Solved by verified expert:TOPIC: SECURITY IN THE ELECTRONICS HEALTHCARE RECORD SYSTEMSPAPER SHOULD LOOK LIKE SAMPLES ATTCHED WHEN COMPLETESummary of the Assignment: Task: In this paper, you will write a document that provides information that an audience can use to inform a decision. We have read various white papers in the class this semester. White papers can be technical papers, business benefit papers, advocacy papers, or hybrid technical/business papers. The CANRIGHT document that we read in class described all four of these types of white papers. Length: 2000-3000 words Graphics: at least three graphics, two of which have to be original Format in Citing and Listing Sources: APA Number and of Sources: at least five sources, at least one of which has to be obtained through In preparing for this assignment, you will want to review the following videos: “White Papers: An Introduction to the Genre and Its Expectations,” from the Purdue OWL “What is a White Paper?” by Mak Pandit In addition, please review sample white papers in our class, especially any samples that were written by students.How to Organize the White Paper: Please include the following sections in your white paper: Executive Summary Introduction Previous Approaches New Findings Conclusion References In the Executive Summary, summarize your research and your purpose. The executive summary should be a stand-alone document. It should be written in such a way that a busy executive could read the executive summary and know exactly what the paper is about without reading the rest of the paper. In the Introduction, you lay the groundwork for your readers for the details that will be introduced in the white paper. If you need to define any terms, you will do so here. You might share an anecdote or illustration to describe why this topic is important. In the Previous Approaches section, you will describe the approaches or strategies that have been previously used or are currently used on the topic. For example, if your white paper is being written to advertise a new taxi service in your area, you might review what transportation services are provided now. You could show the challenges or problems that the current services involve. In this section of the white paper, your use of sources will be very important. You should integrate research to show that the problems you have identified exist. In the New Findings section, you present perhaps the most important information in the paper. In this section, you will describe the findings of your research and relate these findings to the purpose of your report. You will not only provide data and research, but you will also explain the data and research and why it is relevant to your report’s topic.
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Streamlining Healthcare
Enhancing Efficiency Through Emerging
Technologies
A Technical White Paper
Written By:
LIBERO PURUS SODALES MAURIS, EU VEHICULA LECTUS VELIT NEC VELIT:
iwork
Dan Cramer
www.apple.com/
Russell
1 Noe
Table Of Contents
Table Of Contents
TITLE
PAGE
Abstract
1
The Failing US Healthcare System
2
What is an Electronic Health Record?
3
History Behind Medical Records
4
What is the HITECH Act?
Market Drivers
Opposition
Additional Benefits
Call to Action
STREAMLINING HEALTHCARE: ENHANCING EFFICIENCY THROUGH EMERGING TECHNOLOGY
5
6
7-8
9
10
www.apple.com/iwork
The US healthcare system is inef2icient. The current system is causing avoidable medical and
prescription errors. According to Consumer Affairs, Americans pay far more for medical
treatment than anyone in the world and also bear the brunt of the most medical errors. The
Electronic Health Record is one emerging technology that can offer a solution to this healthcare
system. A key bene2it is that overall costs will decrease. The EHR will lessen administration fees
and allow doctors to see more patients in a shorter amount of time. This will ensure a decrease
in medical and prescription error. There is a $20 billion stimulus to incorporate the EHR into the
United States by 2014. Healthcare spending is now shifting from the private sector into the
hands of the government. The Electronic Health Record is answer to the failing healthcare system
and is the future of medicine.
