Epm5700 Management | Software Used Assessment Answers

Answer:

Introduction 

The prevalence of risks to patients and staff have been on the rise in the recent times (Driver, 2016, p.25). As a result, risk management involves any process, activity or policy whose goal is to reduce liability exposure. Thus, from both the perspective of patient safety and financial point of view, it is critical that healthcare organisations perform risk management practices with the aim to prevent harm to patients as well as decline medically related malpractices. Therefore, it is essential for a healthcare organisation to put in place qualified healthcare risk managers to assess, monitor and implement risk management plans with the target to minimise exposure. There some priorities for healthcare organisations, for instance, patient care, finance, and safety. Accordingly, healthcare risk managers are trained to be able to handle various issues in multiple environments. As a result, healthcare managers identify as well as evaluate risks as a way to decline the rate of injury to patients, visitors within the organisation and the members of staff. In this sense, risk managers work both proactively and reactively with the intent to prevent incidents from occurring and to minimise the damages that follow up an event.

Accordingly, since healthcare is an industry with high-risk factors, a small error can result in significant fatalities, injuries as well as increased expenses to the healthcare provider. Consequently, risk management comes in to improve patient care and safety, reduce costs in addition to ultimately benefit the health care providers’ bottom line.  According to (Klindworth, Risk Management Solutions LLC, 2014) risk management is an activity that is used to assess a healthcare facility privacy and safety risks for patients, staff, clinicians, and data. After the risks have been assessed, the healthcare facility establishes risk control protocols by consistently implementing new practices in the entire organisation. As a result of the health care effort to enhance risk management, there is a various software application that has been put forward such as electronic medical records (EMR) management system, integrated risk management systems and clinical risk management systems have been advanced to make sure that health-related risks are prevented and reduced as much as possible.    

The significance of Risk Management in Healthcare 

When a healthcare facility has a strong risk management process, it experiences a reduced number of complaints from patients, errors, readmission cases and inappropriate services. Therefore, such improvements in patient care experience contribute to the growth and development of a healthcare bottom line. Accordingly, risk management entails all factors of a healthcare’s infrastructure and services such as patient care, fire safety, facility maintenance, financial matters in addition to compliance with the applicable rules and regulations (Carroll, 2016, p.25). Healthcare organisations undertake a broad range of activities to decline claims related to medical malpractices like utilising clinical protocols, credentialing and privileging healthcare professionals as well as maintaining medical records. All these practices are essential in some ways such as:

Ensuring patient safety: Healthcare facilities treat a range of conditions, for instance, asthma, hypertension, and diabetes and cardiovascular diseases only but mention a few. These conditions make it imperative for healthcare facilities to make sure that their clients receive the suitable level of care (Peiris et al., 2015, p.89).

Effective patient care practices: through the development and implementation of healthcare risk management programs which are built on extensive continuous research. Consequently, this enables risk managers to be updated with relevant information which helps in shaping risk management practices in the organisation.          

Listing and description of the available software 

Some of the healthcare risk management software applications include electronic medical record systems, integrated enterprise risk management (ERM) system and clinical risk management system.

Electronic Medical Record (EMR) system 

Electronic medical records (EMRs) is a digital manner of keeping patients information which does not use paper or charts. ERMs consists of general information about the patient such as medical history and treatment of the patient. In so doing this has helped to improve patient care as well as declining the chances of losing patient information since all patient records are kept digitally such that there is no use of paper records which if they get lost they cannot be retrieved. Certainly, through the use of EMR, issues of loss of patient information is a matter of the past because everything has been digitized, therefore, cases of loss of clients medical records is a matter of the past.       

Integrated Enterprise Risk Management (ERM) System 

Integrated ERM collects all risks from within the healthcare enterprise together so that to determine the way in which these risks are related to each other. As a result, this helps to unmask the insight that was previously hidden within individual silos.                 

Clinical Risk Management (CRM) System 

Clinical risk management systems are specifically designed to enhance the quality and safety of healthcare services (Tricarico et al., p.746). Therefore, this application work by identifying the circumstances as well as opportunities which place patients at risk of harm and acts to avert or control these risks. The clinical risk management software can manage clinically related risks through four steps which include risk identification, assessment of the frequency and severity of the risk, decline or eliminates the risk and lastly but not least the cost involved in countering the risk (Zadfallah, Bastan, and Ahmadvand, 2017).    

Evaluation Matrix 

Software selection for evaluation

Requirement analysis: This process entails several steps which include:

Meetings with users. The project begins with a kick-off meeting whereby it involves interviewing process owners and stakeholders to collect requirements needed for implementation of the software (Zaidan et al., p.392).

Software research. The health care should use extensive knowledge of the market to identify the software product candidate that is likely to meet its requirements.

Developing requirements. The healthcare can add its requirements from its libraries. Then it can deploy a reverse engineering approach to discover all the relevant requirements.   

Review of the selected software

The process of reviewing the selected software involves weighing of the project requirements. In this case, the healthcare can interview its staff and employees to weight its requirements. Accordingly, this will help the healthcare to create a requirement profile that has a unique standard against which the software can be evaluated.  

