Case 15: Assessing the Value and
Impact of CPOE, Textbook page 625
The CPOE project is a complex project that a hospital can
undertake. It involves the implementation of a computerized provider Order
Entry platform.
The
process of performing the assessment to determine the value of the CPOE project
In the determination of the value of the CPOE project,
the case study provides a process of performing the assessment. The case study
shows that there were several assumptions done in the assessment thereby
resulting to ineffectiveness. First, the University health care system never
did enough investigation on the effects of the process to the existing system. Thus,
the process began without necessarily having the basic information about the
whole project. The major assumption was that since the CPOE project has proven
benefits, they will be to their benefit. The failure was in the lack of considering that the user needs to
understand and have experience of using the computerized system. It has a
significant benefit to the effectiveness of incorporating the system into the
health care operations. The case study shows that the health care staff had
inadequate training on the usage of the system, hence could not effectively
apply it in their daily duties. The idea of implementing the project was good,
but the mode of implementation failed to address the critical issues that would
make it successful.
How my
assessment will address each of the project goals stated in the case study.
According to my assessment, it is important to consider
the incorporation of the existing data and enter it to the new system. It
provides a basis for building upon on the subsequent operations (Classen, Avery
& Bates, 2007). The health care center has many files and records in their
stores, and its better that the information gets to the new system through
automation. Thus, hiring a team of IT specialists for a contract would help in
the entering of the data in the files to the computerized system. The staff in
the health care center requires working collaboratively with the IT specialists
to gain exposure on data entry and improve efficiency in future. Next is the
training of the staff to ensure that they have the basics of the working of the
computerized system. The training is of benefit to the staff to improve
efficiency in data entry. The trainings should continue until the clinicians
are comfortable with the new system. Thus, they can continue using the old
method of data entry as they gain experience on the new system.
The board has a desire for having a return on investment
which I find challenging to achieve following the mode of implementation of the
CPOE project. The organization started the project without a clear
understanding of the benefits and the cost of undertaking it. Thus, getting a
return on investment is not easy without first addressing all the expected
benefits and costs. It would be advisable for the project leaders to
contemplate on the options available in undertaking the project. Another thing
to consider would be the opportunity cost for the project leaders to identify
other opportunities available for them. The project leaders sought to pull out
due to the failure of the project However, there could be other efficient methods of implementing the
project. The concerns of the customers about their security are also an issue
of consideration. The best option would be focusing on all the viable methods
of ensuring information safety and privacy.
The stakeholders to involve in the
assessment
For every successful assessment, it is important to
involve the key stakeholders to have an input in the process. The stakeholders
range from the IT specialists, the staff, and the customers using the
computerized system. Other major stakeholders to involve are the contact people
to link the system to the users. The contact people will by psychologists with
experience in understanding people’s behavior. Thus, they will interact with
the clients and the clinicians as they ask questions regarding their experience
with the new system. The use of researchers in data collection would compromise
the credibility of the information since some have own perceptions about the
issue. The major issues of concern in the evaluation are the views on the
efficiency, reliability, level of automation, nature of service delivery, and
other issues related to the system (AHRQ,
2015). Other stakeholders to incorporate in the evaluation are a team of
experts in analysis of the information obtained to give a report of the viability
of the project.
The metrics for determining if the
CPOE project added value to the organization, based on the case study
In the assessment of the return on investment on the
implementation of the project, there are important aspects to consider. First
is the financial plan. The implementation of the system requires a clear
financial plan having the costs of the purchased items. The major investments
are purchasing the computer systems, and payments for the software and training.
After implementation the next major investment is evaluation process. The
implementation of the project requires a consideration of the human resource,
capital, and the technical aspect s associated with the system. The human resource
within the health care department has to be capable of operating, maintaining,
and ensuring that the system gets the best results. Capital is necessary to
ensure that the project managers understand the cost of developing,
implementing, and maintaining the system. Other expenses are the cost of hiring
IT specialists and acquiring the required hardware components for the system. It’s
important to plan on how and where to source for the capital required for the
development, implementation, and evaluation of the system (Altuwaijri,
Bahanshal, & Almehaid, 2011).
The timeline for performing the
assessment of the success of the CPOE project described in the case study
|
Step
|
Description
|
Timeframe
|
|
1
|
Planning
for the assessment
|
Week
1 and 2
|
|
2
|
Gathering
the required resources
|
Week
3
|
|
3
|
Collection
of data and analysis
|
Week
4 and 5
|
|
4
|
Implementation
of the findings
|
Week
6 and 7
|
|
5
|
Development
of the reports and metrics
|
Week
8
|
|
6
|
Presentation
of the information to the board
|
Week
9
|
The major
ACA’s enhancements to the public health departments
The
Affordable Care Act has the federal
legal framework for the U.S health-care system. The act
seeks to ensure that there is a reduction in the number of the
uninsured Americans by 50 percent (HHS.gov/HealthCare, 2015). The act established
the public health
fund that helps to provide expansive and sustained investments
in various health issues. The act
helps in improving the public health,
improve the health outcomes, and
also enhance the quality of health
care. The ACA enhances the roles
of public health departments in various ways. Among them are the
evidence-based activities like clinical prevention initiatives, research work, disease
surveillance and tracking, and in improving the
public health infrastructure. Other enhancements to the public health department
include the conducting of immunizations and
screening, prevention of drug
abuse, and facilitating
public health training. The ACA also has funding opportunities to the healthcare departments through requests for proposals,
and awards.
