Advocating the Nursing Role in Health Information Exchange Program Implementation
Introduction
The Health Information Technology for Economic and Clinical Health, HITECH, Act was enacted to spur quality healthcare service delivery through investment in health information technology (Alexander et al., 2016). Following the HITECH Act objective, it is imperative to invest appropriately in health information exchange, facilitating coordinated care for patient safety and quality improvement. Implementation of a health information exchange (HIE) program is complex and requires input from numerous stakeholders. This interview transcript details the team efforts and my role as a nurse in advocating for the implementation of an HIE within my practice.
Interview Transcript
Tell us about a healthcare program within your practice. What are the costs and projected outcomes of this program?
Health Information Exchange (HIE) is a program that enables care providers in different institutions to share patient information electronically between themselves for care coordination (Alexander et al., 2016). HIE is a critical component in the realization of healthcare reforms as it enables the achievement of three objectives of quality healthcare: (1) improvement of population health outcomes; (2) reduction of healthcare costs; (3) enhancement of patient experiences through satisfaction and quality. Health information exchange goals are realized through cooperative agreements between individual healthcare organizations engaging in the program.
Implementing the health information system will incorporate the costs of interfaces to enable communication between the participating organizations and installing the internal health information exchange and interoperability (HIEI) capable systems for the clinicians and care providers. Development of a level-3 interface would cost approximately $50,000 for each facility, for example, pharmacies, radiology centers, labs, and hospitals, while shared group offices that engage in the program would spend $20,000 for setting up an interface (French et al., 2016).
The expected outcomes of implementing a health information exchange program include enhanced communication, knowledge, and care coordination among care providers. The positive impacts will incorporate a reduction in duplicative prescriptions, radiology and laboratory testing, reduction in costs, hospitalization rates, especially readmissions, improved processing of disability claims, improved quality of care in ambulatory services, and enhanced public health reporting (Hersh et al., 2016).
Who is your target population?
The HIE program will benefit the whole community around the hospitals engaged in the network. However, patients with chronic illnesses will be the primary target to coordinate their care providers to ensure effective management from different institutions. Consequently, these patients will access healthcare services in the hospitals closes to them without worrying about complications from duplication of services or tests.
What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?
The HIE program will entail communication and exchange of health information. Most of the patient progress reports are drafted by nurses who take care of the patients. First, the nurse will engage in providing input for the user interfaces. Nurses are well-positioned to advise the implementation team regarding the care workflows within the healthcare system that would enable quality service provision. Therefore, they will provide recommendations for designing the user interface to enable easy retrieval of information to improve the quality of care delivered. Secondly, for interoperability with the existing systems, the nurses will detail the typical process of handoff, after which the system will build upon to enable the exchange of patient information between care providers remotely (Kruse, Marquez, Nelson, & Palomares, 2018). For example, by describing the patient information vital for successful handoff, the designers will know the type of information that would likely be shared within the system and put up structures for the successful exchange of such data.
What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?
Besides delivering high quality coordinated services to patients in the health information exchange program, I will be engaged in patient advocacy. From the design stage to the implementation, I will ensure the patients are considered, and the program promotes the healing of patients. During the design stage, my role as an advocate for chronic disease patients will involve floating ideas to ensure the safety of information regarding patient health. Secondly, I will ensure that the design is as simplified as possible to enable easy patient navigation, improving the process of coordinated care from the patient perspective instead of complicating it further. Finally, I will impact the design by validating the ethical aspect of the exchange, ensuring that all the components of ensuring the patients’ equality and dignity are incorporated.
What is the role of the nurse in healthcare program implementation? How does this role vary between the design and implementation of healthcare programs? Can you provide examples?
During the health information exchange program’s implementation, the nurses will engage in documentation to provide structured information for care delivery. As opposed to the designing, the implementation process involves modification of the approach and information for different audiences (Kruse et al., 2018). For example, in discussing patient care issues with a physician or a fellow nurse, the nurses will employ different terms compared to those used for the patient or family member to understand the HIE framework.
Who are the members of a healthcare team that you believe is most needed to implement a program? Can you explain why?
Implementing the HIE program will involve various members of the healthcare team. Some of the team members include physicians, primary care nurses, nurse coordinators, and informatics specialists. The nurse coordinator will be the most needed in implementing the program. The nurse coordinators will ensure seamless transitions of care between care providers within the HIE program framework for efficient care delivery to the patient (Hersh et al., 2016). Therefore, they will form the working cogs of the HIE system, coordinating different providers and the patient between the exchange networks.
Conclusion
In conclusion, implementing an HIE program aims to ensure safe, coordinated, and quality care to the patients, hence improving outcomes. The program’s target population is mainly the long-term care patients who require the involvement of more than one care provider. The nurse has the responsibility of providing input during the designing of the system to ensure the patient’s needs are considered in the design. During the implementation, the nurse will also participate in the generation of nursing documentation to share care information between the care team members.
References
Alexander, G. L., Popejoy, L., Lyons, V., Shumate, S., Mueller, J., Galambos, C., … & Flesner, M. (2016). Exploring health information exchange implementation using qualitative assessments of nursing home leaders. Perspectives in Health Information Management, 13(Fall).
French, D. D., Dixon, B. E., Perkins, S. M., Myers, L. J., Weiner, M., Zillich, A. J., & Haggstrom, D. A. (2016). Short-term medical costs of a VHA health information exchange: a CHEERS-compliant article. Medicine, 95(2).
Hersh, W. R., Totten, A. M., Eden, K., Devine, B., Gorman, P., Kassakian, S. Z., … & McDonagh, M. S. (2016). The evidence base for health information exchange. In Health Information Exchange (pp. 213-229). Academic Press.
Kruse, C. S., Marquez, G., Nelson, D., & Palomares, O. (2018). The use of health information exchange to augment patient handoff in long-term care: a systematic review. Applied clinical informatics, 9(4), 752.