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Health Information Technology In Healthcare Quality

Health Information Technology In Healthcare Quality

The purpose of this assignment is to design a clinical form to be used for oncology RN navigators.

Read the “Integrated Case Study” resource and review the “Oncology North: Navigator Intake Paper Form” and “Oncology South: Oncology Navigator Intake Form,” located in the Class Resources, prior to beginning the assignment.

Based upon the case study and two intake forms, use an Excel spreadsheet or Word document to design a custom form that merges the paper documents and converts them to an electronic form. Be sure to include the different custom fields and topics necessary for navigating the form. Health Information Technology In Healthcare Quality

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Along with your form, include a 250-word rationale in which you:

Evaluate the data governance and heuristic principles used to design the clinical form.
Assess how the documentation aids the oncology RN navigator in providing quality patient care and improves the user experience.
Determine the rationale of the design.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite.

CAHIIM

This assignment aligns to the following AMIA 2017 Core Competencies for Health Informatics Curricula at the master’s degree level:

The paper will involve two parts; designing an electronic form that combines the North and South Oncology Intake and evaluating the form.

Part 1: The Oncology Intake Electronic Form

The Oncology Intake Electronic Form
A.  Physician (s) Official Laboratory Information Only
Reffering Physician:____________________

Address:____________________________

City:___________ State:________ Zip:_____

Phone:__________ Fax:__________

Primary Physician:____________________

Address:____________________________

City:___________ State:________ Zip:_____

Phone:__________ Fax:__________

 

 Initial Receiving Date:__________________

Family:______________________________

Receiving Time:_______:_______(AM/PM)

Proband:

Not Proband:

Received by:__________________________

Lab Comments:_______________________
B. Patient (s) Information
Name:_______________ D.O.B (Month/Date/Year):_____________ Address:_ ________________________ Sex: Male        Female:        City:____________:State:_____________________________ Zip:_________________________________

Age:____________: Ethnicity/Race:____________  Religion:___________ Hospital:________________________

 

 
C. Clinical Information (All Specimens must be labeled/ No freezing specimens)
Specimen Collection Date:_____________ Collected by:_________________

(Month/Date/Year) Collection Time:_________ (AM/PM)

Cancer Type:__________ Metastasis:_______ Stage:_____________________________ Diagnosis:_________________ Date:____________- Referral Diagnosis:_________ Recurrence:________:Date:________________________________

Treatment Process: New          Ongoing          Post
D. Treatment Plan Information
Family History (Brief):________________________

Most preferred Family Member:

Relationship with the patient Telephone Number Address
     
E. Specifics for Handling Specimens
1.      All containers should be tightly closed.

2.      Sterile techniques application.

3.      Containers labeling should include the patient and physician names, MRN, and date received.

4.      Receiving the specimens should be within 24 hours.
F.      Billing Information
Insurance             Cash

Insurance Care Plan:________________________ Street:__________ City:______ State:_____ ZIP:______________

Insured Relationship: Self             Spouse:              Other:

Social Security for the Insured:______________

Alternative:  Attach patient Insurance card

Patient Bill:_____________________

Hospital Bill:____________________

Medicaid Bill:___________________

Medicare Bill:___________________

 
G.                                 Source Information
Hospital:__________________ State:______________ Address:_____________Ward:________________Case Number:_________________

Laboratory:______________ Lab Number:__________________

Form Filled by:___________________ Date:_________________ Sign:_________________

Data Entry by:____________________Date:__________________ Sign:_________________

 

Part 2: The Electronic Form Rationale

From the above electronic form, the electronic form rationale includes heuristic principles and data governance used in designing the clinical form, the effectiveness of the document to RN navigator in providing quality healthcare and user experience improvement, and the design rationale.

Heuristic Principles and Data Governance

Heuristic principles and data governance in healthcare are essential, considering that they aid healthcare management in enhancing patient safety and confidentiality. According to Dowding and Merrill (2018), heuristic principles are computer-related aspects that help in identifying if the software can identify usability issues within a user’s interface design. Hence, the main heuristic principles that the above electronic form incorporates include the real-world reflection of the interaction that a physician needs to have with their cancer patients (Meuleman et al., 2020). Also, it comprises well-known terms in cancer treatment, thus making it more logical and natural when an RN Navigator uses it. The form also promotes user freedom where they can easily copy, paste, or undo information if thus enabling an easier way to correct information. Also, using a word document to design the electronic form was majorly inspired by the fact that if the user mistakenly loses the document, it can be easily retrieved from the auto-save feature in word documents (Feldman et al., 2018). Concerning the data governance, the RN navigator using the form can watermark and restrict the use of the information, which are features also present in the word document (Micheli et al., 2020)Health Information Technology In Healthcare Quality.

The Effectiveness of the Document to RN Navigator

For the RN Navigator, the document will be effective since it will be easier to identify if the patient is a referral or a first-time patient. Also, for follow-ups, it will be easier for the RN to identify the most trusted person by the patient who can aid in ensuring that patients follow the medical requirements to improve their overall patient outcomes.

