Pay-for-performanceand how could it stimulate or encourage EMR adoption
Ina Pay for Performance (P4P) structure, medical practitioners andhospitals are given compensation for the services they provide, basedon their capability to meet predefined quality (Rajaramet al., 2015).Assessment of the performance of physicians involves a lot of data. AP4P program cannot be used with medical practitioners who still usepaper charts. Data contained in EHR will be helpful when determiningthe physicians` performance or outcomes. If a company were to shiftto the conventional evidence-based standards of healthcare, thedoctors would be required to use some clinical procedures for certainconditions. Therefore, EHR will be needed to ascertain that adherenceto the standards is observed. EHR is used to identify gaps in care.This will be essential for P4P programs since they involve theconcept of Patient-Centred Medical Homes, a model that involves theidentification of the gaps.
Advantageand limitations of cost-benefit analysis for IT adoption decisions
ForIT adoption decisions, cost-benefit analysis can assist in thedesigning and budgeting of the process. This is because the study isprimarily focused on the possible impact of the adoption regardingfinance. Also, much emphasis is put on the billing function where thebiggest gains regarding finance can be realized. However, the CBAundervalues the cost of idling. This is dangerous as it would lead to‘paralysis by analysis` due to passivity and inaction.
Supposethe practice had decided not to adopt EMR. What would have been the"cost" of such a decision?
Ifthe practice had not adopted EMR as it continued to grow, it wouldnot be able to keep up with the changes observed in the prescriptionof drugs. More so, the need for quick and correct information wouldnot be met in the offices. The practice would have incurred a highercost of labor since the increased number of requests from patients,images from doctors and calls from pharmacies would require the firmto employ more specialists who would have access to the chart. Itwould not be able to avoid the time-wastage incidences which wouldoccur in case chats were misplaced.
Whatmilestones should be achieved, in terms of IT readiness, before agroup practice decides to implement EMR
ConcerningIT readiness, a group that wishes to implement EMR should havesufficient hardware components which should include notebook anddesktop computers and a server with redundant storage disks. Awireless network should be created to allow for data transmission.Also, the group through professional advice should have equipmentthat will enhance security. For example, it should incorporate audittrails to record all access made to the EMR records. The practiceshould set up a virtual private network to enable the encryption ofdata before it is transmitted over the network. Also, a reliableoperating system to be used by the server should be installed.
Couldthere be less of an incentive and different set of challenges forsmaller practices to take on HMIS projects such as EMR implementationthan large-scale health services organizations, such as amulti-provider health maintenance organization? If so, what are thedifferences? In terms of the incentives, why or why not?
Theset of challenges for smaller practices during the adoption of EMRand other applications is different from that of bigger institutions.Despite the fact that the small rural practices which are mostlylocated in the countryside may share some challenges with largerpractices, they have limited access to capital and infrastructure(Sultan,2014).The workforce force associated with such groups is much lessqualified and costly. For example, the DFM practice did not have anIT individual in its workforce and also, its budget was too limitedto hire an outside consultant. The data that is handled in the smallpractices is small as compared to bigger practices such as urbanhospitals. Therefore in terms of incentives, the practices are lessmotivated to incorporate EMR in their systems.
Rajaram,R., Barnard, C., & Bilimoria, K. Y. (2015). Concerns about usingthe patient safety indicator-90 composite in pay-for-performanceprograms.
Sultan,N. (2014). Making use of cloud computing for healthcare provision:Opportunities and challenges. InternationalJournal of Information Management.