STREAMLINING HEALTHCARE: ENHANCING EFFICIENCY THROUGH EMERGING TECHNOLOGY
www.apple.com/iwork
T h e Failin g H ealth c are
Sy s tem i n th e U n i ted States
USEFUL
DEFINITIONS
EMR/EHR- Electronic Medical
Record, Electronic Health Record
OECD- Organization for
Economic Cooperation and
Development
Patients emptying their bank
accounts to pay hospital bills are
not the only victims of our broken
healthcare system. Doctors,
nurses, hospital employees and
administrators are faced with the
harsh reality that our healthcare
system is in a stagnant state of
complacency. The U.S. health care
industry is arguably the world’s
largest, most inef2icient
information enterprise. In
addition, although the U.S. spends
almost two and a half times the
amount on health per capita in
comparison with the OECD
average (Organization for
Economic Co-‐operation and
Development), there are fewer
physicians per capita, fewer
nurses per capita, fewer hospital
beds per capita, and the U.S.
infant mortality rate is 6.9/1000
compared to the OECD average of
5.7/1000.1 Aside from these
astonishing economic numbers,
there are preventable
misdiagnoses and harmful drug
interactions that are leading to
unnecessary deaths. It is widely
believed that broad adoption of
EMR systems will lead to major
health care savings, reduce
medical errors, and improve
health. But there has been little
progress toward attaining these
bene2its, the U.S. trails a number
of other counties in the use of
EMR Systems. 2 What are the
implications of the
implementation of EHRs? What
are the bene2its? What are the
critical factors for adoption? How
will EHRs affect healthcare
beyond the obvious bene2its?
HITECH Act- Health
Information technology for
Economic and Clinical Health Act,
Passed by government in 2009 to
expedite infiltration of EMR’s into
the market.
HIPAA- Heath Insurance
Portability and Accountability Act
HIT- Health Information
Technology
STREAMLINING HEALTHCARE: ENHANCING EFFICIENCY THROUGH EMERGING TECHNOLOGY
4
What is an Electronic Medical Record
Creating an Electronic Medical
Record
When an individual goes to see a doctor for a specific condition
or care, a medical record is constructed containing information
such as personal and social history, a physical, notes made by
the doctor, consultations, lab or image results from other health
care providers and so forth.
Accessing Information
Doctors then access medical data via information
exchanges accessible to outpatient facilities, physicians
and hospitals through a dedicated and secure network of
providers in order to share information. The Department
of Health and Human Services has been exploring ways
to establish criteria for the development of e-health
records and health information exchange platforms that
maintain security and confidentiality for patients.
Patients are identified by codes or numbers assigned to
patient profiles, as well as by name, Social Security
number or identification protocols utilized by a variety of
health care providers.
Storing Data
Data is stored in computerized networks and
data banks. Such data is typed into the computer
by health information or medical records
personnel and stored in any number of medical
software systems accessed by health care
providers around the globe.
Web Browser Security
Health care providers can access a patient’s database or
electronic medical record by accessing health network
exchanges on certain Web browsers after entering encrypted
passwords and user ID codes into the system. Most health
information networks offer secured socket layers and
encryption programs that offer security and privacy in most
scenarios, and some systems even require biometric
identification by users, such as thumbprints or retinal scans.
STREAMLINING HEALTHCARE: ENHANCING EFFICIENCY THROUGH EMERGING TECHNOLOGY
5
History Behind Medical Records
Written language is arguable one of the greatest and most influential
inventions of all time. New generations have the capabilities of building on the
knowledge of their predecessors and progressing human understanding. This is
moreover true in the medical field, with patient records, scientific research,
chemistry, biology, pharmacology, and so on and so forth.
!
Written medical information dates back to ancient Mesopotamia in
cuneiform tablets. For centuries patient medical records have been in written form,
containing a vast amount of both valuable and very personal information. These
records are now archaic, they are physically stored at the doctors office and
transferred between doctors via fax, scanner, or physical transportation. Due to the
lack of cohesiveness and inefficiency of the current paper medical records, there
has been a push toward computerized information systems that will contain
electronic health records.
!
This migration from paper to electronic records has been light-moderate
over the past twenty years. According to the Center for Disease Control and
National Center for health Statistics, from 2002 to 2009 any use of an EHR system
jumped from 17.3% to 43.9%. This shows that systems are catching on and
doctors are open to new technologies, however, in 2009 only 6.3% of office-based
physicians were using a fully functional system. This is why recent legislation
called the HITECH Act (Health Information Technology for Economic and Clinical
Health Act) has called for a nation wide switch to a fully functional electronic health
record.
