Develop a section (3-5 pages) of a proposal to study whether a group of physicians provided quality of care related to an identified disease or condition and population. Include a plan to manage the information from collection to destruction and an analysis of legal considerations.
Introduction
For this assessment and others in this course, you will assume the role of an office manager for a physician group. In most fields, whether manufacturing, the service industry, or health care, organizations are looking for ways to improve the quality of service they provide to their customers. An eye on quality helps them remain competitive in the marketplace and stay in business. Otherwise, their customers will go elsewhere. This is especially true in the health care field where people’s health and lives are at stake.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:
- Competency 1: Outline the steps of the health care information life cycle.
- Apply steps of the health care information life cycle.
- Competency 2: Apply laws governing health information confidentiality, privacy, and security.
- Differentiate between required confidentiality and security measures.
- Apply laws governing health information confidentiality, privacy, and security.
- Competency 3: Assess system applications used to operationalize health information.
- Evaluate which information system or systems best provide needed information.
- Competency 6: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others, and consistent with the expectations for health care professionals.
- Write clearly with correct spelling, grammar, and syntax, and good organization.
- Apply proper APA formatting and style to references and citations.
Preparation
Your physician group is no different than other organizations. It wants to find ways to improve the quality of care it provides to patients. This, in turn, helps the physician group remain profitable and stay in business. As a result, the senior leaders of your physician group have asked you to provide a documentation review of the quality of care provided by the office. As the office manager, you are the one responsible for the management of the health information within the office and the review of information to determine whether providers met quality of care standards. Determining this will require you to:
- Identify a disease or condition served by the physician group.
- Determine what patient information is needed and from where to retrieve it.
- Compare your overall office data to the national benchmarks.
Typically, in the workplace, the physician group’s specialty area (cancer, diabetes, dermatology, et cetera) would dictate the disease or condition for which you would be collecting information. For the purpose of this assessment, however, you may select the disease or condition that interests you from this list:
- Asthma.
- Diabetes.
- Myocardial infarction.
- HIV/AIDS.
- Cancer.
Select the disease or condition that is important to you and that you want to study. Perhaps, you have the disease or condition. Perhaps, a family member or friend does. Remember you will be working with this condition in the remaining course assessments.
Now that you have determined the disease or condition you are going to study, you will need to begin collecting protected health information (PHI) for the patients treated by your physician group who have the condition you are studying. You will need to consider carefully the privacy, security, and confidentiality of the information within the patients’ office records. Determining how you as the office manager will maintain data security is a key aspect of your work. You are responsible for knowing and understanding the types of documentation, applications, and information systems used within and outside of the office. All information moves through a life cycle from creation to destruction. Regulations, policies, and procedures strictly control this ongoing process. The office manager needs to know this life cycle and where to locate information when it is needed.
For this assessment, you will write a section of a proposal about how the documentation on previous patient care will be retrieved, from where it will be retrieved, and how that data will be kept secure during retrieval and review. Remember that you are focusing on retrieving and analyzing existing documentation within the office.
For this section of your proposal:
- Identify the disease or condition and the population that will be the focus of your study.
- Explain your plan to manage this information from collection to storage to destruction.
- Identify legal considerations and a plan for compliance for the PHI you are collecting.
In later assessments in this course, you will continue on with your proposal and begin to plan for how you will compare the office data you have collected to the national benchmarks. Remember: You will not be able to actually do this comparison. You are simply preparing a proposal for senior leaders about how you would go about performing this work.
Please read the scoring guide for this assessment to better understand the performance levels relating to each criterion on which you will be evaluated.
Instructions
You will not be writing the entire proposal for this assessment, only parts of it. You will add to your proposal in later assessments and complete it in Assessment 3. Be sure this part of your proposal includes all of the following headings, and your narrative addresses each of the bullet points:
Introduction
- Identify the disease or condition from the following list for which you will review the quality of care:
- Asthma.
- Diabetes.
- Myocardial infarction.
- HIV/AIDS.
- Cancer.
- Explain the reasons for your choice.
Information Collection
Complete the following:
- Determine the patient population to be reviewed.
- Evaluate which information system or systems best provide the needed information.
- Determine the specific documentation you are looking for. Explicitly state the reasons for each and all of your choices. Be sure to answer all of the following questions in your narrative:
- Do you want to review information only from your office? Or do you also want to review information for hospital admission and/or emergency room visits?
- Do you wish to review all patients who have ever been treated for the selected condition? Or only those treated within a specific time frame? Will you only review patients within certain demographic parameters?
- What type of documentation do you want to review? This may include:
- History and physical (H&P).
- Discharge summary.
- Progress notes.
- Labs.
- Radiology.
- Others.
- Identify where you are going to find the information you need. Which information system or systems would be best to use, and what information can you collect from each system? Possibilities include:
- Pharmacy.
- Point of care (POC).
- Results management.
- Computerized physician order entry (CPOE).
- Determine the type of system or systems (financial, administrative, clinical, et cetera) you would use.
Information Life Cycle
Complete the following:
- Describe how you plan to manage this information from collection to destruction. Be sure to address all of these questions in your narrative:
- How will the information be collected and documented? By whom? In what context?
- How will the information be stored?
- How will you control access to the information?
- How can you ensure the documentation meets interoperability standards?
- What are the advantages and disadvantages of integrating your office information with an HIE?
- What challenges exist regarding the standardization of health information?