Health Department financial
and operational issues
The
Hillsboro County Health Department has several
operational and financial issues that require consideration. First is the increase in the
public health challenges in Hillsboro County, but
the funds to address the issue
are inadequate. The major sources of funding are the state and
grants that are likely to have limitations due to the cancelation of the large grants. The
department faces serious financial issues to the extent
of reducing the working hours for
some employees. The only reliable
bed-capacity facility, (Manorhaven) faces
an uncertain financial future (Seidel & Lewis, 2013).
Another aspect is the aging of the personnel in which two-thirds of the employees head to retirement. It is also challenging to have qualified staff in the environmental health services. There is also a challenge in the relationship between the department and Manorhaven operated by the County. The strained relationship is due to the challenges in handling the increasing number of patients, but the funding is shrinking (Seidel & Lewis, 2013).
Another aspect is the aging of the personnel in which two-thirds of the employees head to retirement. It is also challenging to have qualified staff in the environmental health services. There is also a challenge in the relationship between the department and Manorhaven operated by the County. The strained relationship is due to the challenges in handling the increasing number of patients, but the funding is shrinking (Seidel & Lewis, 2013).
Goals and objectives to address the issues
Following
the operational and financial issues identified in the Hillsboro County
Health Department, it is essential
to have a set of goals and objectives
to address them. The first goal is to ensure
that the department
gets extra funding from the federal government,
the State, and the local level by presenting funding proposals. The proposals should align with the ACA guidelines on
funding proposals. Another goal would be seeking to have increased accountability
of the funds to avoid the cancelation of grants. Many grant
providers require a high
level of accountability from the
funds they issue
to different departments.
The department
requires improving the access to quality
healthcare services and an environment free of threats to the public’s
health. The strategy helps to attract more grants
and funding. The health care services
provided have to align with the Affordable Care Act.
For the department
to curb the looming staff crisis,
it requires to identify the number
of retiring employees and establish strategies
of fresh recruitments. The other goal is to ensure
increased collaboration between the
Hillsboro County Health Department and the Manorhaven administrator.
Recommendations on the response to the issues
and the obligations
under the ACA
First
is to seek for extra funding from the federal, state, and
the local financial
sources. The fact that the
public health challenges are on the increase raises a concern about the increase in the funding. Secondly, the department
requires requesting for funding proposals as guided in the ACA. The department can request for the
proposal of the provision of certain services within the County and in turn get
financial funding. On the issue of the aging personnel, the department
needs to have a blend of different ages of the employees
and also request
for the staff
regularly. It is disastrous to wait until a significant number of employees retire for there to be recruitment.
The
department should have deliberations with the Manorhaven administration on the best ways of improving
their relationship. They need to address the
issue of funding as a joint problem for them to have a lasting solution.
The department should conduct a thorough job evaluation and have only the
relevant staff for the work.
It ensures accountability
and value for
the resources invested in the department. Lastly, it’s important to push for the
national accreditation to benefit
from the increased funding
from the State.
References
Agency
for HealthCare Research and
Quality (AHRQ) (2015) Health Information Technology: Computerized Provider Order
Entry – Inpatient,
Altuwaijri, M. M.,
Bahanshal, A., & Almehaid, M. (2011) Implementation of computerized
physician
order entry in National Guard
hospitals: Assessment of critical
success factors. Journal of Family and Community Medicine, 18(3), 143–151.
Classen, D. C., Avery,
A. J., & Bates, D. W. (2007). Evaluation and Certification of Computerized Provider Order Entry
Systems: Journal of the American Medical Informatics
Association : JAMIA, 14(1), 48–55.
HHS.gov/HealthCare
(2015) About the Law: U.S Department of Health and Human Services,
Karen
A. Wager, Frances Wickham Lee, John P. Glaser
(2013) Health Care Information Systems: A Practical Approach for
Health Care Management, John Wiley & Sons, 2013; ISBN 1118420934, 9781118420935
Lee
F. Seidel, James Bradley Lewis (2013) The Middleboro Casebook: Healthcare
Strategy and Operations;
Foundation of the Amer College, 2013, ISBN 1567936288, 9781567936285
Sherry Roberts is the author of this paper. A senior editor at MeldaResearch.Com in custom speech writing companies services. If you need a similar paper you can place your order from affordable term papers services.
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