STREAMLINING HEALTHCARE: ENHANCING EFFICIENCY THROUGH EMERGING TECHNOLOGY
6
What Is the HITECH ACT?
The Health Information Technology for Economic and Clinical
Health (HITECH) Act has 4 major goals delineated within the act:
1. Government takes a leadership role
! !
and develops standards by 2010 for
! electronic exchange of Health Information
2. Investing $20 billion in health information
technology infrastructure through Medicare and
Medicaid incentives to encourage HIT adoption for
doctors and Hospitals.
3. Saving the government $10 billion dollars and generating more
savings in health sector, improving health care and care coordination)
4. Strengthening Federal privacy and security law to protect identifiable
health information from misuse as the health care sector increases use of
Health IT.
Office of the National Coordinator for
Health Information and Technology
This bill codifies the ONCHIT within the Department of
Health and Human services. This office is responsible for
creating a nationwide health information technology
infrastructure.
Establishes transparent and open process for development of
standards for nationwide electronic exchange of information
amongst healthcare sector.
ONCHIT and National Institute of Standards and Technology will
test to certify products have met national standards
Provides financial incentives through Medicare and Medicaid
programs to encourage doctors and hospitals to adopt and use
certified EHRs. Physicians will be eligible for $40,000 to $65,000 for
showing they are meaningfully using health information technology.
Privacy and Security of Personal
Health Information
Establishes federal breach notification requirement
for health information that is not encrypted or
otherwise made indecipherable. Requires
notification to patient.
Allows patients to request an audit trail showing all
disclosures of their health information made through an
electronic record.
Shutting down the secondary market that has emerged
around the sale and mining of patient health information by
prohibiting the sale of an individualʼs health information
without their authorization.
Strengthening enforcement of federal privacy and security
laws by increasing penalties and violations for and providing
greater resources for enforcement and oversight of
activities.
STREAMLINING HEALTHCARE: ENHANCING EFFICIENCY THROUGH EMERGING TECHNOLOGY
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MARKET
DRIVERS
Information is a vital
commodity, especially within
the health care system. For
decades, personal medical
information has been
recorded and it serves
purposes beyond just
treatment of the individual.
Personal medical
information is used in
statistics, development of
drugs, enhancing treatment
of disease, and widespread
research. While new
technologies like X-‐rays,
MRI’s, cardiovascular stents,
and pace makers have been
developed for treatment of
disease, until recently there
had been little focus on
renovating the system with
which the health care
entrusts its crown jewel and
the foundation for new
treatments and technologies,
the medical data.
An old saying once said, “If it ain’t broke, don’t
2ix it”. While technically the old system still works,
EMR systems offer a new approach to data collection
and storage that is aimed at solving problems within
the health care system that are driving up costs. The
U.S. currently spends $2.3 trillion dollars in health
expenditures the highest percent of GDP than any
other developed country.
According to a study that looked at closely
related IT investments in other industries, a low end
estimate implies an annual average spending
decrease of $346 billion and the upper end, $813
billion after widespread implementation of EMR
systems.
According to the chart, the savings has an
incubation time of about 15 years (or about 90%
adoption among the industry). While this is true that
it will take a high adoption rate amongst the industry
to achieve the potential savings, this incubation time
may have been reduced by government policies
regarding EHR implementation.
The Health Information Technology for
Economic and Clinical Heath (HITECH) Act was
signed into law on February 17, 2009. In the act is
about $20 billion worth of incentives for doctors and
hospitals to implement EHR records, each physician is
eligible to receive up to $44,000 in total incentives from
Medicare for “meaningful use” of a certi2ied Electronic
Health Record starting in 2011 and ending in 2015. Those
physicians and hospitals that do not fall within the
category of meaningful use after 2015 will receive
payment reductions from any government payor
(AAOS.org Are you ready for HITECH).
