See the details below. Be sure to follow and check the grading rubric listed in the instructions so that everything matches  and be sure to add the table of contents.   

3/5/2018 IFSM 305 – Case Study Page | 1

Midtown Family Clinic

Case Study

In 1990, Dr. Harold Thompson opened the Midtown Family Clinic, a small internal medicine practice, in an
area with an increasing number of new family residences. Dr. Thompson has been the owner and manager

of the medical practice. He has two registered nurses, Vivian Halliday, and Maria Costa, to help him.
Usually, one nurse takes care of the front desk while the other nurse assists the doctor during the patient

visits. They rotate duties each day. Front desk duties include all administrative work from answering the
phone, scheduling appointments, taking prescription refill requests, billing, faxing, etc. So if on Monday

Nurse Halliday is helping the doctor, then it is Nurse Costa who takes care of the front desk and all office

work. The two nurses are constantly busy and running around, and patients are now accustomed to a
minimum 1-2 hour wait before being seen. If one nurse is absent, the situation is even worse in the clinic.

The clinic has three examination rooms so the owner is now looking into bringing a new physician or nurse
practitioner on board. This would help him grow his practice, provide better service to his patients, and

maybe reduce the patients’ waiting time. Dr. Thompson knows that this will increase the administrative
overhead and the two nurses will not be able to manage any additional administrative work. He faces

several challenges and cannot afford to hire any additional staff, so Dr. Thompson has to optimize his

administrative and clinical operations. The practice is barely covering the expenses and salaries at the
moment.

Dr. Thompson’s practice operation is all paper-based with paper medical records filling his front office

shelves. The only software the doctor has on his front office computer is a stand-alone appointment

scheduling system. Even billing insurance companies is done in a quasi-manual way. For billing insurance,
the front office nurse has to fax all the needed documentation to a third party medical billing company at

the end of the day. The medical billing company then submits the claim to the insurance company and
bills the patient. The clinic checks the status of the claims by logging into the medical billing system,

through a login that the medical billing company has provided the clinic to access its account. There is no

billing software installed at the practice, but the nurses open Internet Explorer to the URL of the medical
billing company and then use the login provided by the third party medical billing company. Of course, the

medical billing company takes a percentage of the amount that the clinic is reimbursed by the insurance.
Although the medical practice has the one PC with the scheduling software and an internet connection, it

does not have a Web site or any other technology, and essentially still operates the same as it did in 1990.

One problem that is immediately noticeable is that there is no quick way to check patients in, and if the

nurse is on the phone while a patient tries to check in, then the patient has to wait until she has completed
her call. The doctor could be also waiting for the patient to be checked in, wasting the doctor’s valuable

time. Also many patients experience long waits on the phone when they are trying to schedule an

appointment, while the nurse is checking in patients or responding to another patient’s request in the office.
Every year, the clinic requires its patients to complete a form with their personal and insurance information,

rather than have them just verify what is on file. This annoys some of the parents when they have to fill
out all this paperwork, especially if they are taking care of their sick young child in the waiting room.

When a patient’s laboratory test results are received in the office, the paper copy has to be filed in the
patient’s folder. Lost and misfiled reports are a big concern to Dr. Thompson, as is his inability to quickly

and easily share patient data when he makes a referral to a specialist. He feels he and his staff are
spending too much time handling paper and not enough time improving patient care. All of the medical

records, lab results, and financial and payroll accounts are kept on paper, so there is not a quick way to
look up a patient’s history or current prescriptions during office visits, or when the doctor gets a call while

3/5/2018 IFSM 305 – Case Study Page | 2

he is away from the office. At the beginning of each day, the nurses pull the files for all patients who have

appointments scheduled for that day. However, the clinic also accepts walk-in patients.

At a recent medical conference Dr. Thompson learned about how Electronic Health Records (EHR) can be
shared among health care providers to improve patient outcomes. After attending several demonstrations

by the different vendors, ClinicalWorks, AthenaHealth, etc., he realized how inefficiently his practice is

running and realized all the opportunities that EHR systems can bring. He recognizes all the benefits of
moving to electronic medical records but feels very overwhelmed on how to start, or what to do. He is

also concerned about disruption to his practice which may negatively affect his patients’ care experience.
Moreover, neither the doctor nor the nurses have any knowledge or experience when it comes to

information technology. Upon the recommendation of a fellow doctor, Dr. Thompson has decided to hire

an independent EHR Consultant, to help him select the best EHR for his practice. His friend also advised
him that he should not just buy any package from a vendor but have the EHR consultant analyze the

workflow processes at the practice first, then optimize them, and then look at the EHR systems. The new
EHR system needs to work with the optimized processes of his practice. Dr. Thompson needs to get his

staff’s buy-in and involvement in the process from Day 1, if the EHR adoption process is to succeed. Dr.
Thompson realizes that EHR adoption may add significant costs to his practice, which he cannot afford.

