As a seasoned Health Information Management Director who has experience with data storage and data reliability, you have been asked by the Chief Operating Officer to support LiveWell while he is underway hiring additional managers. There are two initiatives at LiveWell that will benefit from your expertise. One requires a radiology image storage recommendation for hospital administration, and the other requires the development of a plan for data reliability as LiveWell Physician Practices contemplate a quality improvement project.

You will develop an action plan on data reliability to support the development of a quality improvement project for the Physician Practices at LiveWell. You will also complete a radiology storage compare/contrast review and write an executive summary to support the Chief Operating Officer with your expertise.

INSTRUCTIONS

Part One – Action Plan for Data Reliability at Physician Practices

Recommend an action plan on data reliability by considering the information below and performing the steps that follow. Your action plan will include a Research Assessment and Summary, Analysis of Shadowing Observations, and Action Recommendations.

1. Research Assessment and Summary

You have researched the issue of data reliability and prepared vital highlights and takeaways from the article Mining EHR Data for Quality Improvement.

Assess the takeaways below and summarize pertinent aspects that ensure data quality, consistency, and definition.

While their use may not be considered data mining, when you create a new health maintenance alert, you are mining your EHR data for a purpose.

Small practices can consider out- Sourcing data mining and analysis to their EHR vendor or one of its technology partners. Some vendors, such as Epic, Cerner, Meditech, and athenahealth, are incorporating analytics into their EHRs and will do the work for you in the cloud, Mr. Hood says.

Dr. Ejnes also underlines the problem of getting all of the group’s physicians and nurse practitioners to enter data in structured fields, rather than as free text. The group has medical assistants inputting some of this data so miners have something to mine, he says that her EHR includes prebuilt reports for all of the quality measures in Meaningful Use incentive program and the Physician Quality Reporting System (PQRS). However, her practice cannot modify these reports because they’re written to meet EHR certification requirements. To produce custom reports, the practice’s IT staff developed a special web-based application that queries the EHR database.

GETTING THE DATA YOU NEED

Good data gets you actionable results. To start with, lab results may not be available in structured form, depending on whether the EHR interfaces with a particular lab. Dr. Ejnes’ practice, for example, doesn’t have interfaces with all of the labs it uses, so employees must enter some faxed lab results manually into the EHR.

Ms. Nelson says the solution is to train staff members to enter data in agreed-upon fields. But that’s difficult.

2. Analysis of Shadowing Observations

When considering the key takeaways from your reading, you realize that Real-Time live documentation observations of physician office documentation practices will be beneficial. Your goal is to review for contributing factors that hinder data quality in the EHR. To achieve this, you have shadowed both Dr. Welby and Dr. Olisa and noted your observations. Review the notes below:

Observation notes from shadowing Dr. Welby:

• Patients are REGISTERED by Mindy (medical assistant), Mrs. Welby (Dr. Welby’s mom who works part-time as a coder), and by Dr. Welby’s nurse, Sara, but only over lunch periods.
• EHR documentation begins when Sara enters a brief free text note into the EHR for every new patient to summarize previous healthcare treatments and medications.
• Dr. Welby updates the Medication Maintenance Record using structured data fields provided in the EHR for every patient he sees. He adds the medication, dosage, and frequency. The EHR’s structured fields are complete for every patient.

Observation notes from shadowing Dr. Olisa:

• Patients are registered by Mindy (medical assistant), Mrs. Welby (Dr. Welby’s mom who works part-time as a coder), and by Dr. Welby’s nurse, Sara, but only over lunch periods.
• EHR documentation begins when Sara enters a brief free text note into the EHR for every new patient to summarize previous healthcare treatments and medications.
• Dr. Olisa reviews Sara’s entries to familiarize herself with a new patient’s history, treatment, and medications. (Dr. Olisa voted against the purchase of the current EHR because it was not user-friendly, objecting to the time-consuming structured data fields. She appreciates Sara’s efforts in gathering pertinent patient information for each patient visit.)

Analyze the observations above to identify opportunities for document improvement. In a well-written paragraph, assess the difference in physician documentation practices found. Be sure to state what the difference is and why it will impact the generation of quality reports generated by the current EHR and impact data consistency.

3. Action Recommendations

Based on the key takeaways from your reading and your documentation from the shadowing observations, develop action recommendations for three documentation practices for the Physician Practices to present to the Chief Operating Officer.

4. Write your action plan in a Word document. Be sure to include the following:

• The purpose of the plan
• Research Assessment and Summary
• Analysis of Shadowing Observations, which includes identification and analysis of the issues
• Action Recommendations
• Appropriate titles for each part of your action plan

Part Two – Compare/Contrast Data Storage Recommendation for Radiology

1. To prepare the Compare/Contrast data, you will need to conduct research (in the Rasmussen College Library or on the internet) about digital data storage methods. It may be useful to consult Picture Archiving and Communication System (PACS) vendor statements as well as general information articles on digital storage. LiveWell is a small, urban medical center, and the medical center uses x-ray, CT, ultrasound, and mammography; an average of 100 images are completed each business day.

Consider the three (3) storage methods for digital radiology images listed below:

• Storage using active, on-site data server and drives for the main radiology image storage system
• Storage using a remote data storage facility or Cloud, using an applications service provider to deliver images on demand
• Storage using an array of Flash drives that are kept at the facility and are indexed for retrieval of images on demand

Compare and contrast data for storage recommendation to meet the needs of the radiology department in the following areas:

• Cost of storage
• Ease of retrieval
• Size of necessary storage
• Limitations of the storage method (such as security; delays in diagnosis and patient treatment)
• Perks and positives of the storage method

2. To organize your data in preparation for making a recommendation for the Chief Operating Officer, complete the table below using information gathered from your research in the previous step.

3. Write an executive summary for the Chief Operating Officer that includes your compare/contrast table, elements of your analysis, and clearly states a storage recommendation. So that your recommendation is well evidenced by research, be sure to include details, such as:

• What is great about this recommendation?
• Why is another option not the best?
• What are the perks of your choice?

Submit both your Action Plan and Executive Summary documents.