There are also savings from the potential health
and safety bene2its provided by the EMR. The reduction of
adverse drug events in inpatient and ambulatory settings
account for approximately $1 billion and $3.5 million
respectively per year. The use of health information
technology in short term preventative care and chronic
disease management will undoubtedly save millions,
however estimates of the amount are unavailable.
STREAMLINING HEALTHCARE: ENHANCING EFFICIENCY THROUGH EMERGING TECHNOLOGY
8
These Systems Are…
…Hard To use
According to the Technology Acceptance Model used
in a longitudinal review of the impact of EMR systems on
outpatient workflows, the use of a technological innovation is
predicted by perceived ease of use and perceived usefulness. A
study by Gadd and Penrod reported that about 60% of
respondents during the post implementation phase felt the
EMR system was difficult to use. As with any new technology
there is a learning curve, and satisfaction will increase
overtime as the user utilizes and masters it. It is important to
note that the training process and system design are vital in
the implementation process. Healthcare staff members must
be able and willing to work with computers, which is
becoming a norm in this generation. Some studies have shown
nurses’ negative attitudes toward growing computerization,
but these nurses fail to see the technological advantages of
using EMR. This is why it is crucial hospital workers are
educated on the overwhelming positive effects of the EMR in
the healthcare system.
…Expensive
This is true, these systems are not cheap and they do
require a hefty payment. However there are exponential
savings provided by these systems, according to a recent study
on the health information systems savings and cost, by
addressing transcription, chart pulls, lab tests, drug usage,
radiology, nursing time, length of stay, and medical record
costs, EMRs will save approximately $41.8 Billion a year.
Furthermore at 90% adoption rate (goal by 2015) is it
predicted the savings will increase to approximately $77.4
Billion a year.
STREAMLINING HEALTHCARE: ENHANCING EFFICIENCY THROUGH EMERGING TECHNOLOGY
9
M
O
R
E
O
P
P
O
S
I
T
I
O
N
Security and Privacy Concerns
Medical data security is a complex issue involving
medical ethics, law, governmental policy all for the protection
of the patient and their private medical information. There
are legitimate security issues about the safety of medical data
in the electronic medical records. The major threat to the
system is a security breach which can lead to alteration of
patient data leading to medical error, insurance agencies
charging based on the records, stigmas from leak of records,
and public discrimination. On the other hand, over
protection of medical data limits the possibility of public
health data surveillance and epidemiological research.
However the HITECH Act sets aside money and legislative
powers to ONCHIT to certify products and provide
infrastructure for the implementation of EMRs. The bill also
provides further funding to strengthen the Federal Security
and Privacy Law to protect health information from misuse.
Lack of Cohesive Standards
Global and even national standards HIT have no yet been
established to completion. Lack of standards leads to fragmented
patient info that limits the development of medical knowledge and
can lead to medical errors and inefficiency. There is also an issue with
the language used in the EMRs in regards to interoperability and
epidemiological research. Every doctor documents their patients visits
and illnesses in a different way, thus is a need for a standard language
and methodology to documentation in order for interoperability to
occur.
As with any new technology, implementing and getting the
system in place is the first step. While it would be optimal to have
standards in place and all of the kinks worked out this is not the
reality. An XML-based extensible Ontology Mapping Language
(XeOML) which would allow for interoperability amongst different
ontologies is underdevelopment. There are also various vocabulary
search systems for anatomical terms and clinical drug codes that are
either in use today or being developed. While these are good steps in
the right direction, there is still more research needed on how to
optimize and better facilitate health information exchange.
STREAMLINING HEALTHCARE: ENHANCING EFFICIENCY THROUGH EMERGING TECHNOLOGY
10
Additional Benefits
The EHR will replace paper based medical records. Paper-based
medical records tend to be incomplete, fragmented, hard to read and/
or hard to find. The EHR will provide a single, shareable, up to date,
accurate, rapidly retrievable source of information for patients and
healthcare providers. It is potentially available anywhere at any time.
It requires less space and administrative resources.
The EHR will streamline the healthcare system by saving time
for physicians, nurses and administrators. It has huge potential for
automating, structuring and streamlining clinical workflow.
However the training …
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