Clinical Information Systems EHRs and CDS Core Functions

Clinical Information Systems EHRs and CDS Core Functions

(Clinical Information Systems EHRs and CDS Core Functions)

This article discusses Clinical Information Systems EHRs and CDS Core Functions.

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To prepare for your Final Assessment, review at least two healthcare information systems and select one you think works best for the organization. Consider the core functions of the system you selected and the impact these capabilities can have on the organization. Next, reflect on the legal and regulatory requirements for implementing the healthcare information system. Then, think about the value of the healthcare system and the specific attributes that are particularly noteworthy. Be sure to review the Final Assessment instructions for more context on which to base your evaluation of the system’s value and attributes. Finally, think about the key areas of concern the organization will need to be prepared to address in the implementation and evaluation of the healthcare information system.

Clinical Information Systems EHRs and CDS Core Functions-Solution

Introduction

Sound and reliable information form the basis of decision-making across all health systems and are of paramount importance for the development, implementation, governance, and health system policy regulation. Similarly, health education and training, human resource development, human research, delivery of services, and financing depend on the health information system (HIS) that the healthcare organization in context chooses. HIS describes a system designed to manage healthcare data by collecting, storing, managing, and transmitting a patient’s electronic medical or health record (EM/HR), a health facility’s operational management system, or a system that supports health policy decisions (Harriet et al., 2019).(Clinical Information Systems EHRs and CDS Core Functions)

The HISs also includes systems that handle data related to the activities of providers and health organizations. Since it often constitutes an integrated effort, they are leveraged in ways that target to improve patient outcomes, guide and inform research, and influence the making of policies and decisions. Since HISs consists of accessibility, processing, and or maintenance of large volumes of sensitive data, security is a fundamental concern, and health information technology has to be involved in HISs.

Whether it is patient, clinician, or public health official, each can use HISs to collect data and compile it in a manner that can be used in making healthcare decisions. Examples of HISs include EM/HRs, practice management software, master patient index(MPI), patient portals, remote patient monitoring(RPM), clinical decision support (CDS), and computerized provider order entries(CPOEs). The paper outlines a draft report summarizing two HISs, namely EHRs and decision support tools, while CPOEs are selected as the best healthcare organization.(Clinical Information Systems EHRs and CDS Core Functions)

Clinical Information Systems EHRs and CDS Core Functions

Information and information exchange holds the key to delivering care on all levels of the healthcare delivery system. These include the patient and the care team and the hospital, and the political-economic environment. For accurate diagnosis and effective treatment of patients, the individual hospital and its care teams must access at least three types of clinical information: the patient’s health record, the ever-changing medical- evidence base, and the provider orders that guide the process of patient care.(Clinical Information Systems EHRs and CDS Core Functions)

Additionally, they require information on the patient’s preferences and values and crucial administrative information like status and availability of supporting resources like the workforce and hospital’s bed capacity. The integration of these critical information streams also calls for training and education, decision support, information management, and communication tools. According to Gellert et al. (2015), the EH/MRs replace the paper version of a patient’s medical and health history. While the two terms can be used interchangeably, the EHRs capture more health data, test results, and treatments.

Moreover, the EHRs are designed to share data with other EHRs to enable the healthcare providers to access a patient’s healthcare data at the click of a button. On the other hand, clinical decision support systems analyze data from various clinics and administrative systems to facilitate clinical decisions by healthcare providers. The data derived can help prepare diagnoses or predict medical events like drug interactions as they help filter data and subsequent information to help the care team offer the appropriate services to individual patients (Sutton et al., 2020).(Clinical Information Systems EHRs and CDS Core Functions)

The Computerized Provider Order Entry (CPOE)

            In the selected community hospital, it is expected that the implementation of computer technology would significantly impact how providers meet the needs of patients presenting with both acute and chronic diseases. One significant aspect of computer technology application in healthcare is CPOE, whose value enhances patient safety by ensuring that providers enter orders directly into the hospital information system, thereby eliminating errors. It is important to restate that EMRs refer to a collection of individual patient’s computerized medical information stored for easy access by providers but not necessarily shared or integrated. (Clinical Information Systems EHRs and CDS Core Functions)

