2025 UPDATE WITH COMPLETE SOLUTIONS
Instructions:
This worksheet will be used to recommend strategies for adopting a new HIT governance
plan to support the development and management of population health management
initiatives for Paducah Health Medical System (PHMS) as the organization transitions to a
value-based model. The worksheet includes the following components:
• assess the goals and priorities for population health management for PHMS
• assess end-user needs for redeveloping the current HIT system to one that supports
the value-based model
• forecast potential changes in needs and future developments for HIT
• recommend strategies to guide existing and future HIT systems’ projects
This worksheet will form part of the HIT strategy for PHMS that you will create in the
assessment.
Goals and Priorities of Population Health Management
1. Describe how HIT systems improve care. As PHMS transitions toward a
value-based model through its affiliation with Lourdes Hospital, how will the new
HIT system support improved care coordination between teams and across
departments?
Mobile health and telehealth technologies will be an essential tool in meeting the
goals of a value-based model of healthcare. Implementing this technology will assist
in improved, continuous communications between patients and providers/office staff,
seamless continuity of patient care and continuous engagement with the patient no
matter what environment they are in. Implementing health information exchanges
(HIE) will provide the necessary communication between different providers at
different location that will aid in uninterrupted care and ensure patient safety in
respect to repetitive testing and/or medications.
2. Identify the role of HIT in quality improvement. How will the new HIT system
facilitate enhanced development of continuous quality improvement programs?
HIT can assist organizations in stratifying the patient population to identify the
varying levels of need for those individuals. Risk stratification must be done
frequently to keep up with patient needs. Predictive modeling algorithms are also
being used by healthcare organizations to help predict which patients in their
population will require higher and more costly healthcare needs. HIT can also
generate reports for leadership that will help give a current view of patient
population healthcare statuses and benchmarks compared to other healthcare
organizations.
3. Evaluate HIT systems and patient engagement. How will the new HIT system
support each of the following outcomes?:
increased patient use of technology and patient access to data
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, improved care continuity through electronic communication with providers
coordinated patient-centered care across the organization
To ensure patient engagement, HIT systems will assist with providing seamless
communication between the patient and the health team through various modes of
telehealth and mobile health technology (IHT, n.d.) Personal health records will
also assist patient engagement by allowing individuals to assess their own risk
factors and finding care solutions via assessment programs. Also, providing
patients ready access to their healthcare team and primary care manager, via
email or online platforms, has been shown to increase patient online engagement.
Patients that stay in touch with their provider has been shown to be a strong
motivator for being self-engaged with their care. HIT can assist in these
communications through electronic methods that provide reminders to make
wellness appointments, follow-up appointments or send reminders of preventive
care measures that are due, such as colonoscopies, mammograms, dental checks
and more. A HIE system can ensure communication between various provider
clinics for each patient. This exchange platform allows providers to see what care
was given and what medications are prescribed so as not to repeat unneeded tests
or prescribe drugs that are contraindicated with existing ones.
4. Discuss implementing mobile technology. How will the new HIT system be able
to support monitoring of the significant chronic disease conditions present in rural
Paducah County? What challenges and opportunities will exist for implementing
mobile technology to monitor and address these disease conditions?
According to IHT (n.d.), some E.H.R. companies are integrating mobile health apps
that will help manage patients with chronic diseases. Using this technology along
with other interventions may help encourage patient engagement. Mobile health
apps can assist with chronic conditions like diabetes to track blood sugar levels or
apps that enhance self-management behavior like exercise, healthy eating or
weight loss to mitigate the effects of chronic conditions.
The challenge that exists is there isn’t a one-size-fits-all platform available that can
monitor and analyze all of the different data metrics needed to address chronic
conditions. Therefore, multiple platforms will need to be used while ensuring
compatibility with the current system. Once a system is integrated into the PH
model, multiple opportunities to effectively manage a large group of patients with
the same chronic conditions will arise such as mobile messaging, care plans that
are readily available for patients to follow and the ability to communicate with the
care team easily and efficiently via email or secure messaging.
5. Consider patient registries and predictive modeling. How will the new HIT
system adapt current hospital-based patient registries to a population-wide
approach? What features must be built into a new system to support risk
stratification and predictive modeling of risks?
To be able to consolidate large amounts of data, Stagnaro (2016) suggests the
“data lake” concept. This approach allows large amounts of data (patient
registries) to be captured and held in a platform where it can be processed and
analyzed by a data governance process. Considering PHMS is a small healthcare
organization, it is in their best financial interest to partner with the larger budget
hospital, Lourdes, to support a PH model.
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