Data Sources and Reporting, health and medicine homework help

Running head: BUSINESS PLAN: TEST RESULT REPORTING Business Plan: Test Result Reporting Name College August 8, 2017 1 BUSINESS PLAN: TEST RESULT REPORTING 2 Business Plan: Test Result Reporting Test result reporting and follow up is a top patient safety concern for health care organizations. Failure to follow up appropriately on diagnostic test results can lead to delays in care, misdiagnosis, patient harm, and liability exposure for the

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organization (Test Result Reporting, 2017). This process is further complicated by the increased number of tests ordered and the time consuming nature of reviewing and following up on these tests. This added pressure on physicians can lead to decreased productivity and physician burnout, which ultimately contributes to issues around patient access to medical care (Callen, etc 2012). The goal of this strategic plan is to improve quality outcomes for our patients while improving access and affordability. This plan is in alignment with the mission and vision of the organization to enhance the wellbeing of the people in the communities we serve by leading the transformation of health care to achieve the highest levels of quality, access, and affordability (Our Mission, 2017). The majority of ambulatory care practices do not use electronic health records, nor do they electronically communicate with outside laboratories, which creates a unreliable method for following up on test results. A recent study estimated that as many as 5% of adults in the United States experience a missed or delayed diagnosis each year (Ambulatory Care Safety, 2017). In addition to the concerns this raises in regards to patient safety, the legal liability for such errors is also one that the organization must consider. Recently, a case settled for $1.4 million for failure to include the test results in the medical record, ultimately leading to a delayed cancer diagnosis (Failure to Include PSA Test, 2017). Because this is such a critical patient safety concern, it is imperative that a proactive risk approach to the management of test results is executed. Our proposal is to purchase and implement a patient portal that will interface with our electronic BUSINESS PLAN: TEST RESULT REPORTING 3 health record system to serve as an access point for patients to send and receive communication about their health care, including test results (Terry, 2015). With the recent surge of health care organizations that have implemented an EHR system, more physicians are finding benefit with the use of patient portals. A patient portal is a secure mechanism in which physicians can communicate with their patients via a web based program. This communication method allows the physician to deliver test results, refill medications and send online messages to the patient (Terry, 2015). A recent survey by Accenture showed that 90% of patients want to utilize technology to access their medical information (Most Patients Want to Self-Management, 2015). Large health care organizations, like Kaiser, have already implemented this type of system for their patient population. In order to be competitive with other health care organizations, it is essential that we keep up with the latest technology. Access and affordability are at the forefront of every decision that we make in this organization. The implementation of a patient portal should yield improvement in both areas. A national survey of doctors showed that 79% of providers reported that their practices ran more efficiently which should contribute to reduced physician burnout and ultimately improve patient access as a result. Additionally, it is estimated that over a 5 year period the organization could see savings of $37 to $59 million dollars by reducing medical errors related to missed and delayed diagnoses, reduced transcription costs, reduced paper usage and improved and accurate reimbursement coding (Medical Practice Efficiencies, n.d.). The ultimate goal that will be achieved is higher quality of care for our patients by improving the access to patient test results. The installation of the patient portal is anticipated to be a relatively simple process. The patient portal will interface with the existing EHR system. Legal will negotiate an amendment to the current contract with our EHR provider for the additional services provided. In addition, BUSINESS PLAN: TEST RESULT REPORTING 4 education and marketing costs will need to be factored in during the first 5 years of implementation in order to ensure success. Physician buy-in will be critical, as they will be the main drivers of this system and will need to be on board. Once physician buy in is achieved, we can proceed with marketing the service to our patients. It is estimated that the patient portal costs will be about $30-$40 per provider, per month. This cost includes installation, maintenance and ongoing support (Terry, 2015). Additional expenses for training and marketing costs are estimated at $5 million for the first year. In order to determine our financial overview for this project, we would need to review our income statement for the last two years, reflecting our revenues and expenses as well as our projected net income. Our balance sheet, which shows our assets and liabilities will also be important to review prior to implementing this system. This statement will show the organization’s financial position at a certain point in time and will also compare what the company owes versus