Personal Health Records provides a unique platform to store, manage, retrieve, and share medical records in electronic format with the secure shell environment. The paradigm offers a dynamic interface where physicians, nurses, allied healthcare professionals, and the individual patient can share, communicate and manage health records. With the advancement of science and technology, the traditional issues of the healthcare system are being overruled with modern solutions such as PHR. Despite the importance, there are many of the developing nation and their associated health institutions that are devoid of the benefits and usage of PHR (Fuji, Abbott & Galt, 2014, pp.e13). The present report is focused on the issues of PHR, for its implementation and expansion of the service chain, to provide a modern solution towards healthcare aspects.
eHealthManager is a hypothetical multinational company that offers a solution in conjunction with the modern equipment, competency training for healthcare professionals, and software services. The company put forward the step into the electronic format for healthcare organizations in the year 2008, where the first electronic medical record system was bought in the market. The company installed the preliminary version of PHR system at Hawaii, eHealthManager-PHR in the nation medical center, Hawaii in year 2004 as an evaluation system. Since then, the company extended the scope of utility and information for the benefit of healthcare professionals, empowering the patient, and facilitating ease of communication. The software systems and secure shell environment available with the product aids ease in storing, managing and sharing of information. In other words, it helps patient in managing and becoming active participants in their care. The solutions of eHealthManager-PHR offers both complete virtual (web-based portal) as well as a paper-based system for its subscribers. There is a remarkable achievement in terms of partnership and use of software worldwide when considering the importance of electronic health record system and efforts of the company. As of April 2014, 514 recognized clinical locations across the globe are completely live on the automated PHR system, which is a remarkable achievement in 10 years. The adjunct managers, healthcare professionals, allied healthcare professionals and patient community is thus connected with the requisite medical related information.
Stakeholders are the key players in the conductance, expansion, and support for any business firms. Apart from the ethical benefits aspect, it is crucial to have an account of cost-benefit analysis, which can be precisely governed, cross-referred and regulated by stakeholders (Yamin, 2011, pp.568). The list of stakeholders connected with eHealthManager-PHR Project includes:
‘ Key stakeholders (eHealthManager)
1. Insurance agencies (Health Plan)
2. Employers of patients
3. Self-paid patients
4. Insurance providers at State level (especially Medicare)
‘ Key stakeholders (eHealthManager-PHR)
1. eHealthManager key membership revenues
‘ Service providers
1. Clinical staff, general physician, staff nurses, and allied healthcare professionals
2. Support staff of eHealthManager
3. Other ancillary service providers
‘ People getting service
1. Subscribers of eHealthManager-PHR
2. Clinical staff, general physician, staff nurses, and allied healthcare professionals
‘ Public policy makers
1. Steering Committee ‘ eHealthManager
2. Corporate Information System (IS) leadership
3. Administrative leadership
4. Clinical staff, general physician, staff nurses, and allied healthcare professionals
5. Subscribers of eHealthManager-PHR
Description of system:
In eHealthManager-PHR, both paper based and web based portal use a standard graphical interface system for viewing, managing and storage of information. The objective of eHealthManager-PHR is to provide complete solutions dealing with all aspects such as family history, prescription, visits, previous complication, medication management and alert system. Silent features of the products include following features (Woods, 2013; Krist, 2014, pp.418):
‘ Patient can create, edit and manage their profile. Profile can be made linked with healthcare professionals or organization
‘ Cookies should be enabled for appropriate usage of the graphical content. All the medical terminologies used were simpler.
‘ Deletion of information is possible with the patient; however a copy of image will be saved for the concerned healthcare professionals or organizational review.
‘ Navigation is enabled on the user interface, surfing, scrolling, and points are enabled on HTML. Requisite links are present on the portal content.
‘ The profile can be shared with any subscriber, physician or healthcare institution. The tracking system is present that helps the patient to review the profile viewers.
‘ Cost comparison, medication management, diet advice, physical activity benefits, and other similar information are present in the profile.
‘ Messenger service is an optional service that notifies the individual for alarm, beeps, and requisite notification.
‘ Prescription refills are available with a general physician, adjunct pharmacy, and health care organizations. The appointment and scheduling for related activities are possible to make through the portal.
‘ Reminder facility is available with the help of messenger service (mobile message) and e-mail notification.
