Case Study:
The ABC Home Health Agency is a nonprofit, Medicare-certified organization established in the mid-1950s in a small Midwestern city. It is accredited by the Accreditation Commission for Health Care, Inc. The agency offers a continuum of preventive and therapeutic services that have an individual, family, and community focus. Clinicians provide services to patients ranging in age from infants to elders. The agency employs supervisory, administrative, IT, and support staff, as well as 45 clinicians: 25 nurses, 10 home care aides, 5 homemakers, 3 physical therapists, 1 occupational therapist, and 1 social worker. Staff members are on call 24 hours a day.
ABC Home Health Agency services include (1) skilled home health and hospice; (2) home care aide and homemaker; (3) private duty, including nursing, personal care, and respite care; (4) wellness, flu, and immunization clinics; (5) school health; (6) jail health; and (7) durable medical equipment.
There are two hospitals with about 100 beds and 15 physicians within the service area. The Agency has a good working relationship with both hospitals and the physicians. Many patients followed by the Agency have been referred from these services. Last year the Agency provided 20,345 home visits.
The Agency has used an automated billing, statistical, and financial management information system for 15 years. Clinicians enter all patient data using an unstructured, narrative, automated software system. The previous director, who has just retired, did not believe that the cost was justified to implement an EHR capable of capturing discreet clinical data to support tracking patient-specific assessment information, identifying the specifics of care, and generating outcome measures. You have just been hired as the new director. The board of directors asks you to investigate purchasing an EHR and submit your recommendations to them.
Questions:
•Should you introduce the clinicians to standardized terminologies and involve them in discussions about EHRs before contacting potential software vendors? Or should you contact vendors, select the best software, and tell the clinicians what you selected?
•What steps would you need to complete before reporting to the board of directors?
•What are some of the benefits to implementing an EHR? What are some of the challenges?
•What strategies will likely increase your chances of success? What strategies will increase your chances of failure?
•What recommendations would you make to the board? Why?
