This is some additional detailed instruction for the C816 task:
C816 is an applications course and as such presents certain key concepts and evaluates the student’s mastery by presenting a problem to which the student must successfully apply those concepts. In a general sense this course covers health information technology systems development in the context. Please note the bolding of the word apply. The most common mistake students make in this task is recapitulating the concepts and not applying them to the scenario. Success in C816 in general, and in its single performance assessment specifically, lies in using the concepts in the reading to explain in concrete terms how the events in the scenario will come to fruition.
The student is advised to follow the rubric. The student should present their responses to each prompt (section or bullet point) of the rubric so as to meet the expectations listed in the right-most column of the rubric. After completing the draft, self-score the draft against the rubric as if role-playing the evaluator who will grade it. Your self-score should indicate you have demonstrated competency or high competency per the rubric. Anywhere the draft falls short, the student should revise to meet the competency or high competency standard.
The scenario presented is a hospital with a hybrid electronic medical record system deployed in its emergency department. The student should consult the direction and rubric for details. However, the providers in the emergency department (physicians, clinicians, nurses, etc.,) document patient encounters using both paper-based and electronic means, because the universal use of laptops or workstations on wheels was deemed unfeasible. The result is a chart for patients in the ED which is partially electronic and partially on paper.
The above situation produces what is known as a hybrid record, a concept with which all students should be familiar from previous courses. The student may wish to refresh her/his memory as to the limitations of such a record, but the primary problem presented in the scenario is that the distributed nature of the patient information across electronic and physical media complicates timely chart completion.
Imagine a patient, Joan A, who presents to the emergency department with vague symptoms that could be anything from a heart attack to anxiety, asthma or a pulmonary embolism. To complicate matters further, the unfortunate Ms. Joan is a diabetic and is on seven medications she takes daily, including a diuretic, Glucophage and something she cannot identify beyond a pink tablet she refers to as a ‘heart pill.” Doubtless ferreting out what could be at the bottom of the chest pain, anxiety, confusion and recent collapse at work which brought her to Anywhere Memorial Hospital ED would require that the patient be examined and tested by any number of well-meaning clinical treatment staff who would be recording their findings and impressions—some on paper, some electronically and perhaps some by dictation to be transcribed onto paper or into some electronic form. Now presume that Joan spends six hours in the ED, is stabilized, found to have nothing requiring hospitalization and is released with instructions to follow up with her family physician Elise Kumar. Unfortunately two days later, on her way to her appointment with Dr. Kumar Joan has another episode of some kind, blacks out while driving, crashes her car and reappears at the Anywhere Memorial ED in the company of a policewoman and two EMTS alternately attending to the woman and scratching their heads. One of the first tasks is to review Joan’s previous ED visit, but with the work of over a dozen people who saw her scattered across paper and electronic platforms, reconstructing an actionable picture of this patient in short order would be a challenge.
Even so, Ms. Joan cuts a wide swath. She has been in and out of the ED and back again in less than 48 hours, totaled her car and in the process damaged public and private property—a light pole and a taco truck unluckily parked where her car jumped the curb. Insurance companies and attorneys have become involved, including Joan’s health insurer and her own attorney. The former questions why they should subsidize another ED visit so soon after the first and the latter is livid she was discharged so quickly the first time. Joan’s attorney has called the hospital threatening a malpractice suit and has subpoenaed her ED records. Everyone wants complete and accurate information on Joan’s medical issues, they want it now, they want nothing missing or there will be hell to pay and that information must come from a record parsed across different media. This is but one example of the challenge of a hybrid medical record.
Returning the scenario in C816, you are tasked with devising a plan to move all documentation to the new electronic EMR. To do this, you need to:
- Identify the problems of continuing a hybrid record system (such as what results from the misadventures of Joan A above)
- Describe how the transition to a completely electronic medical record will address the problems of a hybrid system. Be specific here. How will it help the hospital in the scenario?
- Describe how the roles of the staff will change and be improved. Also, if there will be a downside, discuss that as well.
- Be inclusive—the change to an all-electronic system will not just change the habits and workflow of clinicians, physicians and nurses. Others will be affected, including but not limited to lab techs, HIMS, Billing, IT, etc. The more stakeholders you include the better evaluation is likely to receive your work.
- The student might consider devoting a paragraph to each stakeholder, discussing the changes, the plusses and the minuses, if any
- Identify two HIM professionals who will be involved in and who may even spearhead this conversion project. Discuss their roles in the SDLC, the system development life cycle. The student may approach this in any way she/he sees fit, but we recommend devoting at least one paragraph to each stage of the SDLC and in that paragraph discussing the role of the two HIMs identified. Alternatively and likely just as valid, the student could devote one section of the performance assessment to each of the HIMs. In the section for HIM #1 devote a paragraph for that HIM’s role in each stage of the SDLC. Then, in the section for HIM#2 write paragraphs for each stage of the SDLC and how that HIM will contribute.
The SDLC (systems development Life Cycle) has six stages. It can be iterative. Iterative means the cycle can repeat as needed, though always in the same order. However, for the purposes of this assignment the cycle can be considered to be just one cycle through the following 6 processes beginning with process #1, identify need.
- Identify Need
- Specify requirements
- Design or Acquire
- Develop or Implement
- Monitor Results
Attached are the instructions of my task for the C816. I was the one who contacted you yesterday regarding the writing assistance.
Remember, on this course, it is crucial that you follow the gridded RUBRICS for each of the Tasks and not the written instructions.
Please follow those RUBRIC instructions through the attached Organization of Task NPN1 for C816 for more explanations.