Therefore, he will go for the EHR adoption at this point only if he can find an affordable system.

Based on his fellow doctor’s recommendation, Dr. Thompson has contracted with an independent

consultant, who is not associated with any vendor, to advise him through this process. Throughout this
course you will be the professional medical consultant.

Strategic Goals

Dr. Thompson has several strategic goals in mind that he shares with you during your first meeting with
him as his consultant. For one, he would like to see his medical practice operate more efficiently and make

some financial profit that he could reinvest into the clinic in order to upgrade and expand it. In a few

years, he will need to invest some funds in a major renovation, primarily in the examination rooms and the
waiting area. If he had extra money, he could also rent the apartment next to his clinic and open up the

space to make a larger clinic. If he did that, he could also expand the clinic into a 3-physician group
practice and maybe rent out some space to a physical therapy physician and generate some additional

income. After much discussion with fellow MDs, he realizes that he can use technology to improve the
quality of care, safety, and financial management decisions of his practice, while also meeting the legal

and regulatory requirements for health care and health care systems. So, implementing an EHR system

for these purposes has now become another strategic goal for the practice.

Your task is to help Dr. Thompson understand the process that occurs during a patient visit to the practice,
how that process should be improved to make it more efficient, and then recommend a certified EHR

system for him to implement. You are not expected to solve all of the problems identified or address all

improvements that could be made at the Midtown Family Clinic.

The following is an example of how a process is identified and optimized using a technology solution: Last
year, the medical practice had no effective way to schedule appointments. The front desk nurse used a

paper calendar to write in appointments. Obviously, as appointments were cancelled and re-scheduled,

the paper calendar became almost unreadable. It was also taking a long time for the nurse to record the
patient name, phone number and other critical information. That was when Dr. Thompson and his nurses

decided to implement the scheduling system on the PC. Now, the patients are all listed in the system, with
the pertinent information, and the scheduler can quickly search for an open time and enter the patient’s

appointment on the schedule. This has significantly improved the scheduling process, but has done nothing

to help with all of the other activities involved with a patient visit to the Clinic.

Note: As you approach the case study assignments, you will find it helpful to think about your own
experiences with a medical practice. Making a trip to a small medical practice may help you think about

the processes, challenges, and opportunities.

3/5/2018 IFSM 305 – Case Study Page | 3

STAGED ASSIGNMENTS

The case study and assignments address the Course Outcomes to enable you to:
 Evaluate the organizational environment in the health care industry to recognize how technology

solutions enable strategic outcomes

 Analyze the flow of data and information among disparate health information systems to support

internal and external business processes
 Evaluate technology solutions in the health care industry to improve the quality of care, safety, and

financial management decisions

 Examine the implications of ethical, legal, and regulatory policy issues on health care information

systems.

Upon completion of these assignments you will have performed an array of activities to demonstrate your

ability to apply the course concepts to a “real world situation” to:

 Analyze an organization’s strategies and processes to determine how a technology solution could

help (Stage 1)
 Analyze the data flow among a clinical practice and external organizations (Stage 2)
 Identify and explain the legal, ethical and regulatory considerations for a system (Stage 3)
 Propose an appropriate certified EHR technology solution (Stage 4)

As explained in the Stage 1 assignment, you will create a System Recommendation Report for Dr.

Thompson, using each stage to develop a section of the report. The staged assignments are designed to
follow the relevant readings in the course content, and are due on the dates as assigned in the class

schedule. These assignments are designed to help you identify how to effectively analyze and interpret
information to improve a medical practice using technology. This is an opportunity for you to apply critical

thinking skills and think like a professional medical consultant.