The Design Rationale

The rationale behind the design is to ensure that it obtains and displays the intake information that the RN Navigator needs in an efficient and accessible way (Spencer et al., 2018).

Conclusion

The paper incorporates an electronic form, a combination of the North and South oncology intake forms that the RN Navigator used to collect patients. Also, the paper has evaluated the heuristic principles and data governance that makes the electronic form efficient, including the design rationale and document effectiveness to the RN Navigator Health Information Technology In Healthcare Quality.

References

Dowding, D., & Merrill, J. A. (2018). The development of heuristics for evaluation of dashboard visualizations. Applied clinical informatics, 9(03), 511-518. DOI: 10.1055/s-0038-1666842

Feldman, S. S., Buchalter, S., & Hayes, L. W. (2018). Health information technology in healthcare quality and patient safety: literature review. JMIR medical informatics, 6(2), e10264. doi: 10.2196/10264

Micheli, M., Ponti, M., Craglia, M., & Berti Suman, A. (2020). Emerging models of data governance in the age of datafication. Big Data & Society, 7(2). https://doi.org/10.1177/2053951720948087

Meuleman, B., Roosma, F., & Abts, K. (2020). Welfare deservingness opinions from heuristic to measurable concept: The CARIN deservingness principles scale. Social Science Research, 85, 102352. https://doi.org/10.1016/j.ssresearch.2019.102352

Spencer, J. C., Samuel, C. A., Rosenstein, D. L., Reeder-Hayes, K. E., Manning, M. L., Sellers, J. B., & Wheeler, S. B. (2018). Oncology navigators’ perceptions of cancer-related financial burden and financial assistance resources. Supportive Care in Cancer, 26(4), 1315-1321. https://doi.org/10.1007/s00520-017-3958-3 Health Information Technology In Healthcare Quality

Integrated Case Study

 Overview:

Throughout this course, you will use this case study to demonstrate knowledge of the following course content:

  • Clinical decision support
  • Assessing user needs
  • Analyzing and documenting workflow
  • Designing and customizing fields, forms, and templates
  • User testing
  • Evaluation metrics
  • Designing user documentation and training

In a series of assignments, you will use this case study to integrate user interface design (including usability/human factor principles) into a design document, analyze and develop workflows, evaluate users’ needs (including their involvement in user testing)Health Information Technology In Healthcare Quality, develop evaluation metrics, and design end-user training materials.

The case study, which will be used throughout the course, will focus on various components of the course topics. It focuses specifically on the unique needs of oncology patients and the health care needs of oncology navigators and prior authorization/financial coordinators.

The Case:

Universal Health is a large not-for-profit health care system with 12 hospitals in three states and two large oncology programs in Arizona. One of the oncology programs is affiliated with Academic Hospital and the other with a larger national oncology health care system. Although both oncology locations are part of Universal Health, there are significant differences in how each of the locations operates due to a recent merger/acquisition of the Academic Hospital oncology program (Oncology South) and the affiliation of the other oncology program (Oncology North) with a national oncology health care system. To compound these operational issues, Oncology North had been part of Universal Health for 8 years, so its Electronic Health Record (EHR) was Chrystal, which was the EHR platform for Universal Health and became the model used to convert Oncology South from its EHR to align with the rest of the organization. Management of oncology patients is quite complex and there was significant concern from Oncology South about the EHR conversion, as well as changes that would affect its operating model. Previously, both oncology programs worked relatively independently with IT to create custom solutions, but now they will need to work together to create a standardized oncology solution for Universal Health.

If a merger/acquisition of a large academic hospital and its oncology program was not complex enough, adding the conversion of an EHR certainly made the situation more difficult. Also compounding the issue, Oncology North—although it had been on the EHR Chrystal for almost 8 years—had significant issues with the current build and felt that there were several gaps related to functionality for oncology clinicians to service its unique population. Since Universal Health was in the process of converting the EHR at Academic Hospital and Oncology program, the EHR vendor, Chrystal, was actively involving its alignment specialists to assist in the conversion. One of the key first steps of the Chrystal alignment specialists was to do a gap analysis and prioritization of EHR functionality for oncology as well as throughout Universal Health. Health Information Technology In Healthcare Quality

The gap analysis done by Chrystal found that the oncology build for Universal Health overall did not align to its recommendation for oncology specialties in several areas within the EHR. As a result, a focused team (including a project manager, nursing informatics, Universal Health IT resources, Chrystal oncology alignment specialists, and Chrystal oncology IT experts) was created to systematically address the recommendations from the Chrystal oncology gap analysis. Although there were recommendations globally related to Universal Health’s overall EHR build, there were some specific recommendations related to the build of the oncology platform within Chrystal. Some of the initial focus was related to concerns related to prior authorization/financial gaps and the functionally/workflow of all the oncology providers/clinicians, but also the oncology navigators who really did not have any oncology functionality within Chrystal.