Criteria for evaluation

The healthcare organisation should select a review method which should comprise two part. The first part can be a general explanation of the health care objectives and functionality of the software application (Boonstra, and van Offenbeek, 2018). Secondly, the healthcare has to review the software using a selected approach which can be conducted using the following approaches flowchart, sample transactions, and source code.  

Discussion on weight for each criterion 

Flowchart. Here the program is explained logically in the form of a flowchart of the program.

Sample transactions. Here the lead programmer explains the way in which the program works by explaining the process that happens using a representative sample of transactions (Garg et al., 2015, p.683).

Source code. The review examines every source code line to understand the        

Healthcare Risk Evaluation matrix

How to use a Risk Matrix

• Identification of hazardous event/scenario
• Determining risk using a risk matrix

1. Assessment of the event’s impact
2. Assessment of the event’s likelihood of occurring

• Determination of risk (plotting the events on the risk matrix)
• Risk evaluation and decision making

Weighting each Software Criteria  

Benefits of Implementing Electronic Medical Record (EMR) system

By implementing EMR, it places healthcare in a better position of tracking its patients’ data for an extended period by various healthcare givers. Therefore, this can help the facility to identify patients who are due to preventive screenings and check-ups as well monitoring the manner in which each patient measure up to specific requirements such as blood pressure readings (Nguyen, Bellucci, and Nguyen, 2014, p.782). Indeed, EMRs have been designed to aid healthcare organisations offer detailed and effective care. Therefore, some of the major benefits that come with the implementation of ERM include:

Financial benefits: If a healthcare facility decides to implement EMRs it is likely to experience a decline in the general expenditure. The decision to utilise the EMR system in the place of paper records could lead to a positive reimbursement on the healthcare financial investment. The use of EMR software has higher chances of boosting the quality as well as the safety of patient care since it is possible for the healthcare to prescribe and order medication for patients online in a more safe way (Fritz, Tilahun, and Dugas, 2015, p.479). The reason for this is that it enables the healthcare organisation to understand if the client was prescribed any medication from a different physician. It is also, possible to understand each patient’s problems. Accordingly, with such precise information at the fingertips of healthcare staff, it is possible for the facility to offer its patients with efficient, safe and personalised care that they deserve.

Improved patient care: EMR applications are designed in a way that they help patient together with their families to become much involved in the healthcare process (Ben-Assuli, 2015, p.289). Similarly the use of ERM software help patients to easily and quickly receive electronic copies of the healthcare information upon request.

Benefits of adopting Integrated ERM among Healthcare organisations

High-quality patient care. Through the implementation of ERM system, it provides healthcare with the opportunity to increase its effectiveness in outlining patients’ safety concerns which can then be resolved. Therefore, Integrated ERM plays a big role in enabling healthcare facilities to easily adopt the increasingly popular patient-centered value-oriented care models (Adler-Milstein et al., 2015, p.2174).

Compliance.  Integrated ERM is not exclusively for managing risks to meet compliance requirements. Compliance is in most cases a benefit for undertaking risks out of the silos, which help to gain an extensive view of these risks (Crema, and Verbano, 2015, p.995). Thus, it aids the healthcare to unmask an action plan which goes beyond the compliance standards.

Improved healthcare services and processes. With the implementation of integrated ERM, it can remove the redundancies which in most cases come to light because of operating in silos. As a result of the transparency as well as coordination among healthcare professionals, it means the possibility of creating additional problems in one part after resolving other problems in other parts. All these paybacks can come into realisation in a range of ways such as a majority of the healthcare organisation are shifting from fee-for-service payments models to value-based payment models (Kruse et al., 2015). In this case, healthcare providers become incentive based on the quality care level that they offer to patients.

Proper investment. Integrated EMR is built on well-established data which can position a healthcare’s risks and also provide it with the insight on what to invest in. Regardless of the sector that the healthcare will opt to invest such as value-incented risk-taking or risk mitigation since integrated EMR make the healthcare to feel confident on how it spends.

Resilience. Since integrated ERM takes into account both downside as well as upsides of risks, it can aid a healthcare facility to be in a better position to withstand vulnerabilities. Also, the adoption of ERM could help healthcare to thrive regardless of the rise of changes in the marketplace (Jensen et al., 2015, p.153). Accordingly, through the adoption of ERM, it makes it easier to implement of value-enhancing risks such as adding the lucrative novel clinical business line as well as the merging of the healthcare with other providers.

Benefits of Clinical Risk Management (CRM) System 

The objective of CRM analysis is to determine the causes of the risk as well as factors that favor errors and the probability of such risks from occurring (Sendlhofer et al., 2016, p.7). Therefore, CRM software plays a significant part in enhancing the quality and safe delivery of health care by introducing applications which can identify and prevent circumstance that place patients at risk of harm.  

Discussion

Results 

Accordingly, based on the above benefits of each software application it is realised that both applications work to see to it that they avert risks from occurring. All the software applications work to ensure that the patient revives high-quality care. As a result, it is upon the healthcare organisation to decide on which software best suits its risk management process.

