Reference no: EM13933195

Business Problem Statement: Christine Newton

The American Recovery and Reinvestment Act of 2009 were established to interoperable health information technology and qualified electronic health records. Doctors and patients need accurate information to improve the outcome of medical care for proper diagnosis and patients need access to their information regardless of the doctor they choose to visit. The solution to this is a centralized national database system which makes diagnosis and treatment easier for doctors and patients. The centralized database system would allow the focus on patient care instead of the monetization of the care by providing vital medical information necessary to expedite diagnosis.Accurate medical history and quick access to this information is a vital part of patient care for emergency which could save lives, provide medical advances with data analysis and increased diagnosis efficiency.An infrastructure to allow health information exchange between non-affiliated hospitals that participate in Medicaid/Medicare which would allow privacy, provide critical information and improve efficiency would provide this solution.

High-Level Functional Requirements:

Automation of process for maintaining medical records:

• Access medical information through Pin Number.
• Provide access of medical information within health care facilities.
• Access medical information from scanning health card via magnetic strip, or barcode
• Information that can be accessed could include known allergies, current and past medical conditions.
• Provide secure way of accessing information, i.e. encryption.
• Provide for the ability to update and add information in real time.
• Granting appropriate permissions to Doctors, Paramedics, Patients, etc.
• Patient authorizes medical personnel access to medical records per HIPAA regulations.
• Track prescription via medications paid for by Medicaid insurance

High-Level Proposed Solution and Business Benefits:

The solution for this type of system is barcode or magnetic strip on insurance cards which would retrieve patient medical. When scanned, important medical information will be readily available to doctors or emergency personnel. This information can then be linked to a centralized database for all hospitals which would be housed by government entity. Currently Medicare/Medicaid hospitals that are nonaffiliated do not have access to customer's information even though they accept Medicaid; by incorporating a centralized database that each hospital can retrieve information via customer consent with pin number or insurance magnetic strip would resolve this issue.
The main benefits of this system to the government areincrease efficiency, increase productivity, improved diagnosis, decrease in cost of patient care, increase in trends analysis for research and wide adaptation by non-Medicare/Medicaid facilities to be a part of this type of system.

Special Issues or Constraints:

Business Constraints:

• Health Insurance Portability Accountability Act - Requires health care and providers as well as business associates to develop and follow procedures that ensure the confidentiality and security of protected health information (PHI). The information applies to all transferred, received and shared: documents, verbal communication, electronic communication and any other methods of communication(State of California, 2015).

• Budget constraints for State or Federal funding - Implementation of the system into federally approved system to work in conjunction with Affordable Care Act

• Hospitals will have to update patient information continually to reflect current medical history

• Patients verifying medical history is current and updated if information is incorrect

• Track changes to medical records and identify who made the changes (may require digital certificate for non-repudiation)
Technology Constraints

• The system is to be accessed through web application available on workstations, Laptops and mobile devices

• Software development of new system to integrate with existing electronic medical record systems

• Security of the system will be paramount to ensure compliance of HIPAA: Web Application, Database, Active storage and Data at Rest

• Strong Encryption Standards will need to be applied AES 256 at minimum; requiring processing and computing strength

• Integration of multiple OS, architecture, mobile devices - Windows 7, 8RT, 8.1, 10, Linux, MAC OS, Android, Windows Phone, Apple Phone

• Setting permissions for create/read/modify/delete/view for users to update patient medical records.

• Medicare/Medicaid cards will need to be updated with magnetic strips or barcodes

References

State of California. (2015). California Department of Health Care Services. Retrieved Janurary 9, 2016, from What is HIPAA: https://www.dhcs.ca.gov/formsandpubs/laws/hipaa/Pages/1.00WhatisHIPAA.aspx

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