‘ Information related to local doctors, health care institution, price, imaging center and disease is also available over the portal.
‘ Comparison in terms of cost, distance, lab information and doctor’s profile is available in the portal.
Management of medical records and information helps the patient in efficiently communicate with the physicians and other healthcare professionals. The paradigm offers online access to lab results to the patient, where they can be engaged in self-care. Thus, the speed and convenience of the online system helps in the efficient transaction of services and information. Likewise, the scheduling of appointments, refilling of prescription and obtaining valuable e-mail responses from doctors is easier for a patient with eHealthManager-PHR. Importantly, the patient can also review the instructions from the doctor after the appointment is over and can follow-up with concerns, doubts or questions. Hence, the PHR service helps in the overall management of health care needs in any community.
Scope of present report:
With the above information, the importance of PHR and reliable service by eHealthManager-PHR is apparent to the knowledge. The objective of this report is to present the importance of opening for the service venture in India. Hence, the benefits and adjunct information is necessary to show before CEO for required revenue investment and management of resources. More precisely the risk factors, benefits, recommendation according to local health patterns and cost-benefit analysis constitute the primary information of this report. Other than this, it is also important to address the local public policy maker for advocating the advantage associated with the implementation of record system.
Utilization of PHR in other organization and risk factors
Utilization of PHR is widespread in the majority of developed countries, including United States, UK, Australia, and other European countries. Considering the population of India (1.4 billion), it is essential to implement an adequate healthcare facility, so as to facilitate the ease of communication. Importantly, the gross domestic product (GDP) of India is 1.87 trillion USD. Thus, there exists brighter prospect of expanding the service venture for eHealthManager.
In various nations, the use of PHR is useful in managing the health conditions and communication between patient and healthcare professionals in varieties of ways:
‘ Presenting family history, past complications, and current health situation
‘ Screening results, lab reports, and medication related information is easy to view both by professionals as well as by the patients.
‘ Fixing of appointment, scheduling for screening, imaging, and another intervention measure is possible using the portal system.
‘ Comparing the cost associated with treatment, intervention, and related information is possible with the help of search engines available on the portal.
‘ Notably, it is possible to retrieve, share and edit the contents, thereby facilitating self-management and self-care.
‘ Prescription refilling is possible either with the help of concerned physician or healthcare organization.
It is clear with this utility prospect that eHealthManager-PHR is being used worldwide not for the record maintenance purpose only but also to enable patient in self-care. The approach thus is helpful for proceeding with communication as well as searching information. Risk factors involved are (Se??or, Fern??ndez-Alem??n & Toval, 2012; Davey & Davey, 2013):
‘ Motivating and promoting people for increased use of PHR are challenging.
‘ It is a time taking the process to communicate and implement the PHR system with doctors, local clinics, and healthcare organization systems.
‘ The utility of PHR is dependent on internet connection. Hence, a service for rural location is a challenge.
Experiences gained by other companies:
A comparison was made with reference to Google health and Microsoft Health Vault, where it is realized that the mobile client is also effective along with the web-based portal system. It offers convenient prospect for the clients to access their profile over phone internet and continue for a further response requisite activity. As discussed in the above section, the complete work frame is dependent on the internet connectivity. Hence, the expansion of the service in rural locations is always challenging for all similar organizations. Likewise, it is also difficult to manage the entire community member for using electronic health record system. Survey results show that the patient community is keener to find the advantage and easier prospects that are possible to achieve in conjunction with self-care. The said prospects are easier to achieve with sharing valuable links related to diet, medication, good lifestyle, doctor’s information and local medical setup (Spil & Klein, 2014, pp.2818).
Adopted strategies by organizations are to promote the utilization of service with the free-of-cost system in the initial runtime. Hence, the patient community and healthcare organization can be made to realize the essence and simplicity of this prospect. Increased communication among the professionals and patients will be further effective in advertising the benefits of the PHR prospect. Overall, it would not be incorrect to state that, applying the cost-benefit analysis in the initial stage of establishment has potential to act a challenge. On the contrary, facilitating the utility benefits is helpful for establishing a long run service in the community.
