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HCI 670 Needs Assessment Case Study (Integrated Case Study) HCI 670 Needs Assessment Case Study (Integrated Case Study) HCI 670 Needs Assessment Case Study (Integrated Case Study) Based on the gap analysis done by Chrystal, it was noted that the Oncology North build for Universal Health did not align with its recommendations for specialists in several areas within the same EHR system (Williams et al., 2020). Great concern was also directed towards the authorization and financial gaps and the workflow of all the clinicians. Identification of such gaps creates opportunities for further advancement of the current EHR system for an effective outcome. Opportunities to Expand or Develop the EHR             The identified gaps led to the determination of several areas of improvement to expand and develop the current EHR system. For instance, the functionality and workflow of oncology clinicians and the authorization and financial limitations within the EHR system must be addressed and improved (Esdar et al., 2019). The other identified opportunity is associated with oncology navigators. It was noted that oncology navigators lack distinctive oncology functionality within the Chrystal. However, based on the relevance of oncology navigators in patient assessment and support for patients and their families during cancer treatment, it is necessary to establish a dedicated section within the EHR system for oncology navigators to feed in data acquired from patients and their family members. Developments to the Clinical Workflow Setting The overall workflow of both the two hospitals must be similar once the merger has been completed. As a result of time constraints experienced by most providers, an encoded problem list can help reduce the interview time between the patient and the provider hence improving the hospital workflow (Esdar et al., 2019). Consequently, the oncology navigator can go through the interview questions quickly and utilize the data for evaluation metrics as a result of the insight. These two development approaches can help improve the effectiveness of the existing workflow and promote the quality provision of care services. This will also help in preventing burnout among healthcare providers and clinicians. Potential Solutions to the EHR Problems For effective management of EHR systems, there is a need to design and customize different fields, forms, and templates. The establishment of a simple user interface can help promote a smooth workflow for both the provider and the patient. The problems identified within the Oncology South EHR system can interfere with competencies and evaluation metrics. As such it is important to implement picklists and radio buttons as checklists for the intake forms (Pascucci et al., 2019). The radio buttons will be used in mandatory fields, whereas picklists will be utilized in sections where answers are allowed. This approach will help in encoding the problem list and provide support for the development of evaluation metrics, and improved provider workflow. User interfaces are significant when it comes to acquiring patient information, and how it can be retrieved and reviewed by clinicians. Conclusion One of the main benefits associated with hospital mergers is the advancement of the EHR system for an effective outcome. Despite individual limitations that might be identified among involved organizations, needs assessments and gap analysis can help spot opportunities for further improvement (Pascucci et al., 2019). For instance, it was noted that both Oncology North and South needed to improve the documentation and workflow system within the EHR. As such, both the two hospitals will benefit from each other after the merger has been implemented successfully. Needs Assessment Case Study The purpose of this assignment is to identify and analyze the needs of an EHR in a clinical setting in order to determine a potential solution to an EHR problem.   Read the ”Integrated Case Study”, ”Oncology North: Navigator Intake Paper Form” and ”Oncology South: Oncology Navigator Intake Form” resources prior to beginning the assignment and use the information in the resource to write a 750-1,000 word paper that provides answers to the following questions: Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: HCI 670 Needs Assessment Case Study (Integrated Case Study)   What are the problems identified in the EHR? What are the gaps resulting from the identified problems? What are some opportunities to expand or develop the capabilities of the EHR? What developments could be made to the clinical workflow setting? What is a potential solution to the identified EHR problem? RUBRIC Needs Assessment Case Study No of Criteria: 10 Achievement Levels: 5 Criteria Achievement Levels DescriptionPercentage 1: Unsatisfactory 0.00 % 2: Less Than Satisfactory 74.00 % 3: Satisfactory 79.00 % 4: Good 87.00 % 5: Excellent 100.00 % Content 70.0   Identified Problems 10.0 A description of the identified problem is not present. A description of the identified problem is incomplete or incorrect. A description of the identified problem is included but lacks supporting details. A description of the identified problem is complete and includes supporting details. A description of the identified problem in the EHR is extremely thorough and includes substantial supporting details. Gaps 15.0 A description of the gaps resulting from the identified problem is not present. A description of the gaps resulting from the identified problem is incomplete or incorrect. A description of the gaps resulting from the identified problem is included but lacks supporting details. A description of the gaps resulting from the identified problem is complete and includes supporting details. A description of the gaps resulting from the identified problem is extremely thorough and includes substantial supporting details. Opportunities 15.0 An explanation of the opportunities to expand or develop the capabilities of the EHR is not present. An explanation of the opportunities to expand or develop the capabilities of the EHR is incomplete or incorrect. An explanation of the opportunities to expand or develop the capabilities of the EHR is included but lacks supporting details. An explanation of the opportunities to expand or develop the capabilities of the EHR is complete and includes supporting details. An explanation of the opportunities to expand or develop the capabilities of the EHR is extremely thorough and includes substantial supporting details. Developments to Clinical Workflow 15.0 A description of the developments could be made to