Likewise, EHRs describes the computerized compilation of a patient’s personal and health information that is shared between physicians, nursing, pharmacy, and other patient care areas in a hospital or between hospitals and where orders from remote locations can be entered in order to accord the client continuous patient care (Bennett, 2015).(Clinical Information Systems EHRs and CDS Core Functions)

CPOE’s attributes permit providers to order medications, radiology studies, and laboratory tests within the EHRs electronically. Furthermore, clinical decision support systems can be added in a CPOE system to have a functionality that alerts the provider to drug interactions, patient allergies, and reminders to order services for a specific patient. The Agency for Healthcare Research and Quality (2015) also note that the added CDSSs can have pop-up alerts to notify the provider if the desired test is redundant, thus costs by avoiding unnecessary testing. Coustasse et al. (2015) note that a legal requirement for CPOE is that eligible providers (EP) and hospitals must have EHRs. (Clinical Information Systems EHRs and CDS Core Functions)

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Clinical Information Systems EHRs and CDS Core Functions

Clinical Information Systems EHRs and CDS Core Functions

Specifically, there is a requirement that states that CMS should reimburse eligible providers only if they have met assessment measures whereby at least a third of all patients have a minimum of one medication in their prescription list entered by the EP. Other alternatives to meeting the reimbursement criteria are that 30% of the patients have been admitted to an eligible hospital or critical care access hospital in-patient or emergency department using CPOE. Suffice it to say that CPOE introduces supportive technology in ordering medicines implying that it can resolve many providers’ quality of care issues.(Clinical Information Systems EHRs and CDS Core Functions)

            At the selected community hospital, organizational concerns are several, with the leading one costing that would successfully implement the CPOE system. The cost of implementing and maintaining a CPOE runs into millions, and the costs continue to rise with every passing day (LeapFrog Group, 2014). Other organizational concerns are provider resistance to change and the interruption of workflow.(Clinical Information Systems EHRs and CDS Core Functions)

Conclusion

            In conclusion, it is essential to acknowledge that the successful implementation of the proposed CPOE system in the selected community hospital depends on a host of several factors like recognition that health informatics is a customer service endeavor that should be pursued relentlessly. The other is establishing and maintaining recurrent health informatics and the hospital executive’s engagement in the implementation strategies and deliverables. Likewise, successful implementation of the CPOE would have to overcome the hospital’s primary barriers using suitable strategies. CPOE use would only enjoy real-time assistance by a CPOE facilitator, thus leading to increased CPOE utilization due to increased perceived ease of use and perceived usefulness.(Clinical Information Systems EHRs and CDS Core Functions)

References

Agency for Health Care Research and Quality. (June 2015). Clinical Decision Support. Retrieved from http://www.ahrq.gov/professionals/prevention-chroniccare/decision/clinical/index.html

Bennett, E. (2015). The intra/inter-operability in healthcare: implementing the electronic medical record (EMR) with the ultimate goal of an electronic healthcare record (EHR)? Pharmacy & Pharmacology International Journal, 2 (1): 00009.(Clinical Information Systems EHRs and CDS Core Functions)

Coustasse, A., Shaffer, J., Conley, D., Coliflower, J., Deslich, S., & Sikula Sr, A. (2015). Computer Physician Order Entry (CPOE): benefits and concerns-a status report. In Healthcare Administration: Concepts, Methodologies, Tools, and Applications (pp. 726-742). IGI Global.

Fischer, S. H., Rudin, R. S., Shi, Y., Shekelle, P., Amill-Rosario, A., Scanlon, D., & Damberg, C. L. (2020). Trends in computerized physician order entry by health-system affiliated ambulatory clinics in the United States, 2014–2016. BMC health services research20(1), 1-6.(Clinical Information Systems EHRs and CDS Core Functions)

Gellert, G. A., Hill, V., Bruner, K., Maciaz, G., Saucedo, L., Catzoela, L., … & Webster, S. L. (2015). Successful implementation of clinical Information technology: seven critical lessons from CPOE. Applied Clinical Informatics6(4), 698.

