Healthcare Ecosystems
A. Analyze three current federal government programs related to health informatics by doing the following:
1. Evaluate how each current program is impacted by licensure, certification, or accreditation standards. 1. The Electronic Medical Record and the Office of the National Coordinator for Health Information Technology (ONCHIT). 1 2
2. The Certification Commission for Health Information Technology (CCHIT). 3
3. HL7 –Health Level 7 4
(1)The Office of the National Coordinator for Health Information Technology (ONCHIT) was formed in 2004 to promote and oversee the adoption of interoperable electronic health records in the US within a 10 year period or by 2014. 1 Currently my employer, St. Mary’s Medical Center has begun an initiative moving towards the Electronic Medical Record and MPI – Master Patient Index. In 2005, the US government funded a nonprofit group, the Certification Commission for Healthcare Information Technology (CCHIT). This group was created to develop a set of standards for the EHR and supporting networks. They were also to certify vendors who met these standards. The CCHIT is approved by the Office of the National Coordinator for Health Information Technology (ONC) as an Authorized Testing and Certification Body.3 They have been performing this certification since 2006. This certification was independently developed but includes a thorough inspection of the electronic health record for interoperability, security and integrated functionality meeting the criteria established for this certification. 3 In our initiative to establish and EHR, we have had to meet and will need to meet various standards and obtain our certification from the CCHIT. Part of this process involved establishing an HL7 interface within our computing systems. HL7 was founded in 1987 to produce a messaging standard for hospital information systems[->0].4 HL7, Inc. is accredited by the American National Standards Institute (ANSI).4 This is the accepted messaging standard for communicating all clinical, health information data and is supported by every major medical systems vendor within the United States. It sets the industry standards for exchanging information, sharing, retrieval and integration. As a healthcare organization moving towards this EHR, we must find flexible, cost effective methodologies to enable our system interoperability and allow us to share electronic health records throughout our health system, hospital departments, clinics and physician offices. There are many regulations and standards already in place that we, as a health organization must meet for our Electronic Health Record to be accepted and certified. Many systems and departments must come together in order for this to happen but it will standardize the patients medical record and allow a much broader access to this record throughout our health system.

2. Predict how each current program will impact the following: a. Clinical quality – All programs that I referred to above have and will have major impact in our quality initiatives. All have quality standards, criteria and certification requirements that must be met. It will standardize our systems as well as the information in the patient Electronic Medical Record.
· The Electronic Medical Record and the Office of the National Coordinator for Health Information Technology (ONCHIT). 1 2
By following and/or upholding the standards instituted by the ONCHIT, the quality of patient care will improve while enabling us to reduce the health care costs. The electronic health record will eliminate waste and duplication of patient records. Information from the patients chart will be available at the time of care, raising the quality of their care by enabling a physician to review previous treatment, symptoms and history for the patient. By having the health information stored electronically, it makes it easier to share among other physician groups, hospitals, labs, etc. It will allow for early identification enabling more rapid response for care in public health emergencies. The initiatives of the ONCHIT and electronic health record will also promote early detection, prevention and management of chronic diseases.
· The Certification Commission for Health Information Technology (CCHIT). 3
By following and/or upholding the standards instituted by the CCHIT, the electronic health record that we institute and the software that creates and stores these records will be certified. This will insure the health record is formatted correctly and is compatible with other health information technology products, allowing vital patient information to be shared among systems such as supply scan, billing, pharmacy, etc. These standards also will ensure the private patient information is protected, following HIPPA guidelines. · HL7 –Health Level 7 4
By following and/or upholding the standards instituted by HL7 it will ensure that the EHR and other software systems interface or “talk” to each other. It is vital to patient care that the systems utilized for the various pieces of their care are compatible. Supply scan, transcription, pharmacy orders, etc. must be able to share and interact with each other. This will insure all caregivers needing vital patient information to make informed decisions on their care, will have access to it. This will also enable us to send out the patients claims, orders and reports in a correct format which will mean the claims will be submitted to the providers promptly and accurately giving the patient the access to affordable healthcare without dealing with issues due to incorrect claims being submitted on their behalf. b. Reimbursement for services – I believe with all the standardization and certification of these records, it will enable us to submit more accurate information to insurance providers, Medicare and Medicaid programs.2 This in turn will directly impact our reimbursement, hopefully avoiding denials due to missing or inaccurate information. c. Patient access to care. By instituting the EHR, this will provide the patient a broader access to healthcare. A patient can go to a family physician, a specialist and then receive services at the hospital and obtain medication through the hospital pharmacy. With the EHR, all care providers will be able to access the patients health information enabling them to provide a continuum of care.
3. Explain how each current program supports the NHIN.

1. The Electronic Medical Record and the Office of the National Coordinator for Health Information Technology (ONCHIT).
2. The Certification Commission for Health Information Technology (CCHIT).
3. HL7 –Health Level 7 Each of these organizations, together and individually supports the NHIN by their part in creating and certifying integrated delivery networks utilizing health informatics in the exchange of information. The three regulatory organizations were created in the effort to standardize and integrate health systems and enable us to securely share that information between those systems.

B. Evaluate the roles of health informatics professionals in operationalizing each of your selected federal government programs by doing the following:
1. The Electronic Medical Record and the Office of the National Coordinator for Health Information Technology (ONCHIT).
2. The Certification Commission for Health Information Technology (CCHIT).
3. HL7 –Health Level 7

1. Discuss the roles health informatics professionals have performed in each federal government program. Health informatics professionals are the key element in each of the above listed programs. Working to create national standards for health information systems and the EHR, developing certification guidelines and criteria to ensure standards are met and upheld, developing HL7 messaging to create a standard for sending information and interfacing between many health systems and software programs, exchanging and sharing health information.
2. Analyze how each federal government program could impact the health informatics workforce. As healthcare grows and changes, healthcare providers will continue to seek a seamless standardization of health information. The ability to standardize and create quality standards to maintain and share health information in a cost effective and efficient manner will maintain a demand for the health informatics professional. As government and payer standards and requirements change, the requirements that a health care provider and/or organization will be required to meet will change as well.

References:

1. The Electronic Medical Record and the Office of the National Coordinator for Health Information Technology (ONCHIT) Retrieved October 25, 2011 from http://www.healthit.gov/ 2. The Electronic Medical Record Retrieved October 22, 2011 from https://www.cms.gov/ehealthrecords/ 3. The Certification Commission for Health Information Technology (CCHIT) Retrieved October 25, 2011 from http://www.cchit.org/about 4. HL7 Retrieved October 25 from http://www.hl7.org/index.cfm [->0] - http://en.wikipedia.org/wiki/Hospital_information_system