- When and how will the information be destroyed?
Legal Considerations
Complete the following:
- Differentiate between the legal aspects of health information confidentiality, privacy, and security, as it applies to your proposal.
- Apply laws governing health information confidentiality, privacy, and security.
- Determine whether the information you are retrieving requires the use of PHI.
- If not, why not?
- If so, summarize how the PHI will be used.
- Plan for how the Health Insurance Portability and Accountability Act (HIPAA) will impact health care personnel, policies, and procedures in your proposal.
Conclusion
Briefly summarize the value of the documentation review you are proposing to be performed.
Additional Requirements
Your assessment should meet the following requirements:
- Written communication: Your paper does not need to be in APA format. It does need to be clear and well organized, with correct spelling, grammar, and syntax, to support orderly exposition of content.
- Title page: Develop a descriptive title of approximately 5–15 words. It should stir interest yet maintain professional decorum.
- References: Include a minimum of two citations of peer-reviewed sources in APA format.
- Length: 3–5 typed, double-spaced pages, not including the title page and references page.
- Font and font size: Times New Roman, 12 point.
Resources: Legal Considerations
As you review the suggested readings listed below, please keep these questions in mind:
- What is PHI?
- What are the HIPPA privacy and security rules?
Legal Considerations
Review the following:
- Oachs, P. K., & Watters, A. L. (2016). Health information management: Concepts, principles, and practice (5th ed.). Chicago, IL: AHIMA Press. Available from the bookstore.
- Chapter 2, “Legal Issues in Health Information Management,” pages 43–95.
- Chapter 10, “Organizational Compliance and Risk,” pages 291–304.
- Chapter 11, “Data Privacy, Confidentiality, and Security,” pages 305–339.
- Chapter 28, “Ethical Issues in Health Information Management,” pages 909–926.
- Health Care Administration Undergraduate Library Research Guide.
Resources: Information Collection
- As you review these suggested readings, please keep these questions in mind:
- What are three application systems? What documentation does each system contain?
- How do application systems optimize the use of health information?
- How does the design of application systems support integration into an HIE?
Information Collection
Review the following:
- Oachs, P. K., & Watters, A. L. (2016). Health information management: Concepts, principles, and practice (5th ed.). Chicago, IL: AHIMA Press.
- Chapter 4, “Health Record Content and Documentation,” pages 97–127.
- Chapter 6, “Data Management,” pages 169–200.
-
Resources: Information Life Cycle
- As you review these suggested readings, please consider these questions:
- What are three different forms of documentation? How are these created?
- What are the regulations regarding the retention and destruction of health care records?
Information Life Cycle
Review the following:
- Oachs, P. K., & Watters, A. L. (2016). Health information management: Concepts, principles, and practice (5th ed.). Chicago, IL: AHIMA Press.
- Chapter 4, “Health Record Content and Documentation,” pages 128–139​.
Expert Solution Preview
Introduction:
The quality of care provided by physicians is crucial to the success of a medical practice. As an office manager, it is important to assess the quality of care provided by physicians to identify areas for improvement. In this proposal, we will discuss the plan to study the quality of care provided by our physician group in relation to a specific disease or condition and population. This proposal will also outline the plan to manage the information collected, including how to maintain privacy, security, and confidentiality of protected health information (PHI). Additionally, the legal considerations related to HIPAA regulations within this study will be discussed.
Identify the disease or condition and the population to be studied:
For this proposal, we will focus on the quality of care provided to patients with diabetes by the physicians in our practice. The patient population to be studied will include all patients with diabetes who have been treated in our practice in the past two years.
Plan to manage information from collection to destruction:
To manage the information collected for this study, a well-structured plan needs to be developed to ensure the confidentiality and security of the PHI. The following steps will be taken to manage the information collected:
1. Identify the data sources: The data sources to be used for this study will include electronic health records, laboratory reports, and medication orders.
2. Collect the data: Once the data sources have been identified, we will collect the data required for this study. All data collected will be securely stored in an electronic data repository that follows minimum security standards.
3. Protect the data: Data protection is critical to safeguard PHI and maintain confidentiality and security. Protective measures that include access control and limiting staff access to sensitive information will be implemented.
4. Dispose of the data: Once the data collection and analysis are complete, all electronic data storage media containing PHI will be destroyed by shredding or wiping.
Legal considerations and plan for compliance:
To ensure compliance with HIPAA regulations, the following steps will be taken:
1. Determine if the data requires PHI: The PHI is any identifiable information that pertains to the patient’s health and medical history. We will analyze the data collected, and if the data is considered PHI, we will protect it according to the HIPAA privacy rule.
2. Apply laws governing health information confidentiality, privacy, and security: The legal aspects of confidentiality, privacy, and security are critical in handling PHI. We will ensure that the electronic data repository for this study adheres to the HIPAA guidelines and other relevant laws and regulations.
3. Develop a privacy policy: To maintain privacy and confidentiality, a privacy policy will be developed and made available to all staff members involved in the data collection and analysis. The policy will outline protocols for access control, data handling, and the disposal of data.
Conclusion:
The proposed documentation review of the quality of care provided to patients with diabetes by our physicians is crucial for identifying areas for improvement. The steps outlined in this proposal will ensure that the PHI is collected and reviewed with the highest level of confidentiality, privacy, and security. Additionally, compliance with HIPAA regulations will be ensured to maintain regulatory requirements and protect patient data.