The Role of Information Technology For A Private Medical Practice Noel Chua Rosalinda Raymundo

BACKGROUND Ellwood Medical Group Zelienople and Ellwood City 5 Doctors, 1 Nurse Practitioner 5 Offices Ellwood City Hospital 8000 patients

MAJOR PLAYERS Doctors and Nurse Practitioner Office staff (secretaries, nurses, etc) Insurers Pharmacies

OBJECTIVE To analyze the problems encountered primarily by doctors in EMG and propose a system that will provide solutions to these problems especially through information technology

PROBLEMS IDENTIFIED Patient record inaccessibility Poor scheduling process and no monitoring of incoming lab results and outstanding messages No integration of diagnosis and billing codes

PROBLEMS CONTINUED No alerts for missed health maintenance protocols No alerts for lack of progress towards an expected goal No process for tracking down referrals and consultation

PROBLEMS CONTINUED Lack of customized flowsheets for various medical problems No process of tracking prescriptions filled by the pharmacies No process of tracking adverse drug reactions according to different categories such as by patient, drug, or pharmacy

PROBLEMS CONTINUED No process available to access single or groups of medical records by specific clinical attributes No process for alerting physician on non-covered medicines or HMO authorization requirements

ANALYSIS OF THE REQUIREMENTS OF THE PROBLEMS To improve accessibility requires a system that will allow capture and storage of patient data easily retrievable at the point of care The system should be capable of different administrative functions

ANALYSIS CONTINUED The system should support physicians in the proper use of billing codes, integrating these codes with diagnosis codes and procedural codes The system should have an alert system that will trigger a response from the physician when treatment objectives are not satisfied

ANALYSIS CONTINUED The system should enable physicians to do ad hoc queries such as tracking referrals and consultations The system should allow physicians to view nationally accepted practice guidelines on demand and enable physicians to provide relevant handouts

ANALYSIS CONTINUED The system must be able to alert physician whether a prescription is filled or not filled The system should be able to monitor and alert physician about adverse drug reactions and classify them according to causation The system must allow physicians or authorized users access to single or groups of medical records by specific attributes

ANALYSIS CONTINUED The system should alert physician about non-covered medication and likely requires integration with the systems of the pharmacy or the insurers

MAJOR VENDOR IDENTIFIED MCKESSON HBOC Strategic mix of applications and technologies, support and services designed to support the entire health delivery process Allows physicians and other clinicians to document patient information at the point of care

HBOC CONTINUED Allows management of cash flow, monitor risk, maintain and share patient demographics and medical records Allows scheduling of services and resources Allows access, control, analysis and integration and sharing of financial and patient information throughout the organization

HBOC CONTINUED Offers managed care software solutions for providers beginning to assume risk for patient populations as well as managed care organizations Offers decision support tools for the provider and payor markets by giving them access to diverse sources of information, powerful analytical functions, and extensive reporting and presentation tools

HBOC CONTINUED Offers extensive clinical management tools to optimize quality, appropriateness and cost- effectiveness of patient care Offers comprehensive financial management tools that facilitate detailed cost accounting and budgeting analysis, resource utilization analysis, member management, risk assessment

GAPS IN EXISTING SOLUTIONS HBOC does not allow customization of chart formats and specialty specific formats Has limited support for customizing flowsheets Does not track prescriptions filled Does not track causes of adverse drug reactions

GAPS CONTINUED Does not have the ability to handle clinical problem solving Does not support education for drug/food interactions

CONCLUSION EMG needs a system that will: allow an integrated delivery of health service streamline all work processes integrate all office functions, monitor patient outcomes and alert physicians

CONCLUSION CONTINUED Boost efficiency and productivity This requires a considerable investment of its resources in order to adapt and stay competitive in a technology driven society