Stage

3

: Ethical, Legal and Regulatory Policy Issues

Overview

Before you begin work on this assignment, be sure you have read the Case Study and reviewed the feedback received on your Stage

2

assignment. Refer to the System Recommendation Report Table of Contents below to see where you are in the process of developing this report.

As a professional medical consultant, your next step in developing your recommendation for an EHR system is to determine what ethical, legal and regulatory policy issues apply and how they will be addressed in the selection and use of the system.

System Recommendation Report

Table of Contents

Introduction (Stage

1

)

I. Organizational Analysis and Requirements (Stage 1) A. Introduction B. Organizational Strategy C. Strategic Use of Technology
D. Components of an Information System

E. Requirements

F. Summary

II. Sharing Data (Stage 2) A. Introduction
B. Need to Share Data C. Types of Data to be Shared D. Data Interchange Standards

E. Summary

III. Ethical, Legal and Regulatory Policy Issues (Stage 3)

A. Introduction
B. Table of Ethical, Legal and Regulatory Policy Issues

C. Addressing the Most Difficult Issue

D. Summary

IV. System Recommendation (Stage

4

) A. Introduction
B. Proposed IT solution C. How the Proposed IT Solution Meets the Requirements

D. Improvements from Proposed IT Solution

E. Implementation Considerations
F. Summary

Conclusion (Stage 4)

References

System Recommendation Report (SRR), Section III – Ethical, Legal and Regulatory Policy Issues

Section III of the System Recommendation Report (SRR) analyzes the ethical, legal, and regulatory policy issues that influence the selection of an EHR system and how it is used. For this assignment, you will identify the ethical, legal and regulatory policy issues related to health care information systems, explain the impact of the ethical, legal and regulatory policy issues on the selection and use of health care information systems, and describe how the ethical, legal and regulatory policy issues can be addressed in the development and use of EHR systems. This analysis leads into Section IV – System Recommendation section of the SRR (the Stage 4 assignment) that will propose an EHR solution to meet the Midtown Family Clinic’s organizational strategy and fulfill its operational needs.

Below are a list of course resources and an example to assist you in completing Section III of the Report.

Course Resources: The table below provides the sources for the definitions and explanations of the topics. You should use other resources as well, but be sure they apply to health care information technology implementations.

Week 3: “Data Quality Improvement” lecture a

Week 4: “Security,” lecture c

Week 4: “Privacy, Confidentiality & Security,” lecture a

Week 4: “Security,” lecture c

Week 4: “Privacy, Confidentiality & Security,” lecture a

Week 4: “Privacy, Confidentiality & Security,” lecture a

Week 4: “Security,” lecture a

Course Resources for Table of Ethical, Legal and Regulatory Policy Issues
		Topic	Source of Definitions/Explanations (located in Course Content)
	1		Safe Design	Week 2: “Principles of Quality and Safety for HIT,” lecture b
	2		Meaningful Use	Week 2: “Introduction to Quality Improvement and HIT,” lecture a
	3		Quality Improvement	Week 2: “Introduction to Quality Improvement and HIT,” lecture b
	4		Data Accuracy		Week 3: “Data Quality Improvement” lecture a
	5		Data Accessibility
	6		Data Comprehensiveness	Week 3: “Data Quality Improvement” lecture a
	7		Data Consistency	Week 3: “Data Quality Improvement” lecture b
	8		Privacy				Week 4: “Privacy, Confidentiality & Security ,” lecture a
	9		Confidentiality
	10		Security
	11		Individually Identifiable Health Information
	12		Protected Health Information	Week 4: “Privacy, Confidentiality & Security,” lecture c
	13		HIPAA Privacy Rule	Week 4: “Privacy, Confidentiality & Security,” lecture c Week 4: ” System Security Procedures and Standards,” lecture a
	14		HIPAA Security Rule	Week 4: “Privacy, Confidentiality & Security,” lectures c and d Week 4: ” System Security Procedures and Standards,” lecture a
	15		Business Associate Contracts	Week 4: “Privacy, Confidentiality & Security,” lectures c and d
	16		Authentication		Week 4: “Security,” lecture a
	17		Authorization
	18		Encryption	Week 4: “Security,” lecture b
	19		Technical Safeguards	Week 4: ” System Security Procedures and Standards,” lecture b
	20		Healthcare Ethical Principles	Week 4: “Ethics and Professionalism,” lecture a

Example: An example for a topic entry is provided below.