what it owns. Finally, our cash flow statement will need to be evaluated as this shows what will be coming and going out of the organization at certain times of the year. This will help us to determine when the best time would be to begin this project (Fontinelle, n.d.) As with any major project, we have a projected timeline for implementation. Our implementation schedule is as follows: • One to six months: Information Systems will evaluate current operating system to ensure compatibility. Information Security and Privacy will evaluate system to ensure that Protected Health Information (PHI) is not compromised. Installation of patient portal will be completed. • Six months to one year: BUSINESS PLAN: TEST RESULT REPORTING 5 o Interactive training classes will be conducted by the vendors of the system. These training sessions will be held in the IT training room located on site. The training costs associated with the purchase of this system are included in the overall cost. Training sessions will be scheduled on various dates and times. Department managers and supervisors will be responsible for ensuring that coverage will be provided so that staff can attend these mandatory training courses. Physicians will have the option of attending the training sessions or scheduling one on one sessions with the trainer in their offices. o Super Users will be identified to receive additional training. Super Users are a critical aspect of ensuring that the go-live date is successful. The Super User will be available and on site during the first six months of go-live to assist physicians and staff with the use of this system. o Marketing will begin advertising this new patient portal option, providing patients with informational packets about the benefits of this system. • The Go Live Date is anticipated to be one year from installation date. Marketing will advertise this Go Live date in flyers, posters, and television and radio ads. Once the system is ready for use, staff will be provided with a script to use when informing patients of this new service. Marketing will develop an instruction sheet that will show patients how they can sign up. Staff will also have the ability to set up patients on this system while they are in the exam room waiting for the physician. Additional Resources: This project will utilize a number of additional resources. It is anticipated that we will need an additional five (5) full time IT technicians to maintain and support this system. In BUSINESS PLAN: TEST RESULT REPORTING 6 addition, the use of registry may be required as we will need to ensure that support staff (Medical Assistants, Nurses, Technicians, and Administration staff) are relieved of their responsibilities in order to attend the training sessions. In addition, the staff that has been identified to be Super Users will need to be relieved of their normal duties for the first six months of go live. As previously mentioned, the goal of this project is centered on patient safety, ensuring that we have safe patient outcomes by reducing the risk of delayed or missed diagnosis due to failures to follow up on test results. The market has indicated that patients are more receptive to receiving their information electronically and upon demand. In order to maintain viability in this marketplace, we must ensure that we are keeping up with the current technology. In addition, while the initial investment will be somewhat substantial, the overall cost savings show that this is a smart investment overall. The improvements that this system will have in the physician workflow will also increase productivity while decreasing physician burnout, which contributes to access issues. BUSINESS PLAN: TEST RESULT REPORTING 7 References Ambulatory Care Safety (2017) In Agency for Healthcare Research and Quality, Retrieved From: https://psnet.ahrq.gov/primers/primer/16/patient-safety-in-ambulatory-care on August 8, 2017 Callen, J., Westbrook, J., Georgiou, A., Li, J. (2012). Failure to Follow Up Test Results For Ambulatory Patients: A Systematic Review. Retrieved From: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3445672/ on August 8, 2017 Failure to Include PSA Test Results in Medical Record Prompts $1.4M Settlement (2017). In Physicians Practice News. Retrieved From: https://www.ecri.org/components/PhysicianPracticeENews/Pages/Phys040317_Failure.as px on August 8, 2017 Fontinelle, A. (n.d.) Business Plan: Your Financial Plan. Retrieved From: http://www.investopedia.com/university/business-plan/business-plan7.asp on August 10, 2017 Medical Practice Efficiencies & Cost Savings (n.d.) In Health IT.gov. Retrieved From: https://www.healthit.gov/providers-professionals/medical-practice-efficiencies-costsavings on August 8, 2017 Most Patients Want to Self-Manage Health Care Online (2015). In Accenture. Retrieved From: https://newsroom.accenture.com/industries/health-public-service/most-patients-want-toself-manage-healthcare-online-accenture-survey-finds.htm on August 8, 2017 Our Mission (2017). In Sutter Health. Retrieved From: http://www.sutterhealth.org/about/mission/ on August 8, 2017 BUSINESS PLAN: TEST RESULT REPORTING 8 Terry, K. (2015). Patient Portals: Essential but Underused by Physicians. Retrieved From: http://medicaleconomics.modernmedicine.com/medical-economics/news/patient-portalsessential-underused-physicians?page=full on August 8, 2017 Test Result Reporting and Follow Up (2017). In ECRI Institute. Retrieved From: https://www.ecri.org/components/HRC/Pages/PatientSafetyTop10_2017_4.aspx on August 8, 2017 SWOT Analysis Strengths Use these prompts to complete this section: 1. 