Health informatics

HINF 4430: Health Information Exchanges & Networking
Long-Term Paper / Project
Background Information
As the leader of your organization’s newly formed population health management
team/department you have been tasked with improving care coordination, communication,
quality, patient access, patient satisfaction, and cost containment through the development of
an integrated health information exchange (HIE) that follows the OpenHIE format. Your
organization realizes that use of various electronic medical records and health information
systems throughout their three hospitals and twenty plus outpatient facilities has created
significant barriers to the continuity of care for patients. Therefore, the executive board has
tasked you with developing a detailed plan for freely exchanging patient information between
their disparate health information systems with the purpose of implementing a new population
health management strategy that will help address your population’s specific medical
conditions.
The following information will outline the organization’s structure and specific demands made
by the executive board. You will report to the Chief Information Officer (CIO) and Chief
Financial Officer (CFO), along with the Chief Medical Information Officer (CMIO) given the
highly technical nature of this project and need to address improvements in clinical care.
Furthermore, you will be working with a team comprised of the following:
 Chief Operations Officer (COO) – responsible for all hospital and outpatient operations,
concerned about impact on workflow, patient throughput, and ensuring regular
processes are maintained and delivered for quality of care.
 Director of Quality Improvement – oversees all quality improvement projects across
hospital and outpatient settings, including Meaningful Use, commercial and government
reimbursement contracts, especially pay-for-performance (P4P) contracts with various
insurance companies.
 Chief Nursing Officer (CNO) – responsible for all nurses within the organization and
concerned with the duties nurses and other non-physician staff are tasked with
performing for any project.
 Director of Information Technology – second in command for all IT related projects and
activities, direct liaison for CIO, and key resource for your technical infrastructure
development
 Chief Medical Officer (CMO) – responsible and speaks for all physicians across the
organization, important resource for reviewing what changes might take place in care
delivery as a result of information collected from your population health management
project.
 Chief Medical Information Officer (CMIO) – also your direct report for this project, but
key resource for designing information systems that will benefit patient care
Organizational Structure
Three (3) hospitals:
 Hospital A: 300 beds; academic teaching affiliation; all services; HIS = Epic
 Hospital B: 50 beds, acute-care facility; emergency department, minor surgery,
diagnostic imaging, and in-house laboratory; HIS = Epic
 Hospital C: critical access hospital (CAH); 20 beds; HIS = Cerner
Urgent Care Facilities:
 Urgent Care 1: minor care facility; laboratory, and diagnostic imaging; HIS / EHR =
Allscripts Enterprise
 Urgent Care 2: minor care facility; laboratory, and diagnostic imaging; HIS / EHR =
Allscripts Enterprise
Outpatient Clinics (#20)
 Outpatient Group A: ten (10) practices; EHR = AthenaHealth
 Outpatient Group B: ten (10) practices; EHR = eClinicalWorks
Laboratory
 Laboratory information system (LIS); HL7 compliant
Diagnostic Imaging Center
 Radiology information system (RIS); HL7 compliant
Home Health Agency
 Standalone EHR system
Project Scope of Requirements
The population health management (PHM) department is tasked with developing the
administrative, operational, regulatory, security & privacy, and technical components necessary
to collect patient health data from all information systems, store it in a centralized data
warehouse, perform analytics, and produce usable reports for improving patient care. In
addition, the organization will utilize the electronic communication network developed by the
PHM team to create more effective workforce planning and coordination within the
organization. This new information and communication technology (ICT) must adhere to all
government regulations and abide by the rules and regulations set forth by HIPAA. The goal of
this project is to bring together the organization’s disparate IT systems for integrated care
delivery and information storage, while overcoming the fragmented IT environment currently in
place.
1. Describe the importance of population health management and the ways in which it can
help improve the quality of care for our patient population (15 points: a & b)
a. Discuss how this PHM initiative will help our organization adhere to pay-forperformance
(P4P) reimbursement contracts with commercial and government
payers.
b. Explain how PHM will help government surveillance programs and disease
prevention and tracking
2. Lay out the governance framework for our organization’s stakeholders, HIPAA
compliance requirements, and data use and sharing agreements needed to ensure a
sustainable program (15 points)
3. Discuss the ways in which this PHM program will help our organization meet Meaningful
Use requirements and other quality improvement initiatives (10 points)
4. Describe in detail the technical infrastructure needed to effectively and efficiently
collect, store, analyze, and report on patient data
a. Architecture of the system
b. Interoperability, both syntactic and semantic (e.g. terminologies)
c. Data standards needed to share information across our organization structure;
(20 points)
5. Outline the shared health record (SHR) and how it will function in this population health
management initiative (10 points)
6. How client registries, patient identification, matching, and mapping will be designed to
ensure clinicians and PHM analysts have the appropriate information to improve care
coordination, quality, and communication (10 points)
7. Discuss how facility and health worker registries will be utilized for care delivery and
workforce management (10 points)
8. Summarize how the PHM program will utilize this newly developed HIE and SHR to
deliver higher quality of care, improve communication and coordination between the
members of our organization, provide increased patient access, and reduce costs for our
organization (10 points)