Health Informatics Manager Interview

Overview

The person interviewed is Mrs. Wonser, a supervisor for the Information Technology (IT) department, as well as the Clinical Nurse Analyst and Clinical Integration Specialist at Coffeyville Regional Medical Center (CRMC). When asked what her responsibilities are at the facility, Mrs. Wonser states, “my responsibilities in a nut shell are; leading the core team who have been working on building our new Meditech EHR (Electronic Health Record) upgrade, that we have been working on for over a year”. In addition to the upgrade, she also maintains users access, observes workflows, and improves and adjusts documentation to ensure we are capturing appropriate documentation and charges.

Criteria Used When Deciding on New Technology

When asked what criteria is used when deciding on new technology, Mrs. Wonser states, there are many things that are taken into consideration including; will it be beneficial in cost savings, for example the cost of new technology vs. cost saving in the future. A review is completed to determine if it will it save time for employees allowing them to perform other task that would normally require additional staff.

Another important consideration that is asked is whether it is a requirement in the future such as a Meaningful Use or a Merit-Based Incentive Payment System (MIPS) measure. Also, “does it work with what we already have in place, as it must be able to interface with our EHR system, does it support staff on the other end, and is the new technology the best or are other competitors on the edge of making a better solution”.

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Ways costs and effectiveness are evaluated

According to Bergmo (2015), there is not a set of standard recommendations on the most appropriate way to measure costs and benefits of economic evaluations. Mrs. Wonser discussed some topics that are evaluated at CRMC; “does it save time for staff, is it worth the cost? Cost of staff time vs cost of new technology. Ease of use, does it blend in with the current workflow? Will it interface with all other programs? What are all the available user options? Does it do what it is supposed to do”?

Bergmo states

The most commonly used method for measuring and valuing health care costs is to use the resource costing method. This method involves collecting health resource use data from patient charts, hospital records, or from case report forms in trials or observational studies and then multiplying service use by price weights. There is no standard method for selecting appropriate resource use and price weights. Benefits refer to the effects that alternative interventions have on people’s health. These nonresource benefits are often measured as health changes and can range from biomedical markers, to event-free time, or to more final health outcomes. Outcome measures included can, for example, be blood pressure and glucose levels, cases of illness avoided, symptom-free days, successful treatments, lives saved, and life years gained. (2015)

Ways privacy and patient and provider risks are addressed

All employees at CRMC are educated about the Health Insurance Portability and Accountability Act of 1996 (HIPAA) laws, “which is huge on the IT side”. The staff is not to send any patient information to outside email address and when sending in house we suggest only using the patients visit numbers. When an email must go beyond the walls of the facility the word encrypt: is to be added to the bottom of emails, to protect any information. System and Meditech Passwords must be changed by the new user upon entering in the computer and Meditech will prompt staff to change their passwords every 6 months. Staff must not share their password with anyone and could result in termination. Mrs. Wonser states, “we have several virus protectors and lock down sites on the Network to decrease the risk of getting any viruses. Only computers we set up are allowed on the private network, all others must connect to the public”.

It is important that employees are looking in the appropriate chart, there is always the risk of a provider looking up the wrong patient or clicking on the wrong patient and receiving the wrong information. CRMC has added some features to help decrease this from happening. The patients name is highlighted and positioned at the top of the chart at all times, including; documentation, orders, progress notes, and more. We have tried to improve charting by adding the point and click options so that time is cut down on charting and more time can be spent with the patients. On the flip side patients are now able to research their provider online and read reviews, ratings, etc. so they can be better informed and make their choice of where they receive care.

The EHR has greatly increased patient safety with the ability of medication verification at and blood transfusion verification at the bedside, among other safety features. This is huge impact on patient safety. The quality of care has also increased with the addition of the EHR by allowing staff to have access to the patient history. It could also pose a patient safety concern as well, for example, if the system goes down there are possibilities of many errors or loss of pertinent patient information.

Stakeholder considerations

With the recent implementation of a new EHR at CRMC, every department was affected by the project. Kushan (2017) discusses six key groups to consider when identifying stakeholders to ensure input from all areas is obtained to plan a successful project. One of the first being financial stakeholders. Kushan states, “nearly every project will have a financial impact on an organization; therefore, the insight of board members, the chief executive officer, and chief financial officer is a valuable resource in the planning stages” (2017). Others include, medical leaders, end-users, patients, vendors, and billing and audit functions. At CRMC champions from each department were assigned to building the application used in their area. They are also in charge of training those who will be using it.

Ethical and legal issues

HIPPA is one of the main concerns when it comes to legal issues. A leak in patient information could be detrimental for the patients and could cost the facility thousands of dollars. Other legal concerns include viruses or hackers among many others. Mercuri mentions, “addressing these concerns requires the application of ethical principles such as autonomy, justice, beneficence/non-maleficence, and privacy and confidentiality” (2010).

What she has learned while being a healthcare manager

The IT supervisor I interviewed states as her time as a supervisor she has learned a multitude of things. She mentioned, “transitioning from being a nurse working the floor to a supervisor of the IT department”. One of the most important qualities of a leader is the need for effective communication skills and building a teamwork culture within the organization. Also, being committed and dedicated is a core value that makes her lead the team members within the facility. She believes in remaining determined and committed to the vision of the organization while also building trust with the team members in a way that fosters positive and creative work environment will result in success of the organization.