Please can you do the stage two for me, i want an original answer
Please can you do the stage two for me, i want an original answer. Thanks
01/23/2014IFSM 305 – Case Study DescriptionPage | 1UMUC Family Clinic Case StudyIn 1980, the UMUC Family Clinic was opened in a growing family area near UMUC, Maryland, by Dr. TomMartin, a University of Maryland graduate after he retired from the US Navy.It is a small internalmedicine medical practice. Dr. Martin has been the owner and manager of the medical practice. He hastwo nurses, Vivian and Manuella, to help him. Usually, one day nurse takes care of the front desk whilethe other nurse assists the doctor during the patient visits. They rotate duties each day. Front deskduties include all administrative work from answering the phone, scheduling appointments, takingprescription refill requests, billing, faxing, etc. So if on Monday Vivian is helping the doctor, then it isManuella who takes care of the front desk and all office work. The two nurses are constantly busy andrunning around and patients are now accustomed to a minimum 1-2 hour wait before being seen. And ifone nurse is absent, the situation is even worse in the clinic. The clinic has 3 examination rooms so theowner is now looking into bringing a new physician or nurse practitioner on board. This would help himgrow his practice, provide better service to his patients, and maybe reduce the patients’waiting time. Dr.Martin knows that this will increase the admin overhead and the 2 nurses will not be able to manage anyadditional admin work. He faces several challenges and cannot afford to hire any additional staff foradmin so the owner has to optimize his admin and clinical operations. The practice is barely covering theexpenses and salaries at the moment.Dr. Martin’spractice operation is all paper-based with paper medical records filling his front desk shelves.The only software the doctor has on his front office computer is an appointment scheduling software.Even billing insurance companies is done in a quasi-manual way. For billing insurance, the front officenurse has to fax all the needed documentation to athird party medical billing company at the end of theday. The medical billing company then submits the claim to the insurance company and bills the patient.The clinic checks the status of the claims by logging into the medical billing system, through a login thatthe medical billing company has provided the clinic to access its account. There is no billing softwareinstalled at the practice, but the nurses open Internet Explorer to the URL of the medical billing companyand then use the login provided by the third party medical billing company. Of course, the medical billingcompany takes a percentage of the amount that the clinic is reimbursed by the insurance. The medicalpractice does not have a Web site, and essentially still operates the same as it did in 1980.One problem that you notice immediately is that there is no quick way to check patients in and if thenurse is on the phone while a patient tries to check in, then the patient has to wait until she is done. Thedoctor could be also waiting for the patient to be checked in, wasting valuable doctor time. Also manypatients experience long waits on the phone when they are trying to schedule an appointment, while thenurse is checking in patients or responding to another patient’s request in the office.Every year, theclinic requires its patients to fill their information and insurance information anew, rather than have themjust verify what they have on file. This annoys some of the moms when they have to fill all thispaperwork and take care of their sick young child in the lobby. All of the medical records, lab results andfinancial and payroll accounts are kept on paper, so there is not a quick way to look up a patient’s historyor current prescriptions if the doctor gets a call while he is away from the office. At the beginning ofeach day, the nurses pull the files for all patients who have appointments scheduled for that day. But theclinic also accepts walk-in patients.At a recent medical conference Dr. Martin learnedof the government’s financial incentives forElectronicHealth Records (EHR) and meaningful use adoption. After attending several demonstrations by thedifferent vendors, ClinicalWorks, AthenaHealth, etc., he realized how inefficiently his practice is runningand realized all the opportunities that EHR systems can bring. The ownerrecognizes all the benefits ofmoving to electronic medical records but feels very overwhelmed on how to start, or what to do.He isalso concerned aboutdisruption to his practice which may negatively affect his patients’care experience.Moreover, neither the doctor nor the nurses have any knowledge or experience when it comes toinformation technology. Upon the recommendation of a fellow doctor, Dr. Martin has decided to hire anindependent EMR Consultant, to help him select the best EHR for his practice. His friend also advised himthat he should not just buy any package from a vendor but have the EHR consultant analyze theworkflow processes at the practice first, then optimize them, and then look at the EHR systems. The new