2. 3. What are the recognized strengths of your identified area? Weaknesses Use these prompts to complete this section: 1. What are the recognized weaknesses of your identified area? Multiple specialists throughout the East Bay area. In addition, our providers accept a large number of insurance plans. Communication of test results – no standardized process for reporting test results in a timely manner which could potentially affect quality outcomes. What does your identified area do better than other companies? Communication with outside providers relating to patient care. Care coordination within the organization, affordability, and offices located throughout the Bay Area, making it easy to access the care that you need close to home. Timely access to health care services, particularly primary care services. 2. Large health care systems like Kaiser communicate well because all providers are part of the health care system. Our patients have the ability to go outside of our health care system to see multiple providers which can cause communication issues. What unique capabilities or resources does you identified area possess? As part of a large health care organization, our physicians have access to a number of specialists across the Bay Area. Care coordination across multiple locations and specialties ensure that we are providing our patients with the highest level of care. As a member of this organization, patients have access to a large number of services. What do competitors do better than your identified area? 3. What areas can be improved at your current position? Improve communication of test results to allow for timely diagnosis and treatment of diseases and conditions. Improve access to health care services 4. What do other companies consider to be your strength? Our physicians have received national recognition for the care that they provide to our patients from organizations such as the California Association of Physician Groups, Best Doctors Inc., Best Doctors in America, Integrated Healthcare Association, and the Institute of Medical Quality. 4. What do other companies consider to be your weakness? Communication among multiple specialists outside of the organization which result in delays. Access to primary care and specialty services, on average about 4-6 weeks out. Opportunities Threats Use these prompts to complete this section: 1. Use these prompts to complete this section: What trends or conditions impact the company in a positive way? 1. Focused efforts on patient satisfaction related to communication among health care providers. Nationwide physician shortage Increased patient population as a result of the ACA. Focus on clinical quality dashboard related to healthcare maintenance Improving access and affordability with the recent changes resulting from The Affordable Care Act (ACA). Patient population has doubled in this area while there continues to be a nationwide shortage of physicians – projected to reach a shortage of 90,000 physicians by 2025 in the U.S. (Bernstein, 2015). 2. What trends or conditions impact the identified area in a negative way? Increased demand on current physicians resulting in physician burnout (AMA, 2017). 2. Integrated health care systems like Kaiser Permanente can offer lower insurance premiums, resulting in lower patient volumes for other health care providers and systems. What opportunities exist for the identified area? Improving access to primary care services by hiring more Advanced Care Practitioners (ACPs) What is the competition doing that may have an impact on your identified area? 3. Does your identified area have solid financial support? The health care organization as a whole has defined affordability and access as a strategic goal and have set aside funds to aid in this effort. Improving communication methods of test results to ensure timely treatment. 4. What impact does your weakness have on the threats your identified area faces? With the influx of patients as a result of the ACA, provider ability to communicate with their patients is going to be an even bigger challenge. If we do not develop a standardized method for communicating with our patients, this will lead to higher physician burnout, higher patient access issues and affect overall patient quality outcomes. Strategic Goal: Develop standardized method for communicating test results to patients in a timely manner, leading to higher quality outcomes and reducing the risk of physician burnout, which can ultimately lead to patient access issues. 2 References AMA: Better Patient Communication May Reduce Physician Burnout (2017). The Cardiology Advisor. Retrieved From: http://www.thecardiologyadvisor.com/practice-management/reduce-physician-burnout-through-communication/article/675580/ on July 30, 2017 Awards and Recognition (2017). Sutter Health. Retrieved From: http://www.sutterhealth.org/about/achievements/index.html#Sutter East Bay Medical Foundation on July 30, 2017 Bernstein, L. (2015). U.S. Faces 90,000 Doctor Shortage by 2025, Medical School Association Warns. Retrieved From: https://www.washingtonpost.com/news/to-your-health/wp/2015/03/03/u-s-faces-90000-doctor-shortage-by-2025-medicalschool-association-warns/?utm_term=.66a84a687b29 on July 30, 2017 3 Running head: STAKEHOLDER ANALYSIS/ACTION PLAN Stakeholder Analysis/Action Plan Name College Date 1 STAKEHOLDER ANALYSIS/ACTION PLAN 2 Stakeholder Analysis The identification of key stakeholders is an essential element to developing a successful communication