Clinical Systems Improvement, Research Paper Example

Application of Concepts learnt in class

There has been a significant increase in concerns as pertains to the use of such procedures as magnetic resonance imaging (MRI), computer tomography (CT) and other nuclear cardiology tests in relation to their improvement of a patient’s health within the medical fraternity. These high tech diagnostic procedures (HDTI) increased in use in the recent past, and prompted centers’ for medi care and state health plans to implement prior notification policy to ensure appropriate ordering of HTDI scans. This meant that patients had to contact the radiology benefit management (RBM) firm to determine whether the HDTI test to be conducted was insured. As a result there was decline in the number of HTDI scans ordered, but this implementation had a setback. It resulted in patient dissatisfaction and inconveniences, inefficiencies in the part of the providers and was also costly (Rebecca Lipner, et al., 2010, p. 8).

Due to numerous obstacles and challenges posed by the RBM system the institute for clinical systems (ICSI), opted to develop an alternative approach. This institute of medical informatics designed a pilot program to determine the use of standardized appropriateness criteria which would forego the health plan call in prior notification process (Levick and O’Brien, 2003, p. 2). The main push for this medical agenda was, to provide patients and physicians with the best clinical science available at decision time, and also improve the appropriateness of imaging orders providing quick feedback to clinicians thereby ordering the right tests for patients. The institute of Medicine’s primary goal for designing of this system is, to determine whether the use of embedded appropriateness criteria would deliver the level of decision support needed to provide a viable option to call-in prior notification processes.

This pilot project has incorporated several players in Health Information Technology, and has been quite efficient than calling a RBM firm and has greater capacity for shared decision making with patients, and more so can serve as a useful patient and provider education tool. More so HITSP, pushed for a license certification from the Certification Commission for Healthcare Information Technology (CCHIT), which was to facilitate the use of a common set of robust appropriateness criteria by from a vendor and that could be offered to Leapfrog or medical groups. A test was carried out in Minnesota, where there was a review of a number of a number of Leapfrog members with the aim of providing decision support criteria a secured health information website. Nuance communication, a member of the consortium was selected to provide appropriateness criteria and optional data tools (Simpson, 2000, p. 1). The Nuance tool, showed a diagnostic utility of imaging scan selected, once the patients indications are in the Electronic Health Record (EHR), the screen feeds back the utility of the order with ratings and offers higher utility options based on the provided evidence. The HIT and CCHIT, have access to identified ordering data as provided by EHRs by medical groups adopting the decision support option. Generally this criterion has seen appropriate ordering of scans and reduction of patients’ risk of cancer caused by unnecessary exposure.

Analyses from Health Information Organization indicates that, with these systems in place, medical groups can analyze their clinical operation data or EHRs to improve imaging services, and also participating health plans can track improved patient outcomes overtime. More so they can incorporate the use of Medline Plus, in reaching out and educating patients on their performance and handling of themselves. The use of these bioinformatics technologies, that is, telemedicine, tele-health, or in general medical informatics, is a potential model of how health information technology can have meaningful and positive impact on patients care while also reducing health care costs for consumers, patients, providers, health plans and in general improving the efficiency of the whole HIT fraternity. Extensive adoption of these options would enable the state as a whole to standardize HTDI procedures and contribute to the improvement of patients’ health through a broad population.

Works Cited

Levick, Donald, and David O’Brien. “CPOE Is Much More Than Computers.” Physician Executive 29.6 (2003): 48-52. Business Source Complete. Web. 7 Dec. 2011.

Rebecca Lipner, et al. “Current Yardsticks May Be Inadequate For Measuring Quality Improvements From The Medical Home.” Health Affairs 29.5 (2010): 859-866. Business Source Complete. Web. 7 Dec. 2011.

Simpson, Roy L. “In Our Hands? The Future of Health Care Technology.” Nursing Management 31.12 (2000): 34-35. Business Source Complete. Web. 7 Dec. 2011.