01/23/2014IFSM 305 – Case Study DescriptionPage | 2EHR system needs to work with the optimized processes of his practice. Dr. Martin needs to get hisstaff’s buy-in and involvement in the process from Day 1, if the EHR adoption process is to succeed. Dr.Martin realizes that EHR adoption will add significant costs to his practice, which he cannot afford.Therefore, he will go for the EHR adoption at this point, only if he can expect to qualify for the financialincentives for achieving meaningful use1. This extra money will help reduce the burden of the cost on aclinic that is barely able to sustain any more costs at this time.Dr. Martin, the owner of the UMUC Family Clinic, has just learned that 2014 is the last year to beginparticipation in the Medicare Incentive Program and that beginning in 2015, Medicare eligibleprofessionals who do not successfully demonstrate meaningful use will be subject to a paymentadjustment according to CMS. To add to his confusion even more, he also learned that there is also aMedicaid Incentive Program and is confused on which one to pursue. For the Medicaid IncentiveProgram the last year however is 2016. Time is running out. He needs to act before it is too late.Based on his fellow doctor’s recommendation,Dr. Martin has contracted with an independent EHRconsultant, who is not associated to any vendor, to advise him through this process. Throughout thiscourse you will be the EHR consultant.Dr. Martin has several strategic goals in mind that he shares with you during your first consultation withhim as his consultant. For one, he would like to see his medical practice operate more efficiently andmake some financial profit that would allow him to reinvest into the clinic in order to upgrade and expandit. In a few years, he will need to invest some funds in a major renovation, primarily in the examinationrooms and the waiting area. If he had extra money, he could also rent the apartment next to his clinicand open up the space to make a larger clinic. If he did that, he could also expand the clinic into a 3-physician group practice and maybe rent out some space to a physical therapy physician and generatesome additional income. After much discussion with fellow MDs, he realizes that it is in his best interestto actively start the process of EHR adoption and take advantage of the incentives provided through themeaningful use program1. So this has now become another strategic goal for the practice. Byimplementing an EHR system, he will be able to fulfill another strategic objective, which is to raise thelevel of IT-awareness among his staff. Dr. Martin also wants to use technology to improve the quality ofcare, safety, and financial management decisions of his practice, while also meeting the legal andregulatory requirements for health care and health care systems.Your task is to help Dr. Martin decide which of his clinical processes can benefit from an IT solution,which processes should be automated first, how an EHR system could help his practice, which incentivesprogram to qualify for, how to achieve meaningful use by adopting a certified EHR system and how tomeet meaningful use reporting requirements. You are not expected to solve all of the problems identifiedor address all improvements that could be made at the UMUC Family Clinic.Note:We’re looking for atechnology solution.While installing a TV in the waiting room may attract new patients, it is not atechnology solution.The following is an exampleof how you will identify a process and optimize it using an EHR system:Lastyear, the medical practice had no effective way to check its members in when they arrived.Sign-insheets were used at the front desk, and the nurse had to check off the name on the sheet againstexisting medical records in the filing cabinet.Some of the patients were walk-ins, so the nurses had notpulled their files off the shelf when they started the day. The nurse had to leave the desktop go searchfor the file on the shelf. This caused patients a long wait at the front desk, and several had complainedto Dr. Martin about this situation.To address the business need of quickly checking members in, theappointment scheduling system was modified to allow the clinic office to quickly lookup patients by lastname and date-of-birth (DOB) on the computer as they sign in.1From the CMS.gov website:“The Medicare and Medicaid EHR Incentive Programs provide financial incentivesfor the “meaningful use” of certified EHR technology to improve patient care. To receive an EHR incentivepayment, providers have to show that they are “meaningfully using” their EHRs by meeting thresholds for a numberof objectives. CMS has established the objectives for “meaningful use” that eligible professionals, eligible hospitals,and critical access hospitals (CAHs) must meet in order to receive an incentive payment.” Meaningful use will becovered in the course materials.
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