MHA6120 WEEK 5 DISCUSSION AND PROJECT INSTRUCTIONS
Week 5 focuses on the role of the government, healthcare managers, and leaders in IT implementation. In addition, you will understand the importance of health information technology (HIT) strategic planning to organization performance and the important elements of an HIT strategic plan.
Your Learning Objectives for the Week:
- Evaluate the various functions, responsibilities, and organizational structure of a healthcare organization’s IT department, including compliance with the Health Insurance Portability and Accountability Act (HIPAA).
- Examine the design, management, and maintenance of clinical information systems to maintain healthcare data security, enhance quality, decrease costs, and improve patient safety in various healthcare settings.
- Discuss management’s role in the alignment, strategic planning, and governance of an organization’s information technology and technology systems.
Government Policy and Healthcare Reform
Government regulation is pervasive in the US healthcare system. The recent mantra of regulatory bodies, whether federal, state, or local agencies, focus on quality of care and patient safety. In Weeks 1 and 2, we focused on the Health Insurance Portability and Accountability Act (HIPAA) privacy and security regulations to protect patient information. Not all regulations are imposed on healthcare providers and organizations. Executive order no. 13335, 3 CFR established the Office of the National Coordinator (ONC) for HIT. The main purpose of this was establishing “leadership for the development and nationwide implementation of interoperable HIT infrastructure in order to improve the quality and efficiency of healthcare” (Wager, Lee, & Glaser, 2017). The current center for Medicare and Medicaid quality initiatives, such as the submission of data for clinical core measures of hospitals, nursing homes, home health agencies, physicians, etc., can be uploaded directly without a third-party IT provider. In addition to clinical core measures, the ten objectives of electronic health record (EHR) Meaningful Use standards will also be achieved (Glandon, Smaltz, & Slovensky, 2013). The goal of ONC is to achieve a nationwide interoperability by 2024 (Wager et al., 2017).
Public health management and intervention will be facilitated by a health information infrastructure that would support interoperability and would be capable of extrapolating data to identify healthcare needs of a community or the population in just a few strokes from the keyboard, thereby facilitating information for early public health management. In addition, the healthcare administrator will also be able to identify the prevalence of disease in the community that will support implementation of services without the rigor of getting information from public health data sites.
HIT leaders must be skilled in translating regulations and implementing approaches to educate organizational leadership and the end users affected by government regulations. Similarly, healthcare managers/administrators must know of the current and proposed legislatures and should be involved in providing inputs when the Center for Medicare and Medicaid services or any of the federal agencies request inputs from healthcare organizations for a new or newly implemented legislation or standard.
Link to Resources
Review the following links to learn more.
Newsroom opens in new window Why Is Health Care Regulation So Complex? opens in new window Making Health Care Markets Work Better: The Role of Regulation opens in new window Laws & Regulations opens in new window
Reference:
- Wager, K. A., Lee, F. W., & Glaser, J. P. (2017). Health care information systems: A practical approach for health care management (4th ed.). San Francisco, CA: Jossey-Bass
Additional Materials
From your course textbook, Information Systems for Healthcare Management, review the following chapter:
- Government Policy and Healthcare Reforms
From the Internet, review the following:
- CMS.gov. (2018). Newsroom. Retrieved from https://www.cms.gov/Newsroom/Newsroom-Center.html
- Field, R. (2008, October 33). Why is healthcare regulation so complex? Pharmacy and Therapeutic. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730786/
- Guterman, S. (2017, January 24). Making healthcare markets work better: The role of regulation. Retrieved from https://www.commonwealthfund.org/blog/2017/making-health-care-markets-work-better-role-regulation
- U.S. Department of Health & Human Services. (n.d.). Laws & regulations. Retrieved from https://www.hhs.gov/regulations/index.html
Management’s Role in Assessing and Maintaining Value in Healthcare Information Systems
The healthcare administrator’s role in IT implementation is crucial in ensuring achievement of time frame and budgetary limit. A healthcare administrator also ensures that the goals and objectives of the HIT acquisition are achieved or the benefits are realized (Wager, Lee, & Glaser, 2017). Hook (2017) reports that in EHR implementation, the failure rate is 20%. Common causes of failure include, but not limited to, technical failure, financial failure, software incompatibility, and people-related issues (Hook, 2017). While a healthcare administrator may not possess technical acumen, Wager et al. (2017) suggest that he or she focuses on the following:
- Lack of clarity of purpose: What are the needs in implementing application, and what will be improved in relation to patient care?