Example from another industry: For example, for a fitness center that is adopting a new technology solution involving a kiosk for customers to use to pay for their membership at the gym, then for the Area of Accessibility, the following might be entered. Note the thorough explanation.

Topic

Definition of Topic	How it impacts and will be addressed in the selection and use of a system
Accessibility	Accessibility is the degree to which a product, device, service, or environment is available to as many people as possible. This includes accessibility to people with various impairments such as: cognitive, visual, hearing and /or dexterity issues.	Since the customers will use the kiosk to pay their membership fees, it must be accessible to everyone, including those with some disabilities. The system will be required to give instructions in both written and audible forms. The system provides audio instructions and other tools for people with disabilities. As part of the implementation, these capabilities will be tested and front desk personnel will be trained to assist customers if needed.

Stage 3 Assignment Instructions

The first step is to incorporate the feedback you received on your Stage 2 assignment, making any needed corrections or adjustments. If you have not incorporated the feedback from your Stage 1 assignment, you should do so prior to submitting Stage 3. Although the incorporation of feedback will not be graded until the final Report is submitted in Stage 4, it will assist you going forward to incorporate feedback at each stage. For this assignment, you will add Section III to Sections I and II of the System Recommendation Report (SRR).

Using the case study, the overview above, Course Content readings, and external resources, develop your Section III on ethical, legal and regulatory policy issues. Approximate lengths for each section are provided as a guideline; be sure to provide all pertinent information. Apply specific information from the case study to address each area listed below.

III. Ethical, Legal and Regulatory Policy Issues

A. Introduction – Introduction to this section describing what is included. (3-4 sentences)

B. Table of Ethical, Legal and Regulatory Policy Issues – The table below lists 20 topics related to ethical, legal and regulatory policy issues for healthcare IT systems. Each of these is defined in the course materials; the table above provides the sources where the definitions and explanations can be located. (Provide an introductory sentence and copy the table and insert information within.)

For each topic, you will provide:

· a brief definition, a minimum of two sentences,
in your own words

· a brief explanation, a minimum of two sentences, of the impact of the topic or issue on the selection and use of the EHR system; and

· a brief explanation, a minimum of two sentences, of how the topic or issue will be addressed in the development and use of the EHR system.

DO NOT copy the definitions from the class resources or other sources, but use your own words and provide enough information to demonstrate your understanding of each topic.

The “right” and “wrong” answers have to do with whether or not you correctly define each issue as it relates to an EHR technology solution and provide a well-supported explanation for how it will be accommodated. Your responses will be evaluated on whether they are applicable to an EHR solution, appropriately defined, adequately explained, and are appropriate to the Midtown Family Clinic.

1

Safe Design

2

Meaningful Use

3

Quality Improvement

4

Data Accuracy

5

Data Accessibility

6

Data Comprehensiveness

7

Data Consistency

8

Privacy

9

Confidentiality

10

Security

11

Individually Identifiable Health Information

12

Protected Health Information

13

HIPAA Privacy Rule

14

HIPAA Security Rule

15

Business Associate Contracts

16

Authentication

17

Authorization

18

Encryption

19

Technical Safeguards

20

Healthcare Ethical Principles

Table of Ethical, Legal and Regulatory Policy Issues
Topic	Definition of the Topic (minimum 2 sentences for each, a definition in your own words)	How the topic impacts and will be addressed in the selection and use of an EHR system (minimum 4 sentences for each topic – 2 on impact and 2 on how addressed)

C. Addressing the Most Difficult Issue – Consider each of the 20 issues listed and choose the one that you believe will be the most difficult for the Midtown Family Clinic to implement. Explain why you selected the issue and what should be done to ensure it is properly addressed when the system is selected, implemented and used. Your response will be assessed on its applicability to the Case Study and how well you support your choice and explain what should be done. (A paragraph of five to six sentences.)

D. Summary – briefly summarize the content of this section and tie the information together for the reader. (3-4 sentences)

Formatting Your Assignment

For academic writing, the writer is expected to write in the third person. In third person, the writer avoids the pronouns I, we, my, you, your, and ours. The third person is used to make the writing more objective by taking the individual, the “self,” out of the writing. This method is very helpful for academic writing, a form in which facts, not opinion, drive the tone of the text. Writing in the third person allows the writer to come across as unbiased and thus more informed. The Report is to be written for the Midtown Family Clinic, and reference should not be made by name to individuals who own or work in the Clinic.

