Reference no: EM133344455

Case Study: Clinic for Kids is a provider practice with three pediatricians, two nurse practitioners, three licensed practical nurses, a half-time behavioral health therapist, and a part-time office manager. It earned initial certification as a patient-centered medical home and acquired an EHR over 10 years ago from a small, start-up company which provided the EHR via a subscription service and which also maintained the clinic's computers. One of the pediatricians refused to use the EHR, but agreed to allow a nurse practitioner to scribe. Another pediatrician reviews the EHR at the point of care, but documents notes on scraps of paper and takes them home at the end of the day to enter into the EHR. The third pediatrician and the nurse practitioners are power users of the EHR, although the pediatrician is often frustrated with the lack of analytics support, especially as the clinic wants to participate in alternative payment models. The nurse practitioners, who are also taking on the role of care coordinators to further the VBC initiatives, find the EHR limiting in "customer relationship management" tools and the lack of interoperability with their patients, other providers, schools, and social service agencies. The behavioral health therapist, as a contractor, maintains separate paper-based records. At the time of the conversion to ICD-10-CM a few years ago, the EHR company went out of business. As a result, the clinic's office manager hired a part-time medical coder and IT support person who created a small registry on an Access database and documented ICD-10-CM data therein, which a healthcare claims clearinghouse then merged with claims data.

All members of the clinic recognize they need a new EHR, but they are now frustrated with the affordable offerings that do not incorporate the latest of technologies. Their primary hospital affiliation has one of the major EHR vended systems. The hospital has offered to supply a small-office version of the product to the clinic. The clinic is evaluating the cost differential, as the product costs more, but the cost could be outweighed by cost reductions in compiling the coding database and clearinghouse fees. They also believe their nurse practitioners could be put to better patient care use with a better EHR and hence see more patients. At least two of the physicians are convinced that in a VBC environment, they would gain more than they would lose because their quality of care has always been outstanding. One of the clinic's health plans and the local school are also looking into ways to support the clinic in its IT management needs.

Real-World Case Questions

1. Identify which technological components of their new system should be considered that would most help the parents of the kids seen at this clinic?

2. Compare/Contrast the considerations this clinic must make when deciding on which EHR to acquire, and when?

3. Propose how the higher costs of the hospital's EHR offer may be offset.

4. Identify the advantages or disadvantages to adopting the hospital's EHR offering?