Problems and Pitfalls

The main problem, in this case, is to make sure that risks among healthcare organisations are reduced and if possible prevented. Nonetheless, the major problem that faces healthcare organisations is lack of resources to implement risk management software whose implementation is expensive.   

Recommendations

Based on the selected risk management software above I would recommend that the most effective software that should be implemented is the integrated risk management software. Indeed, this software application has several advantages as compared to the EMR and CRM application. Therefore, its implementation could be of greater benefit to the healthcare, not only regarding offering high-quality patient care but also offer the organisation returns as well as regarding compliance.   

Bibliography

Adler-Milstein, J., DesRoches, C.M., Kralovec, P., Foster, G., Worzala, C., Charles, D., Searcy, T. and Jha, A.K., 2015. Electronic health record adoption in US hospitals: progress continues, but challenges persist. Health affairs, 34(12), pp.2174-2180.

Ben-Assuli, O., 2015. Electronic health records, adoption, quality of care, legal and privacy issues and their implementation in emergency departments. Health Policy, 119(3), pp.287-297.

Boonstra, A. and van Offenbeek, M.A., 2018. Shaping a buyer's software selection process through tendering legislation. Information Systems Journal.

Carroll, R., 2016. Identifying risks in the realm of enterprise risk management. Journal of healthcare risk management, 35(3), pp.24-30.

Crema, M. and Verbano, C., 2015. Investigating the connections between health lean management and clinical risk management: insights from a systematic literature review. International journal of health care quality assurance, 28(8), pp.791-811.

Driver, J., 2016. Challenges in healthcare risk management driving innovative, evidence-based solutions. Modern healthcare, 46(13), p.25.

Fritz, F., Tilahun, B. and Dugas, M., 2015. Success criteria for electronic medical record implementations in low-resource settings: a systematic review. Journal of the American Medical Informatics Association, 22(2), pp.479-488.

Garg, R., Sharma, R.K., Sharma, K., and Kumar, R., 2015. Identification, selection and evaluation of COTS selection criteria using fuzzy set theory. International Journal of Advance Research and Innovation, 3, pp.682-690.

Jensen, R.E., Rothrock, N.E., DeWitt, E.M., Spiegel, B., Tucker, C.A., Crane, H.M., Forrest, C.B., Patrick, D.L., Fredericksen, R., Shulman, L.M. and Cella, D., 2015. The role of technical advances in the adoption and integration of patient-reported outcomes in clinical care. Medical care, 53(2), p.153.

Klindworth, W.A., Risk Management Solutions LLC, 2014. Automated Healthcare Risk Management System Utilizing Real-time Predictive Models, Risk-Adjusted Provider Cost Index, Edit Analytics, Strategy Management, Managed Learning Environment, Contact Management, Forensic GUI, Case Management And Reporting System For Preventing And Detecting Healthcare Fraud, Abuse, Waste, And Errors. U.S. Patent Application 14/027,193.

Kruse, C.S., Mileski, M., Alaytsev, V., Carol, E. and Williams, A., 2015. Adoption factors associated with electronic health record among long-term care facilities: a systematic review. BMJ open, 5(1), p.e006615.

Nguyen, L., Bellucci, E., and Nguyen, L.T., 2014. Electronic health records implementation: an evaluation of information system impact and contingency factors. International journal of medical informatics, 83(11), pp.779-796.

Peiris, D., Usherwood, T., Panaretto, K., Harris, M., Hunt, J., Redfern, J., Zwar, N., Colagiuri, S., Hayman, N., Lo, S. and Patel, B., 2015. Effect of a computer-guided, quality improvement program for cardiovascular disease risk management in primary health care: the treatment of cardiovascular risk using electronic decision support cluster-randomized trial. Circulation: Cardiovascular Quality and Outcomes, 8(1), pp.87-95.

Sendlhofer, G., Brunner, G., Tax, C., Falzberger, G., Smolle, J., Leitgeb, K., Kober, B. and Kamolz, L.P., 2015. Systematic implementation of clinical risk management in a large university hospital: the impact of risk managers. Wiener klinische Wochenschrift, 127(1-2), pp.1-11.

Tricarico, P., Tardivo, S., Sotgiu, G., Moretti, F., Poletti, P., Fiore, A., Monturano, M., Mura, I., Privitera, G. and Brusaferro, S., 2016. Clinical Assessment of Risk Management: an INtegrated Approach (CARMINA). International journal of health care quality assurance, 29(7), pp.744-758.

Zadfallah, F., Bastan, M., and Ahmadvand, A.M., 2017. A Qualitative System Dynamics Approach to Clinical Risk Management. In The 13th International Conference on Industrial Engineering.

Zaidan, A.A., Zaidan, B.B., Al-Haiqi, A., Kiah, M.L.M., Hussain, M. and Abdulnabi, M., 2015. Evaluation and selection of open-source EMR software packages based on integrated AHP and TOPSIS. Journal of biomedical informatics, 53, pp.390-404.