5 3 LOW 4 4 4 LOW 3 4 4 17 17 21 HIGH 3 2 4 MED 3 2 3 HIGH 2 2 3 MED 3 2 3 MED 3 5 4 MED 3 4 4 132 186 159 Vendor Evaluation Matrix Instructions: Score each vendor on a scale from 1 (poor) to 5 (excellent) on each of your prioritized items. Total up your ratings for each vendor to help make your comparisons. Write the names of the vendors you are comparing in the watermark space provided in vendor columns. Use the blank rows at the end of the worksheet to ask your own questions. Functionality/Usability Charting Can the system accommodate (and potentially improve) my workflow? Can I easily build and/or customize “off-theshelf” templates? Does the system offer a variety of data entry options, e.g., dictation, voice recognition, structured notes, etc.? 1 Priority Vendor A Vendor B Prescriptions Can I complete a prescription within a few clicks? Can I look up medication information, and is this information valuable? How extensive (and how sensitive) is the system’s interactions-checking capability, e.g., drug-drug, drug-allergy, drug-food? Lab and Results Management Can I complete a lab order within a few clicks? Can the system send lab orders electronically to laboratories, hospitals, etc. in my local market? Can I pull up and review lab results within a few clicks? 2 Decision Support Does the system utilize clinical information from all parts of the chart to provide decision support? Disease and Population Management Assuming good data entry for all patients, can I query the system and identify patients that have a particular condition, are on a certain medication, etc.? Health Record Management Can I look up a patient by a number of different criteria, e.g., name, MRN, SSN, etc.? Does the system provide a summary view of a patient’s health status? 3 Clinical Tasking and Messaging Can I access and manage various tasks, e.g., sign progress notes, review labs, etc. within a few clicks? Can I task or message someone else in the practice and do it with a few clicks? Financial Considerations Roughly how much could the system cost my clinic? TOTAL SCORE 4