· Include Sections I and II revised according to any feedback received, and add to it Section III.

· Keep your paper concise: Use the recommendations provided in each area for length of response. Content areas should be double spaced; table entries should be single-spaced. It’s important to value quality over quantity. Section III should not exceed 4 pages.

· Ensure that the table is preceded by an introductory sentence that explains what is contained in the table, so the reader understands why the table has been included.

· Use at least two resources with APA formatted citation and reference. Use at least one external reference and one from the course content.

Compare your work to the Assignment Instructions above and the Evaluation Criteria/Grading Rubric below to be sure you have met content and quality criteria. Do not overlook this step. Read your work out loud or have your computer read it to you. Fix the grammar and other areas identified.

· Submit your paper as a Word document, or a document that can be read in Word.

· Your submission filename should be as follows: Lastname_firstname_Stage_3

EVALUATION CRITERIA/GRADING RUBRIC:

Criteria

90-100%

Far Above Standards

80-89%

Above Standards

70-79%

Meets Standards

60-69%

Below Standards

< 60% Well Below Standards Possible Points Section Introduction and Summary 9-10 Points Provides effective introduction and summary to Section III; is clear, logical, derived from the Case Study; demonstrates a sophisticated level of writing. 8.5 Points Provides an introduction and summary to Section III; is clear, logical, and derived from the Case Study. 7.5 Points Provides an introduction and summary to Section III; is adequate, and derived from the Case Study. 6.5 Points Not clear, logical and/or derived from the Case Study. Or, either the introduction or summary is not included. 0-5 Points Not included, or demonstrates little effort. 10 Table of Issues 20 Topics; 2 sentences each for: definition, impact and how addressed in system 45-50 Points Fully and logically explained, are clearly related to the Case Study, and demonstrate a s sophisticated level of analysis and writing. Effective Introduction to table is provided. 40-44 Points Logically explained, are related to the Case Study, and demonstrate analysis and effective writing. Introduction to table is provided. 35-39 Points Definitions and explanations provided and relate to the Case Study. Introduction to the table is provided. 30-34 Points Not all clearly explained and/or are not related to the Case Study. Introduction to table may not be provided. 0-29 Points Not all addressed or little effort is demonstrated. 50 Most Difficult Issue Issue identified; explanations of why selected and what is to be done 18-20 Points Issue selected is clearly related to the Case Study; explanations demonstrate sophisticated analysis and critical thinking. 16-17 Points Issue selected is related to the Case Study; explanations demonstrate effective analysis and critical thinking. 14-15 Points Issue is related to the Case Study; explanations are provided. 12-13 Points Issue is not identified; and/or explanations provided are not correct; and/or issue is not related to the Case Study. 0-11 Points Issue and/or explanations are not related to the Case Study; and/or little effort is demonstrated. 20 Research Two or more sources--one source from within the IFSM 305 course content and one external (other than the course materials) 9-10 Points Required resources are incorporated and used effectively. Sources used are relevant and timely and contribute strongly to the analysis. References are appropriately incorporated and cited using APA style. 8.5 Points At least two sources are incorporated and are relevant and somewhat support the analysis. References are appropriately incorporated and cited using APA style. 7.5 Points Only one resource is used and properly incorporated and/or reference(s) lack correct APA style. 6.5 Points A source may be used, but is not properly incorporated or used, and/or is not effective or appropriate; and/or does not follow APA style for references and citations. 0-5 Points No course content or external research incorporated; or reference listed is not cited within the text 10 Format 9-10 Points Well organized and easy to read. Very few or no errors in sentence structure, grammar, and spelling; double-spaced, written in third person and presented in a professional format. 8.5 Points Effective organization; has few errors in sentence structure, grammar, and spelling; double-spaced, written in third person and presented in a professional format. 7.5 Points Some organization; may have some errors in sentence structure, grammar and spelling. Report is double spaced and written in third person. 6.5 Points Not well organized, and/or contains several grammar and/or spelling errors; and/or is not double-spaced and written in third person. 0-5 Points Extremely poorly written, has many grammar and/or spelling errors, or does not convey the information. 10 TOTAL Points Possible 100

IFSM 305 Stage 3: Ethical, Legal, and Regulatory Policy Issues 10/31/2019 6