- Lack of organizational belief in the project: Staff are not convinced that the project is worthy of implementation.
- Insufficient support from executive leadership: Executive commitment must be visible and unyielding to the cause of the project implementation.
- Organizational inertia: Organizational culture must embrace and participate with diligence to the implementation from leadership to grassroots.
- Organizational baggage: Identify barriers to HIT implementation.
- Lack of appropriate reward system: A recognition system must be in place to keep dedicated talent in pursuing organizational objectives in HIT implementation.
- Lack of candor: Encourage an internal environment that encourages conflict and management of conflict that focuses on shared goals and objectives.
- Project complexity: Recognize or acknowledge changes in work processes. Be ready for curve balls and unexpected events but remain steadfast.
- Respect uncertainty: Expect potential of unexpected outcomes and listen to feedback but discern noise that comes with change and focus on real problems. Be agile and navigate toward a direction that will lead to solutions.
- Avoid undernourishment: While trying to keep within budget, avoid cheap replacement or talent.
- Anticipate short term disruptions: Be tolerant, listen to the staff, and appreciate their endurance.
- Lack of technology stability and maturity: Avoid extensive technological change. Recognize and provide for adequate time to learn and adapt (Wager et al., 2017).
Earl and Feeney (as cited in Wager et al., 2017) reported five management behaviors in leaders with an effective HIT implementation:
- They studied, rather than avoided, IT.
- They incorporated IT into their vision of the future of the organization and discussed the role of IT when communicating that vision.
- They actively engaged in IT architecture discussions and high-level decisions.
- They made sure that IT was closely linked to core management processes.
- They continuously pressured the IT department to improve its efficiency and effectiveness and to be visionary in their thinking (p. 457).
Perhaps, there is a need to develop a management checklist in supporting and implementing a HIT project to guide a prospective HIT project champion. What Wager et al. (2017) offered serves as an initial focus that will guide students of healthcare administration. In addition, the five management behaviors as framed by Earl and Feeney (as cited in Wager et al., 2017) can also be tested and used to evaluate managers in becoming a HIT project champion.
References:
- Hook, J. (2017, January 30). The top four reasons for EHR implementation failure. Retrieved from https://www.foxgrp.com/information-technology/the-top-four-reasons-for-ehr-implementation-failure/
- Wager, K. A., Lee, F. W., & Glaser, J. P. (2017). Health care information systems: A practical approach for health care management(4th ed.). San Francisco, CA: Jossey-Bass
Additional Materials
From the Internet, review the following:
- Health Information Technology Research Center. (2013). Change management in EHR implementation. Retrieved from https://www.healthit.gov/sites/default/files/tools/nlc_changemanagementprimer.pdf
- Heath, M., & Henry, R. (2013). The role of leadership in leadership and governance in a successful electronic health records implementation. Retrieved from https://www.researchgate.net/publication/280090950_The_Role_of_Leadership_and_Governance_in_a_Successful_Electronic_Health_Records_Implementation_THE_ROLE_OF_LEADERSHIPAND_GOVERNANCE_IN_A_SUCCESSFUL_ELECTRONIC_HEALTH_RECORDS_IMPLEMENTATION
- Shapiro, W. (2018, January). Organizational change management for EHR. Retrieved from https://www.optimumhit.com/blog/ehr-implementation/organizational-change-management/
HIT Governance and Decision Rights
A review of the literature reveals various definitions of IT governance. Lindros (2017) defined IT governance as a “formal structure for aligning IT strategy with business strategy.” This structure provides a framework of best practices and controls (Lindros, 2017). Wager, Lee, and Glaser (2017) described IT governance as the composition of “processes, reporting relationships, roles and committees that an organization develops to make decisions about IT resources and activities and to manage the execution of those decisions.” Jahn (2016) noted that healthcare IT governance is still at its infancy stage compared to other sectors of commerce. Perhaps, the lack of a well-framed IT governance in many healthcare organizations has led to failures in implementation, over-budgeted systems or applications, lengthy implementation, and the lack of alignment and interoperability of clinical, management, and financial applications.
HIT Governance Functions
Wager et al. (2017) suggest the following HIT governance functions:
Review each tab to learn more.
Scope
Determine the distribution of the responsibility for making decisions. Determine the scope of the decisions that can be made by different organizational functions and the process to be used for making decisions.
