Partners HealthCare

1. Create a table that lists the benefits to the patient and to the hospital of an enterprise system for patient medical information and for patient prescriptions and related medical therapies. Benefits for:PatientHospital Patient Medical InformationIf patient’s medical information is in the system and accessible by any PHS personnel, the patient doesn’t have to give the doctors their medical information every time the go to the hospital. The doctor can simply pull up their profile and find out all the info they need to know.

It reduces redundancy and increases ease and efficiency. Speeds things up! The fact that the hospital doesn’t have to gather patient info at each time of their visit will make the process go faster and may even result in the hospital being able to see more patients as a result. Also, doctors can get a good understanding of the patient by looking at their profile and finding out all they need to know. Patient is better taken care of and at a faster rate – reduces delays in service delivery.

Allows all records to be electronic – not only reduces space from paper files but makes it easy for all employees of the hospital the ability to access the info as needed. Improved quality in patient care (reduces mistakes from doctors). Gives PHS management the ability to data mine. They can look at the data and see how to move forward. The new systems, while hard to get used to at first will benefit the entire population and give the management innovative ways to look in the future. Accurate, timely, and comprehensive information sharing among PHS personnel.

Consolidates and collects all the info about a patient over time, including textual info like x-rays. Reduce delays in service delivery, mistakes in treating the patient, and overall health care costs. Patient Prescriptions and Related Medical Therapies Patient wins out too because they are better taken care of as a result of doctors learning from one another through this enterprise system. By having a firm wide system, knowledge can be spread across the network about the best practices from the observable outcomes of recommended medical therapies.

Lower cost! Medical practitioners can now make the best recommendations at the lowest cost. Can constantly improve and reform existing therapies from lessons learned Decision support processes that support the medical practitioner in making the best recommendations for drugs and other therapies to patient at lowest possible cost. 2. List the challenges faced by Partners in implementing an enterprise-wide electronic medical records system. •Cost – could be very expensive to implement; also additional costs as part of the TCO and extensive upgrades •Time!

Can take a lot of time to build and implement •Data migration – potential data loss from moving paper to electronic form •Need for a new backend system to support all electronic data; also, Partners might be required to keep copies of patient’s medical data for 15+ years •Ensuring privacy – making sure that only those that need access to the documents gets access to the documents •Non-integrated – this could be a problem if the systems do not work with each other or with their clients’ systems •Change in workflow for physician– the new EMR requires documenting a lot more information.

Not only does the physician have to keep up with this increase in data, but they also have to do it on a new system. This could definitely slow down the physician at first. •Disruptive – can change the attitude of the workplace; new technology that will be hard to use at first. Can also affect the culture. •Rollout – The issue of when rather than if to do it. Is Partners ready for such a system?

•Complexity of the system – most likely very difficult to change once implemented •When a system is improved, there also has to be oversight that the processes are aligned to match the system •Training – personnel need adequate training, but this can also be expensive 3. What are the operational IT/MIS challenges and benefits posed by the systems now in place? a. For PHS management? •PROS: Gives PHS management the ability to data mine to look for innovative solutions; easy/constant access to patient information; all the data is now in one place; can use the large database of client information to discover trends, patterns, etc.

•CONS: Have to learn new systems – might be harder for management who have been accustomed to older systems to learn the new ones; with the ease of access to all this confidential information, management needs to make sure there are safeguards in place to ensure that privacy is always upheld; collecting quality data could be a problem b. For PHS health care practitioners? •PROS: Eliminates the risk that comes with inputting paper copies of records into an electronic system – by inputting the information directly into the system at the time of talking with the patient, it means that the information given is correct.

•CONS: Change in their work – physicians now have to document a lot more information than they have in the past, and perhaps this is the first time they’re responsible for documenting the work themselves; all the data collection could potentially slow them down – maybe they can get the patients to fill out some information on their own c. For health care practitioners and allied agencies who must interact with PHS? •PROS: Easier to do everything, really.

Also – opportunities to improve documentation; ease of information access; can get access to some of the most advanced hospital systems in the world; can collaborate with the hospital to improve practices and try to find ways to lower costs •CONS: In order for the processes to work, those interacting with PHS must be able to align with their systems. So for example, if allied agencies are currently using a different system that is not compatible with PHS’s new one, then they either have to change their systems altogether or they won’t be able do business with PHS anymore.

Also, they might have to sometimes operate using both paper and electronic processes when dealing with their practices and hospitals. Going off that, will also have to learn two different EMR system – one in their own practice as well as the hospitals. d. For the PHS IS organization? •PROS: While the IS bears most of the work, they will also ream a lot of the benefits as well. These new systems will make life more efficient at PHS and will eliminate almost all paper documents. It also increases organization, accessibility, and accuracy of the information.

•CONS: Most of the work of implementing this new system falls into the lap of the IS department. They are the ones that have to handle all the electronic data entry, ensuring all the information is reliable, accurate, and timely, and also ensuring privacy and confidentiality with the patient’s records. It’s not an easy process. They also have to train the PHS staff on how to use the systems and act as help-desk personnel whenever a PHS staff member does not know how to use the new system.

So, basically the IS team has to deal with the connection, integration, and collaboration with the new systems. 4. What are the TCO implications of the overall LMR/CPOE investment? As noted in the case, the TCO for the LMR/CPOE investment is quite extensive. It requires a high level of data quality including constant data validation and collection. While it seems like Partners had to put in a lot more money even after their original investment, it is undoubtedly necessary to ensure the success of the systems.

As noted in the case, these major systems need love and care even after they’re implemented. Each few years, Partners goes through re-documentation, clean-up, and ongoing maintenance. These clean-ups allow Partners to keep up with best practices across the network. So – TCO can be a lot, but maintaining the on-going costs by upgrading/cleaning up the systems when necessary will make the LMR/CPOE investment last a lot longer (even though it could hurt their ROI).

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