Haried, P., Claybaugh, C., & Dai, H. (2019). Evaluation of health information systems research in information systems research: A meta-analysis. Health informatics journal25(1), 186-202.(Clinical Information Systems EHRs and CDS Core Functions)

LeapFrog Group (2014). Results of the 2014 Leapfrog Hospital Survey: Computerized physician order entry

Question

The Module Pre-Assessment is your opportunity to practice applying module content before submitting the final Competency Assessment. In the Final Assessment, you will be asked to evaluate several healthcare information systems and recommend the best system for your healthcare organization. Then, you will create a report that begins with an overview and rationale for your healthcare information system recommendation.(Clinical Information Systems EHRs and CDS Core Functions)

To prepare for your Final Assessment, review at least two healthcare information systems and select one you think works best for the organization. Consider the core functions of the system you selected and the impact these capabilities can have on the organization. Next, reflect on the legal and regulatory requirements for implementing the healthcare information system. Then, think about the value of the healthcare system and the specific attributes that are particularly noteworthy. Be sure to review the Final Assessment instructions for more context on which to base your evaluation of the system’s value and attributes. Finally, think about the key areas of concern the organization will need to be prepared to address in the implementation and evaluation of the healthcare information system.(Clinical Information Systems EHRs and CDS Core Functions)

For this Module Pre-Assessment, create a draft of your report that summarizes the two healthcare information systems you evaluate and the one you selected as the best for the organization. Be sure to include the technology’s core functions, its value and attributes, any legal and regulatory requirements, any organizational concerns. Your presentation should cite the resources used for the content. Finally, review the Final Assessment Instructions for more information.(Clinical Information Systems EHRs and CDS Core Functions)

part 2

The Module Pre-Assessment is your opportunity to practice applying module content before submitting the final Competency Assessment. In the Final Assessment, you will be asked to evaluate several healthcare information systems and recommend the best system for your healthcare organization. Then, you will create a research-based proposal to further the process of selecting your recommended information system.(Clinical Information Systems EHRs and CDS Core Functions)

To prepare for your Final Assessment, consider how the healthcare information system you recommended is compatible with the organization’s mission, goals, and values. Next, reflect on the core functions of the recommended healthcare information system and the specific impact these capabilities will have on the organization including how it ensures absolute privacy and security and how it will integrate with other products. Then, reflect on the usability factors you addressed with the healthcare information vendor, why you chose to address these factors, and what vendor support will be supplied if the system is adopted. Finally, think about the estimated cost of the system as well as the timeline of major milestones for the selection and acquisition process.(Clinical Information Systems EHRs and CDS Core Functions)

For this Module Pre-Assessment, create a draft of the research-based portion of your report. Your draft should cite the resources you intend to use to support the content. Be sure to review the Final Assessment Instructions for more details.

Related FAQs

1. What are the core functions of an EHR?

In the report, IOM outlined eight core functions an EHR should be capable of performing to achieve the overriding goals of improving quality care, chronic disease management, efficiency, and feasibility. These functions included: These functions include: health information and data; result management; order management; decision support

2. What are the benefits of using CDSS in EHR?

CDSS can improve and expedite an existing clinical workflow in an EHR with better retrieval and presentation of data. Disrupted/fragmented workflow CDSS can also disrupt existing workflows if they require interaction external to the EHR, or don’t match the providers’ real world information processing sequences.

3. How does the patient care information system work with the EMR?

Data Flow between Components of Patient Care Information System and the EMR The CIS facilitates the use patient data through three main mechanisms: Provision of data entry tools (usually either forms, charts or automatic transfer of results from machines / instruments)

4. What are the functions of the clinical information system?

FUNCTIONS OF CLINICAL INFORMATION SYSTEM (CIS) The Clinical Information System (CIS) is that part of the Hospital Information System (HIS) which facilitates direct patient care i.e. activities where care providers: interact face to face with patients perform procedures that affect them physically, physiologically or psychologically

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