Question

Kaiser Permanente Implements Electronic Health Record (EHR) system Kaiser Permanente is an integrated healthcare organization founded in 1945. The company operates one of the nation's largest not-for-profit health plans, with over o m on health plan subscribers. Kaiser Permanente includes Kaiser Foundation Hospitals 37 pitals) The Permanente Med Groups, with 611 medical offces The company employs nearly 176,000 people, i 17,157 ncluding HealthConnect operating revenue was almost $51 billion name of Kaisers comprehensive health information system. over the past decade HealthConnect has been a leader in the im plementation of electronic health records (EHR), computer-readable records of health-related information on In 2003, Kaiser had announced its intention to work with Corporation over a three-year period to build an integrated set of systems to support EHRs, computerized physician order entry, scheduling and billing, and clinical support a an estimated cost of $1.8 billion. This decision came after Kaiser had already made several unsuccessful attempts at clinical automation projects. The project eventually ballooned into a seven-year, $4.2 billion effort as the scope of the project was expanded time and again Training and productivity losses made up more than 50 percent of the cost of the project as Kaiser had to cut physicians' hours at clinics during training and was forced to hire physicians temporarily to handle the workload However, in 2010, Kaiser announced that it had fully implemented EHR applications at all of its hospitals and clinics Finally, it could begin reaping the benefits from its efforts. The HealthConnect system connects Kaiser plan ubscribers to their healthcare providers and to their personal healthcare information. The system uses EHRs to coordinate patient care among physician's offices, hospitals, testing labs, and pharmacies. The EHR is designed to ensure that patients and their healthcare providers all have access to current, accurate, and complete patient data. The system and its data are now accessible via smartphone as well as nal computer. During 2012, there were over 88 million subscriber sign-ons to the system. Physicians and nurses in hospitals, clinics, and private offices document treatment in the EHR system. After a physician enters a diagnosis into the system, he or she may receive a system message indicating that there is a best practice order set available for treating the condition. When hey enter a medication order, physicians receive alerts about potential allergic reactions or adverse dnug reactions based on other medications a patient is already taking. Physicians also receive automatic notifications about how lab test results should affect medication orders HealthConnect also provide capabilities to support bar coding for the safe administration of medicine. Under this system of administering medication, the murse first scans the patient's barcoded identificat wristband. The nurse next scans a bar code on the medication container that identifies the specific medicine and dosage. The system verifies that this medicine and dosage has been ordered for this patient. If there is not a match, the nurse receives an audible warning sigal Kaiser has found that use of a comprehensive EHR mproves health plan subscribers' satisfaction th the ncare delivery system. In addition, HealthConnect empowers healthcare plan subscribers to take more responsibility for managing their own health care. Kaiser subscribers can access HealthConnect via a Web portal at kp.org. Here they are able to view most of their personal health records online, including their lab results, medication history, and treatment summaries. Patients can enter their own readings from blood pressure and glucose meters. They can also securely email their bealthcare providers which cuts down on the amount of time patients spend on hold waiting to speak to a doctor and on the number of office visits the number of outpatient visits has dropped an average of 8 percent in the one and one-half years following EHR implementation at each hospital Each month patients send over 1 million emails to their doctors and healthcare teams through this component of the system. over 29 million lab test results were viewed online in 2011. In addition approximately 827,000 prescriptions are being refilled online monthly, and 230,000 appointments are scheduled month

Answer 1

a. The advantages of EHR system:

1. The most advanced electronic health records are available to the members which have 24/7 access to their medical information and health management tools from anywhere in the world.

2. Manual work has been decreased as more work will be done automatically.

3. Accessibilty via smartphone and personal computer is highly achievable.

4. E-mail messaging and scheduled telephone visits consume much less time; logic suggests that the efficiency gains offset any increases in documentation time.

"Our comprehensive electronic health record and our vast array of mobile and video applications have allowed us to reduce the chances of our patients dying from cardiovascular disease, cancer and systemic infection by as much as 30 to 40 percent, compared to doctors and hospitals without this technology,” said Robert Pearl, MD, executive director and CEO, The Permanente Medical Group. “The greatest advances in the 21st century in improved quality outcomes have been from information technology. The beneficiaries are patients and their families.”

b.

Some benefits Kaiser Permanente provides in many of their plans, as of 2015, include a $50.00 copayment for the first three office appointments with a primary care physician, no charge for preventive care services, and outpatient mental health care coverage, explains its website. Subscribers receive prescribed contraceptives at no charge, with no deductible costs. The Kaiser Permanente Copayment Gold plan provides no annual deductible, and a $20.00 copayment covers many services, including primary care office visits. Many of Kaiser Permanente's plans give subscribers a 90-day supply of approved prescriptions for the cost of a 60-day supply when ordered via mail.

Kaiser Permanente offers several different plans, each of which has a different deductible cost and monthly premium. Available plans and rates vary according to the subscriber's physical address, age, tobacco use and the effective date of enrollment. Annual deductible amounts range from $0.00 to $13,700, while maximum out-of-pocket charges are $5,000 to $13,700. Different copayments and coinsurance apply to specialty and non-preferred drugs.

1. HealthConnect empowers the subscribers to manage their own heath care.
2. Subscribers can connect via the web portal kp.org. Here, they can view most of the information of personnel health care records online, including lab records and meditation history.
3. Talking to the health care providers will be easier as it cuts down the amount of time.

c. Three risks/issues :

1. intermittently unable to access [HealthConnect] -- receiving Citrix error message and therefore unable to access any patient info or update patient info in a timely manner. (Connectivity issues)

2. Medical Office were unable to place new orders for in-patients. "Drug Database information is not populating for pharmacist and technicians," the report said. "New orders will have to be manually done. In the manual process, the nurses cannot see patient updates for new orders for new medications or changes in meds, such as stopping orders. The manual process will create significant delays in patient care."

3. Pharmacists must handle medication orders on these patients manually because one cannot enter medication orders into the system on patients that have not been admitted," the report said. "Also, if a patient were transferred during this time, they would need to track their location manually. In addition, the [users] are reporting that multiple patients are showing in the wrong beds. Patient Care Impact: The [users] reported that the potential for patients to not get the treatments they need and the possibility of patients receiving the incorrect medications."

The TAM hypothesizes that user intended behavior predicts their actual system use . It proposes two main factors that determine users’ behavioral intention (BI) toward using a new technology, specifically perceived usefulness (PU) and perceived ease of use (PEoU) . This theory suggests that external variables, such as human and social factors, indirectly determine attitude toward technology acceptance by influencing PU and PEoU  and. The TAM is one of the most influential frameworks for predicting users’ perceptions about information system use.

The factors which will influence Customer's attitude:

1. High Quality,

2. clinical information available 24/7. and clinical outcomes are unsurpassed.

3. Real-time the recommended best practices.

4.  Access information via telephone, Web and email.

5. Eliminate costly in-person services unless medically necessary or desired by the patient.

6. Eliminate waste associated with paper medical records and missing medical records.