Roles
Define the roles that various organizational members and committees fulfill for IT. For example, which committee should monitor progress in an EHR implementation and what is the role of a department head during the implementation of a new system for his or her department?
Processes
Develop IT-centric organizational processes for making decisions in key areas such as:
- IT strategy and development
- IT prioritization and budgeting
- IT project management
- IT architecture and infrastructure management
Procedures
Define policies and procedures that govern the use of IT. For example, if a user wants to buy a new network for use in his or her department, what policies and procedures govern that decision?
In summary, HIT governance guides executives, managers, IT staff, and every member of the organization in HIT implementation of the structures and processes involved in acquisition and implementation. The goal of HIT governance is transparency in process and alignment with business strategy. It is important to note that HIT governance functions require an ongoing evaluation for further improvement (Wager et al., 2017). Thus, an HIT governance performance measure must also be conducted.
References:
- Jahn, M. (2016). Nine best practices in healthcare IT governance. Retrieved from http://www.managedhealthcareexecutive.com/business-strategy/nine-best-practices-healthcare-it-governance
- Lindros, K. (2017). What is IT governance? A formal way to align IT & business strategy. Retrieved from https://www.cio.com/article/2438931/governance/governanceit-governance-definition-and-solutions.html
- Wager, K. A., Lee, F. W., & Glaser, J. P. (2017). Health care information systems: A practical approach for health care management (4th ed). San Francisco, CA: Jossey-Bass
Additional Materials
From your course textbook, Information Systems for Healthcare Management, read the following chapter:
- HIT Governance and Decision Rights
From the Internet, review the following:
- Chang, M. S. (2018). Overview of the IT governance structure. Retrieved from https://documents.health.usf.edu/display/UHID/Overview+of+the+IT+Governance+Structure
- Information Systems Audit and Control Association. (n.d.). IT governance round table: Defining IT governance. Retrieved from http://www.isaca.org/Knowledge-Center/Research/ResearchDeliverables/Pages/IT-Governance-Roundtable-Defining-IT-Governance.aspx
- IT Governance Network. (n.d.). Definition of IT governance. Retrieved from http://www.itgovernance.com/index.php/cobit-5-implementations/92-articles/it-governance-articles/200-definition-of-it-governance
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END OF LECTURE NOTES
BEGINNING OF DISCUSSION & PROJECT INSTRUCTIONS
Discussion Topic
Top of Form
Due August 12 at 11:59 PM
Bottom of Form
Discussion Questions
Before beginning work on this discussion forum, please review the link “Doing Discussion Questions Right” and any specific instructions for this topic.
Before the end of the week, begin commenting on at least two of your classmates’ responses. You can ask technical questions or respond generally to the overall experience. Be objective, clear, and concise. Always use constructive language, even in criticism, to work toward the goal of positive progress. Submit your responses in the Discussion Area.
Introduction:
The role of a chief information officer (CIO) is critical in the acquisition, implementation, maintenance, and improvement in HIT. Healthcare administrators work collaboratively with a CIO with the goal of achieving organizational improvements in both clinical and business processes and while ensuring quality safe care, access, and cost containment.
Tasks:
- Interview a CIO from two healthcare facilities and ask the following questions:
- What are the duties and responsibilities of a CIO?
- What are the required skills and competencies of a CIO?
- Who does the CIO report to, and how are decisions made in HIT/health information systems implementation? Prepare and present an organizational chart for each organization.
- What future challenges does the CIO anticipate in the next five years?
- Compare and contrast each of the CIO’s duties and responsibilities, required skills and competencies, and reporting mechanisms.
- Evaluate both CIOs’ perceptions of challenges in the next five years and make recommendations in addressing each challenges.
Submission Details:
To support your work, use your course and textbook readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.
Your initial posting should be addressed at 500–1000 words as noted in the attached PDF. Submit your document to this Discussion Area by the due date assigned. Be sure to cite your sources using APA format.
Respond to your classmates throughout the week. Justify your answers with examples, research, and reasoning. Follow-up posts need to be submitted by the end of the week.
The following resources are provided for this discussion:
From your course textbook, Information Systems for Healthcare Management, review the following chapter:
- Leadership: The Case of the Healthcare CIO
From the Internet, review the following:
- Maripuri, S. (2017, October 26). The changing role of CIOs in healthcare. Retrieved from https://whatsnext.nuance.com/healthcare/the-changing-role-of-cios-in-healthcare/
RubricAssessment-MHA6120-ManagementInformationSystemsinHealthcareWeek5Project (1)