the clinical workflow setting is not present. A description of the developments could be made to the clinical workflow setting is incomplete or incorrect. A description of the developments could be made to the clinical workflow setting is included but lacks supporting details. A description of the developments could be made to the clinical workflow setting is complete and includes supporting details. A description of the developments could be made to the clinical workflow setting is extremely thorough and includes substantial supporting details. Potential Solution 15.0 A description of the potential solution to the identified EHR problem is not present. A description of the potential solution to the identified EHR problem is incomplete or incorrect. A description of the potential solution to the identified EHR problem is included but lacks supporting details. A description of the potential solution to the identified EHR problem is complete and includes supporting details. A description of the potential solution to the identified EHR problem is extremely thorough and includes substantial supporting details. Organization and Effectiveness 20.0   Thesis Development and Purpose 7.0 Paper lacks any discernible overall purpose or organizing claim. Thesis is insufficiently developed or vague. Purpose is not clear. Thesis is apparent and appropriate to purpose. Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. Argument Logic and Construction 8.0 Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. Mechanics of Writing (includes spelling, punctuation, grammar, language use) 5.0 Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed. Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech. Writer is clearly in command of standard, written, academic English. Format 10.0   Paper Format (use of appropriate style for the major and assignment) 5.0 Template is not used appropriately or documentation format is rarely followed correctly. Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent. Appropriate template is used. Formatting is correct, although some minor errors may be present. Appropriate template is fully used. There are virtually no errors in formatting style. All format elements are correct. Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 5.0 Sources are not documented. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. Total Percentage  100 CASE STUDY Overview: Throughout this course, you will use this case study to demonstrate knowledge of the following course content: Clinical decision support Assessing user needs Analyzing and documenting workflow Designing and customizing fields, forms, and templates User testing Evaluation metrics Designing user documentation and training In a series of assignments, you will use this case study to integrate user interface design (including usability/human factor principles) into a design document, analyze and develop workflows, evaluate users’ needs (including their involvement in user testing), develop evaluation metrics, and design end user training materials. The case study, which will be used throughout the course, will focus on various components of the course topics. It focuses specifically on the unique needs of oncology patients and the health care needs of oncology navigators and prior authorization/financial coordinators. The Case: Universal Health is a large not-for-profit health care system with 12 hospitals in three states and two large oncology programs in Arizona. One of the oncology programs is affiliated with Academic Hospital and the other with a larger national oncology health care system. Although both oncology locations are part of Universal Health, there are significant differences in how each of the locations operates due to a recent merger/acquisition of the Academic Hospital oncology program (Oncology South) and the affiliation of the other oncology program (Oncology North) with a national oncology health care system. To compound these operational issues, Oncology North had been part of Universal Health for 8 years, so its Electronic Health Record (EHR) was Chrystal, which was the EHR platform for Universal Health and became the model used to convert Oncology South off its EHR to align with the rest of the organization. Management of oncology patients is quite complex and there was significant concern from Oncology South about the EHR conversion, as well as changes that would affect its operating model. Previously, both oncology programs worked relatively independently with IT to create custom solutions, but now would need to work together to create a standardized oncology solution for Universal Health. If a merger/acquisition of a large academic hospital and its oncology program was not complex enough, adding the conversion of an EHR certainly made the situation more difficult. Also compounding the issue, Oncology North—although it had been on the EHR Chrystal for almost 8 years—had significant issues with the current build and felt that there were several gaps related to functionality for oncology clinicians to service its unique population. Since Universal Health was in the process of converting the EHR at Academic Hospital and Oncology program, the EHR vendor, Chrystal, was actively involving its alignment specialists to assist in the conversion. One of the key first steps of the Chrystal alignment specialists was to do a gap analysis and prioritization of EHR functionality for oncology as well as throughout Universal Health. The gap analysis done by Chrystal found that the oncology build for Universal Health overall did not align to its recommendation for oncology specialties in several areas within the EHR. As a result, a focused team (including a project manager, nursing informatics, Universal Health IT resources, Chrystal oncology alignment specialists, and Chrystal oncology IT experts) was created to systematically address the recommendations from the Chrystal oncology gap analysis. Although there were recommendations globally related to Universal Health’s overall EHR build, there were some specific recommendations related to the build of the oncology platform within Chrystal. Some of the initial focus was related to concerns related to prior authorization/financial gaps and the functionally/workflow of all the oncology providers/clinicians, but also the oncology navigators who really did not have any oncology functionality within Chrystal. Servicing an oncology population is a significant part of the patient demographics of any large health care organization. Oncology patients have unique needs due to the frequency of their visits and the length of their treatments and