Advantage and disadvantage of PHR utility
Prime importance of PHR lies in managed care and ready to display option regarding the information. As stated in the initial part of this report, that PHR is useful in terms of safe storage, easy retrieval, and comfortable to share approach. Hence, the information pertaining to the information of patient health can be accessed either patient or any concerned health care professionals, from any part of the globe. Additionally, all the information will also be stored in the system architecture (Baird, North & Raghu, 2011, pp.281).
The collection, the notes from a previous prescription, memorizing and illustrating all the history, family records, and medication detail is not possible for any individual. Conversely, all of this information can be found in the electronic format within eHealthManager-PHR. Hence, analysis and recommendation in conjunction with the future management of disease or disorder is convenient by the professionals. Notably, the chances of error are also reduced to the maximum possible extent, as because there is no scope of skipping or hiding any information.
Analyzing the prospect of health care settings, the possible advantage lies with respect to efficient delivery of the health-related intervention, management, and advice. The same will be reflected in terms of increased patient satisfaction, improved outcome, and faster recovery of ill health conditions. Other than this, the patient can also discuss, ask, or find an explanation for any particular advice. The pathological or clinical reports can be easily conveyed to the patient for self-analysis and management (Lauscher, Stacy, Cordeiro & Ho, 2012, pp.189). Hence, the successive meetings between patient and physician are possible to produce a fruitful outcome. Other than this, the billing related information, fixing meeting, rescheduling of appointments, prescription refilling, and managing advice to the patient also becomes easy. Providing reminder or notification to patients becomes convenient with the incorporation of messenger service. More importantly, it is also easier for the healthcare organization to share the information among other professionals, to make partnership care delivery.
Apart from the advantage prospects, it is also necessary to make considerations regarding the disadvantage and limitations associated with the system. The major challenge for the implementation of eHealthManager-PHR is managing the change for hospital and clinic employees. Additionally, it is also necessary to provide training and education paradigms for the professionals, so as to adopt the system and making correct utilization of the same (Robinson, 2012, pp.184). The prospect cannot be useful if any of the parties, viz. Patient and health care professionals are not familiar or using the system. Hence, sharing and ease of informational exchange cannot be possible and thus the value of prospect will be difficult to analyze. Another problem is related to increased investment by the healthcare organization in terms of a computer system, hiring of computer skilled personal, internet connectivity, and arrangement for the training session. The problems as such discussed are common to all the organization moved forward for implementing the change. On the contrary, the prospect is valuable, once the system integrates with the routine workflow. It is the responsibility of managers and leaders of the concerned healthcare organization to motivate their employees and patients for using the eHealthManager-PHR system.
Scope of recommendation for healthcare organization
It is obvious to find that the objective of eHealthManager Company is to increase the venture and expand the business prospects in India. Conversely, it is also true that implementation for any healthcare organization is necessary in order to maintain the healthcare standards with the current time. Hence, the utility with respect to the advancement of technology can be made worthy for the healthcare prospects. The recommendation in this context is necessary, where advocating the advantage associated with the PHR system is required (Robinson, 2012, pp.184). In addition, providing the facts and figures of improvement from other healthcare organization using eHealthManager-PHR can prove to be effective. Such information will not only motivate the usage of the new system but can also make the paradigm familiar in adjacent healthcare settings for adoption.
It is noteworthy for the stakeholders that judgment of the company’s performance in the initial runtime with respect to cost-benefit analysis can prove to be deleterious. Since the prospect is new to the Indian system, hence sufficient time is necessary to make the prospect familiar and integrate with routine work procedure (Gunter, 2013, pp.141). Offering the preliminary version to the healthcare organization at low cost can avail more prospect of acceptance. Likewise, the cost associated with training and regular support for software usage is necessary. Recommendation for usage and support should be made available for both healthcare professionals, as well as a patient. In this panorama, it would be valuable to make health outcome related analysis during the installation and preliminary period of service by company.
Infrastructure requirement for PHR
The requirement of the infrastructure is mainly based on the functional capabilities of PHR system. The first factor is the security and privacy issue, which can be resolved by the technical mechanisms for achieving data security. The permission of editing, uploading, deleting and managing the profile is necessary to be in the hand of individual and the same can be in combined permission with healthcare settings. Such collaboration also helps in data integration and maintenance of patient health records. Architecture needed for the purpose is the location for data storage and a synchronization mechanism to connect the health information with providers. Note that interoperability of the system is also included within the same scope (Steele, Min & Lo, 2012, pp.1079).