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Servicing an oncology population is a significant part of the patient demographics of any large health care organization. Oncology patients have unique needs due to the frequency of their visits and the length of their treatments and follow-up, which can last a lifetime. A cancer diagnosis is life changing and can cause great emotional, physical, and financial stress. Oncology navigators exist to assess and assist patients and their families during their cancer treatment and hopefully into remission/survivorship. Unfortunately, cancer treatment can be costly, and dealing with insurance companies for prior authorization is an unfortunate reality in the current health care system. For health care providers, there is great financial responsibility in providing cancer treatment, so obtaining authorization from insurance companies and ensuring that patients are aware of their own financial responsibility are essential for both the patient and the organization Health Information Technology In Healthcare Quality.

After a patient receives a cancer diagnosis, the next step is usually a referral to an oncology specialist/program like Oncology North or Oncology South. That referral can come from a patient calling an oncology specialist/program directly or from the diagnosing physician contacting an oncology specialist/program. Oncology South and Oncology North both have dedicated intake referral specialists who work directly with patients, families, and referring physicians to get patients scheduled with an oncology specialist based on their diagnosis. Before the patient sees the oncology specialist for the first time, many documents need to be sent to the prior authorization team for review to ensure that the appropriate prior authorization is obtained from the insurance company, as well as making sure that the patient will be seen by the most appropriate oncology specialist for the specifically diagnosed cancer. These documents vary from pathology reports, diagnostic results, and referring physician notes that can be sent to the prior authorization specialist at different times for different patients. It is essential to have a standard workflow and expectation of standard documentation in a certain place in the EHR, so that everyone involved in the initial authorization and clinical care knows what steps have been taken and what actions are pending. While these financial steps are occurring behind the scenes and are important details that need to be secured before a patient’s first appointment, it is worth noting that at this juncture patients have just received some of the worst news in their life and they just want to get treatment as soon as possible Health Information Technology In Healthcare Quality.

Oncology navigators are nurses that specialize in assisting patients navigate their cancer journey from diagnosis through treatment and into survivorship. After the first contact with the oncology intake specialists, oncology navigators are the next foundational step in the patient’s journey towards treatment and recovery. After the initial documentation is completed by the intake specialist who provides some basic information, including name of person calling, contact information, referral sources, provider information, and diagnosis information, such as type of cancer. Based upon the type of cancer on the intake documentation, an oncology navigator who specializes in that cancer type is notified of the new patient and contacts the patient to initiate a custom navigation plan based upon assessment of needs. The oncology navigator role is an extremely important part of the oncology team. However, oncology navigators were identified as being significantly underdeveloped within Universal Health EHR based upon Chrystal’s gap analysis, so there needed to be focused attention on this group within the organization.

As a result, a dedicated team needed to be formed to include individuals from nursing informatics from Universal Health, Chrystal oncology alignment and IT specialists, Chrystal IT staff, and oncology navigators from both Oncology North and Oncology South. This team would be responsible documenting workflow, assessing end-user needs, and submitting a final design recommendation (including training materials) to the Universal Health IT build team. The completion deadline for the design document is 8 weeks Health Information Technology In Healthcare Quality.

Assessing current state and understanding end-user needs must be one of the first goals of this dedicated team. Two days were dedicated for onsite observations of oncology navigators at Oncology South and Oncology North, during which it was discovered from the observations that even though the oncology navigators at both locations performed the same role, they had some significant differences that needed to be overcome to be able to collaborate and create a single oncology navigator solution. The grid below outlines some of the differences.

Operations Differences Oncology South Oncology North
Initial Contact With Patient Phone interview within 3 days Initial physician clinic visit
Patient Oversight All oncology patients Only oncology patients that have identified needs
Documentation Paper form: See document: Nav Assessment 2018 Paper form: See document: Oncology North

Although each location has operational differences, they also have several similarities in how they used some of the tools in the EHR, as well as their need for data and the ability to track/trend the outcomes of their patients. One key request was to make it easier for all oncology clinicians to be able to see their documentation within Chrystal. These foundational similarities aligned to what Chrystal oncology specialists had implemented at other institutions, having already created an Oncology Navigator Recommended Design Document that could be used at Universal Health. The table below provides some similarities between Oncology North and Oncology South Health Information Technology In Healthcare Quality.

Operations Similarities Oncology North and Oncology South
Position Navigator/Coordinator RN
Data Request Wanted discrete data for reports
Electronic Documentation Used same two electronic methods to chart:

1.      Electronic forms shared by all types of navigators (e.g., ortho, pulmonary)

2.      Free-text note also shared by same navigators above
Electronic Documentation Wanted it to be easier to find specific oncology navigator documentation

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Health care is all about data. In addition to using EHR for recording documentation, it is used to extract data to evaluate outcomes. Data in the EHR can come from discrete data from ICD10/ICD9 used by providers/coders, SNOMED, IMO codes used clinicians, but also directly from forms and flowsheets from discrete data fields. Understanding the unique data requirements of the oncology navigators, as well the initial prior authorization team, is foundational to creating the appropriate discrete fields or using existing data fields like ICD10 to help sort and organize data Health Information Technology In Healthcare Quality