The Interdependency, Integration, and Competition among Healthcare Sectors

Introduction

In this LearnScape, the Board of Directors of a national healthcare system is considering which electronic health record (EHR) system to use and how to implement the EHR system across all of its facilities. As a health care IT consultant, the student will work with various team members at the corporate level to gather information and analyze the efficacy; safety, security, and legal factors; cost effectiveness; and cost-benefit factors of two possible new systems to help the Board decide whether or not to implement one of them.

Like many industries, the healthcare industry is heavily dependent on technology and innovation in order to maintain a competitive advantage in the marketplace. As you’re probably aware, there are significant cost implications associated with the implementation and maintenance of new information systems and technology. In addition to cost considerations, there are also privacy and security issues, legal and regulatory requirements, usability concerns, as well as interoperability issues with existing and legacy systems. New EHR technologies are designed to interface with accounting and billing applications, which can facilitate improved operational efficiency and reduce the frequency, but not eliminate human error. Most healthcare organizations rely on a diverse payer mix for its total patient service revenue. Each payer has its’ own rules regarding what services are covered, the need for pre-approvals, the methods and rates of reimbursement, the time frame in which claims may be submitted for payment, and deadlines for appeals. From a financial standpoint, time is money, in that a dollar today will buy more than it will tomorrow. Keeping this in mind, we, in health care, want to receive our reimbursement as soon as possible to lessen our accounts receivable (AR), reduce our opportunity costs, and free up the cash necessary to cover our debt service obligations. Information systems, such as electronic health records, that seamlessly interface with an organization’s admission, accounting, and billing systems can facilitate a more efficient revenue cycle, help realize cost savings, improve quality, and strengthen a facility’s financial performance. This LearnScape will address a number of factors that need to be taken into consideration when considering capital purchases, such as an EHR system.

Unit Learning Outcomes

• ULO #1: Evaluate the extent to which information systems, such as electronic health records, interface with other operating, accounting, and billing systems to achieve optimal efficiency. (CLO 7)
• ULO #2: Consider the efficacy, privacy, security, legal, and cost-benefit factors of electronic health records in formulating a recommendation for the adoption and implementation of said systems. (CLO 3 and 7)
• ULO #4: Consider regulatory requirements, healthcare reimbursement changes, the competitive environment, and community impact in developing recommendations on how to position a healthcare organization for success. (CLO 2, 3, 4, 5, 6, and 7)

Directions

Initial Posting

The initial posting should be prepared as a Microsoft™ Word document, and then attached to the unit discussion thread. There is no minimum or maximum in terms of the word count; however, the response should explicitly address all required components of this discussion assignment. The document should be prepared as a practical business deliverable (single-spaced) and reflect higher-level cognitive processing (analysis, synthesis, and evaluation).

Support the initial posting with at least 3 references of credible or peer-reviewed sources. The in-text citations and the list of references should be consistent with the APA writing style (7th ed.). To earn the maximum number of points for the initial posting, the overall quality of the writing should be consistent with that expected of a graduate student and industry professional.

LearnScapes Scenario

(Initial Posting) Students are to complete the LearnScape for Health Care Delivery: Episode 1: The New System (Scenario).

To view the Scenario:

• Click on the link below to access this Unit’s Scenario
• Copy and paste the appropriate Access Code you received from http://www.shopjblearning.com/ into the Subscription Activation field

The New System

• If your last name begins with the letter “A” through “E,” consider that this small, 18-bed rural hospital is physically located in France.
• If your last name begins with the letter “F” through “J,” consider that this small, 18-bed rural hospital is physically located in Mexico.
• If your last name begins with the letter “K” through “O,” consider that this small, 18-bed rural hospital is physically located in Portugal.
• If your last name begins with the letter “P” through “T,” consider that this small, 18-bed rural hospital is physically located in Israel.
• If your last name begins with the letter “U” through “Z,” consider that this small, 18-bed rural hospital is physically located in United Arab Emirates.

Prepare your initial discussion posting consisting of two parts:

Part 1 – Briefly describe the extent to which information systems, such as electronic health records, penetrate and interface with other operating, accounting, and billing systems in healthcare organizations in your assigned country. Compare its status to the United States.

Part 2 – Assume that you are a Health Care IT Consultant, hired by Bright Road Health Care System that is located in your assigned country. Based on your observations in the LearnScapes scenario and a review of the available literature, develop a formal recommendation that includes a high-level implementation plan that considers system cutover, change management, and how the system can be leveraged to improve the revenue cycle. The recommendation needs to be well supported, logically presented, and thoroughly vetted.

Due Dates

Online Students: The initial response is due by Wednesday at 11:59 p.m. (CT). Respond to a minimum of two peers’ initial postings. The peer responses are due by 11:59 p.m. (CT), on Sunday.

Blended Students: The initial response is to be posted to the unit discussion thread at least five (5) hours PRIOR to the scheduled class session. Respond to a minimum of two peers’ initial postings. The peer responses are due by 11:59 p.m. (CT), on Sunday.