plan. Each stakeholder has different priorities and areas that are important in their line of work. Developing an action plan that addresses those priorities and concerns is crucial in order to achieve buy in from each stakeholder. The proposal is to implement a patient portal in order to communicate test results electronically. The overall goal is to improve patient safety while reducing the risk of missed and delayed diagnoses. This plan will tie into the strategic goal of improving quality, affordability and access. In addition to ensuring that patients receive their test results in a timely manner, this process will also improve affordability by eliminating waste and over processing. Patients will be able to receive their results electronically, eliminating the use of paper and other resources needed to process mailings and calls to patients. Patient portals have also been shown to improve the workflow of physician’s practices, which contributes to a decrease in physician burnout. Physician burnout is one of the main components that affects patient access (Medical Practice Efficiencies, n.d.). This project will require input from many different stakeholders across the organization. The stakeholder analysis tool below helps us in identifying those stakeholders, allowing us to best determine how to market this plan. STAKEHOLDER ANALYSIS/ACTION PLAN Communication Action Plan Based on our stakeholder analysis tool above, we have determined that the stakeholders that are most affected will be physicians, patients, and IT support staff, as this process will be utilized the most by them. However, each stakeholder has a role in ensuring that this is a successful launch. The communication of the strategic plan will be presented in a clear and concise manner. We will present the plan in different ways, acknowledging that each stakeholder absorbs the information differently. Finally, we will create a setting in which all stakeholders will have the opportunity to have their questions answered and provide their own feedback (Weaver, 2016). 3 STAKEHOLDER ANALYSIS/ACTION PLAN 4 Prior to presenting our plan to physician and organization leadership we need to ensure that we know what is important to the clinicians so that we can address them in our presentation to the board. This will require rounding with the physicians, discussing the plan with them and getting their feedback. With this information we will create a powerpoint presentation that will address the history and rationale behind the proposal as well as provide responses to the clinicians top concerns. We will include claims and incident reporting data to demonstrate why this is an important plan to invest in. Finally, we will tie this plan with our strategic goal, to show leadership how this project aligns with the vision of the organization. We will include plenty of time for questions and answers at the end of our presentation. Patients are just as important as the physicians, as this will be a portal that they will use to communicate with their physicians as well. As part of our research, we will conduct on site random surveys with our patients to get a better understanding of what is important to them in regards to communication. This information will be given to our marketing team so that they can create a robust marketing plan aimed at addressing those key components. IT support staff will need to be consulted to make sure that we are providing them with the tool and resources that they need to ensure success. Again, this will require meeting with the IT leadership team to identify their “must haves”. The IT support team doesn’t need to have this project “sold” to them, rather they need to be confident that we will provide the necessary resources that they need to make their jobs easier. The powerpoint presentation that was developed for the board will be customized and tailored to address each stakeholder’s focus. For example, when presenting this plan to Privacy/Risk/and Quality we need to ensure that we address their concerns with how this patient STAKEHOLDER ANALYSIS/ACTION PLAN 5 portal will affect their areas of concern. Each stakeholder has a committee structure and will be presented at their respective committees for input and feedback. Once the plan has been approved it will be important to keep all stakeholders informed about the progress, challenges and barriers that we are faced with during the implementation process. This will be done in the form of email communication and regular committee updates. Communication among stakeholder is an important component to ensuring a successful launch of any project. When stakeholders are not informed or included in the planning and developing stage, many key concerns or areas of opportunity may be lost, resulting in a poorly executed project. Our plan is to make certain that we have addressed our stakeholder’s concerns, that they are included in the process and that they are aware of the progress along the way. As issues arise with this project, we will consult with the affected stakeholders as soon as possible. STAKEHOLDER ANALYSIS/ACTION PLAN References Medical Practice Efficiencies & Cost Savings (n.d.) In Health IT.gov. Retrieved From: https://www.healthit.gov/providers-professionals/medical-practice-efficiencies-costsavings on August 8, 2017 Weaver, J. (2016) How to Effectively Communicate Your Strategic Plan to Employees. Retrieved From: https://www.clearpointstrategy.com/communicating-strategy-be-effective/ on August 11, 2017 6
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