Additionally for the management of data access, exchange, and interoperability option can be followed in conjunction with the public policy applied according to the regulations. Accessibility of information, lab location, doctor information, and other health related aspects can be made available to the profile holders with website linking. Modern sources such as PUBMED, Google map, LacationReader tools and messenger services can be combined with the profiles for requisite functioning. Secure communication and fault tolerance of the PHR system is one of the key inclusion within the architecture of eHealthManager-PHR. Mechanism of integration with relevant communities, application interface with profile and messaging services such as e-mail solve this purpose (Steele, Min & Lo, 2012, pp.1079). Data should be sustainable for a longer duration for retrieval and usage option. The backend system is hence necessary to be placed on the system design of healthcare organization. In addition, there is a requirement for computer professionals, computer, and hardware system, which are a common need for PHR setup.
Best practice to manage the concept of PHR
Discussion of the cost-benefit analysis and health -aspect analysis during the initial runtime was discussed in great detail. The primary requirement is the advocacy of beneficial prospect to the patient community as well as to the employees of the healthcare organization. The need lays with respect to incorporating the issue within the scope of the public policy, thereby making the content useful for the community health prospects (Lahtiranta & Nurminen, 2014, pp.347).
Considering the view point of eHealthManager-PHR, it is wise to distribute the software and conduct training or education session free of cost. The ideology behind the paradigm is to motivate people for the application of modern technological concept into the health management. In addition, the same prospect is also useful for making the community people realize the essence of PHR utility. Collection of references with respect to statistical figures and facts from another organization across the globe is efficient for the motivation of implementation change. The necessary benefits acquired in similar healthcare organizations can prove to be worthy of implementation, as well as the incorporation of same into policy priority matters.
It is much essential to maintain the features as discussed in conjunction to associated advantage of PHR. Common features such as ease of information sharing, uploading, sending clinical reports to the clients, and providing comparison information should be at par expectation level. Such prospects will not only help in efficient conduct of electronic health record management, but also helps in gaining the trust of patient and healthcare professionals. With the creation of profiles for individual regarding their personal health records, it is necessary to incorporate other relevant information also. Standard information includes family history, intervention records, clinical records, meeting and appointment with physicians. Note that training session and education programs for the usage of PHR is necessary to motivate and promote the usage. Similarly, integration of the individual profiles with the healthcare organization is also necessary (Suter, Gorski, Hennessey & Suter, 2012, pp.394). Notably, the procedure of health record usage is incomplete if any of the party (patient and healthcare settings) is not using the prospect. Hence, education and training for both the parties are relevant.
Regarding the architecture requirement, the mentioned features of the previous section is necessary for consideration. Initial conditions such as computers, hardware system, backup facility, and computer professionals constitute the primary element. Other than these necessary measures to maintain security and privacy aspect of the information is also necessary to take care (Krist, 2014, pp.418). Since, internet and its data usage speed is one the limiting factor for the usage of PHR, it is necessary to create the e-portal with Ajax and.NET programming. Software based on such programming language usually consumed data in small traffic. Mobile client and standalone tools for the uploading of information is also worthy of this regard. The overall objective of these prospects is to facilitate ease for usage and making the concept prevalent in new health market of India. Adopting of these measures will be useful in conjunction with the promotion of newer paradigm for the health management aspect of the community.
Time and resource schedule
Importantly, the initial focus of the entire paradigm will be focused on health-benefit analysis rather that implementing cost-benefit analysis. The objective behind initial timeframe is to make the prospective of PHR popular among the healthcare professionals and patient community. All the health-benefit analysis from stakeholder point of view will be carried out till further analysis and resource schedule for entire architecture. Approximation of time duration for initial set-up and advocacy of the prospective will be carried out for 16 months, after will further implementation and investment scope will be analyzed.
Objective Time frame
Collection of evidence, preparation of report for dictating policy priority matter 2 months
Planning, advocating, and discussion with experts 1 month
Resource allocation and investment by company 6 months
Resource scheduling and supplementing infrastructure 6 months
Analysis of the prospective, popularity among community, utility benefit in health management 2 months
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