follow-up, which can last a lifetime. A cancer diagnosis is life changing and can cause great emotional, physical, and financial stress. Oncology navigators exist to assess and assist patients and their families during their cancer treatment and hopefully into remission/survivorship. Unfortunately, cancer treatment can be costly, and dealing with insurance companies for prior authorization is an unfortunate reality in the current health care system. For health care providers, there is great financial responsibility in providing cancer treatment, so obtaining authorization from insurance companies and ensuring that patients are aware of their own financial responsibility are essential for both the patient and the organization. After a patient receives a cancer diagnosis, the next step is usually a referral to an oncology specialist/program like Oncology North or Oncology South. That referral can come from a patient calling an oncology specialist/program directly or from the diagnosing physician contacting an oncology specialist/program. Oncology South and Oncology North both have dedicated intake referral specialists who work directly with patients, families, and referring physicians to get patients scheduled with an oncology specialist based on their diagnosis. Before the patient sees the oncology specialist for the first time, many documents need to be sent to the prior authorization team for review to ensure that the appropriate prior authorization is obtained from the insurance company, as well as making sure that the patient will be seen by the most appropriate oncology specialist for the specifically diagnosed cancer. These documents vary from pathology reports, diagnostic results, and referring physician notes that can be sent to the prior authorization specialist at different times for different patients. It is essential to have a standard workflow and expectation of standard documentation in a certain place in the EHR, so that everyone involved in the initial authorization and clinical care knows what steps have been taken and what actions are pending. While these financial steps are occurring behind the scenes and are important details that need to be secured before a patient’s first appointment, it is worth noting that at this juncture patients have just received some of the worst news in their life and they just want to get treatment as soon as possible. Oncology navigators are nurses that specialize in assisting patients navigate their cancer journey from diagnosis through treatment and into survivorship. After the first contact with the oncology intake specialists, oncology navigators are the next foundational step in the patient’s journey towards treatment and recovery. After the initial documentation is completed by the intake specialist who provides some basic information, including name of person calling, contact information, referral sources, provider information, and diagnosis information, such as type of cancer.  Based upon the type of cancer on the intake documentation, an oncology navigator who specializes in that cancer type is notified of the new patient and contacts the patient to initiate a custom navigation plan based upon assessment of needs. The oncology navigator role is an extremely important part of the oncology team. However, oncology navigators were identified as being significantly underdeveloped within Universal Health EHR based upon Chrystal’s gap analysis, so there needed to be focused attention on this group within the organization. As a result, a dedicated team needed to be formed to include individuals from nursing informatics from Universal Health, Chrystal oncology alignment and IT specialists, Chrystal IT staff, and oncology navigators from both Oncology North and Oncology South. This team would be responsible documenting workflow, assessing end user needs, and submitting a final design recommendation (including training materials) to the Universal Health IT build team. The completion deadline for the design document is 8 weeks. Assessing current state and understanding end user needs must be one of the first goals of this dedicated team. Two days were dedicated for onsite observations of oncology navigators at Oncology South and Oncology North, during which it was discovered from the observations that even though the oncology navigators at both locations performed the same role, they had some significant differences that needed to be overcome to be able to collaborate and create a single oncology navigator solution. The grid below outlines some of the differences. Operations Differences Oncology South Oncology North Initial Contact With Patient         Phone interview within 3 days   Initial physician clinic visit Patient Oversight            All oncology patients      Only oncology patients that have identified needs Documentation Paper form: See document: Nav Assessment 2018            Paper form: See document: Oncology North Although each location has operational differences, they also have several similarities in how they used some of the tools in the EHR, as well as their need for data and the ability to track/trend the outcomes of their patients. One key request was to make it easier for all oncology clinicians to be able to see their documentation within Chrystal. These foundational similarities aligned to what Chrystal oncology specialists had implemented at other institutions, having already created an Oncology Navigator Recommended Design Document that could be used at Universal Health. The table below provides some similarities between Oncology North and Oncology South. Operations Similarities   Oncology North and Oncology South Position              Navigator/Coordinator RN Data Request     Wanted discrete data for reports Electronic Documentation          Used same two electronic methods to chart: Electronic forms shared by all types of navigators (e.g., ortho, pulmonary) Free-text note also shared by same navigators above Electronic Documentation          Wanted it to be easier to find specific oncology navigator documentation Health care is all about data. In addition to using EHR for recording documentation, it is used to extract data to evaluate outcomes. Data in the EHR can come from discrete data from ICD10/ICD9 used by providers/coders, SNOMED, IMO codes used clinicians, but also directly from forms and flowsheets from discrete data fields. Understanding the unique data requirements of the oncology navigators, as well the initial prior authorization team, is foundational to creating the appropriate discrete fields or using existing data fields like ICD10 to help sort and organize data.   Order Now