Chapter on "Accountable Care Organizations"

Chapter 6 pages (2076 words) Sources: 6

[EXCERPT] . . . .

You have a reasonable budget and adequate staff to make meaningful changes and you do have support from key institutional stakeholders, including healthcare system executives, the nursing informatics officer, and the chief medical informatics officer. You have been asked to devise a strategic plan for CDS at your institution within 3 months of your arrival and to have concrete "wins" within 12 to 18 months.

Discussion Questions

1. Describe the approaches you would use to ensure that all aspects of patient care were considered when developing a CDS system. How would you prioritize the efforts of your CDS team? Potential areas on which to focus include areas in which payment rates are tied to national quality measures, CDS interventions that meet Meaningful Use requirements, readmissions for congestive heart failure and other care events for which payers increasingly are not reimbursing, and areas that have been identified as institutional priorities for clinical improvement.

The Clinical Decision Support would have to be complete and accurate when it comes to making clinical decisions. Priority will be given to evidence-based practice and the tests or procedures that can be used to eliminate false positives and so forth. There should be a strong focus on anything that is potentially fatal to the client and/or anything that is expensive and damaging in nature such as readmissions for certain disorders, as mentioned above.

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2. How would you balance the need to deliver desired CDS capabilities quickly against the benefits of establishing robust infrastructure to enable future deliverables to be implemented more quickly?

Things need to be capable and quick but they should not be so robust and complicated that they are not easy to use and wield. It should be kept as simple as possible while keeping accuracy and data integrity at a high. Bad processes that do not work (or do not work completely) should be jettisoned and processes that get the job done should be encouraged.

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3. Identify one area for quality and value improvement. Define the CDS interventions that you would implement to address this area of need. Describe how your approach aligns with the best practices discussed in this chapter, such as the CDS Five Rights, the CDS 10 commandments, and the desire to use standards-based, scalable approaches. How would you systematically measure the impact of these CDS interventions?

Ease of use and the ability to make what a user wants out of the experience is the best way to go. Indeed, if a user can self-register online, they should have the ability to do that. However, if they want to register the "old-fashioned way" by going to the desk at a provider's front desk, then that should be the way it is done. As the demographics in the healthcare population change, their preferences will change as well.

http://blog.ensocare.com/trend-reports/how-demographics-impact-health-care-delivery READ MORE

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