Robert Wood Johnson Foundation (RWJF)

The Robert Wood Johnson Foundation (RWJF) multi-billion dollar philanthropy dedicated to improving health and health care for all Americans has a fundamental objective of taking Health Information Technology (HIT) a notch higher. Since the objective of this project is to align itself with the RWJF primary objective of improving the health care of all American citizens including the manner in which it is delivered, paid for, as well as how well it is reciprocated by patients and their families, this project’s scope is to assist health care providers to avail improved care to patients, drive down their costs, receive federal incentives and increase revenues   (Yu, 2009).

This project which is to be funded by RWJF to the tune of $2.5 million has already put up a foundation to ensure that all revenues realized from the project will be used to fund its future expansion. RWJF is the largest philanthropic organization in the USA that is devoted to health care has already dedicated itself to the completion of this project. To do this RWJF will work with diverse groups of individuals and organizations to not only identify solutions but also to obtain timely, comprehensive and measurable change (Tucker, 2011).

RWJF believes that in this century and beyond every American citizen wants to be involved actively in the management of their own health. However to ensure they take charge of this situation there is a need to help them access a wide range of tools and information to assist them in not only comprehend their health.  By RWJF  providing the systems and tools that will allow medical information to be easily shared between medics and their patients it intends to ensure that users experience a distinct level of engagement with both the health care system and their own health (Sharon, 2012).

There are various bottlenecks in the adoption of health information technology (HIT) as well as its capacity to augment health care transition and barriers to its usefulness, implementation, and use (Moskop, 2009). Even though various stakeholders in the US health care system have made strides in examining, researching and assessing distinct strategies in the improvement of fragmented health care a broad adoption of a consistent paradigm to augment it is still lacking. There is a critical push to adopt technology solutions to help in the improvement of communication in the entire US health care sector. RWJF believes that the availability of health information technology that communicates further than the boundaries of a health system or an institution is fundamental to the improvement of future health care transition (McCullough, 2010).

Limitations of the US Health care system

Family caregivers and their patients tend to encounter numerous challenges every time they come into contact with the health care system. RWJF intends to ensure through financing this project that this remains to be a problem of the past. Recent surveys by the National Partnership for families and women found two unfailing pain points whenever they interact with the US health care sector: Lack of coordination and lack of communication. 75% of those that were surveyed indicated that they wished that they had doctors who would share information not only with them but also with each other (Longhurst, 2010).

Families and their patients comprehend that the consequences of this coordination and communication void include: misdiagnosis, medical errors, treatment duplication, and testing and overly negative and frustrating care experience. Evidence indicates that one out of six adults that have challenging chronic health conditions are readmitted within a month of their discharge from the hospital. This substantiates the fact that in order to improve outcomes there is a need to improve the effectiveness and safety of care transitions. RWJF believes that improvements in care are needed for all transitions for instance from nursing homes to hospitals (Koppel, 2005).

Improving outcomes through ensuring Effective Health care transition

One of the fundamental advantages of the use of technology in health care delivery is the capacity to guarantee that the right information is availed in all the health care process stages. It is because of this situation that RWJF has decided to fund this project since the biggest benefit it will obtain from the project is not in terms of revenue but the fact that it will no longer engage in individualized field studies, rather it will have the advantage of having first-hand information about patients through the new system (Himmelstein, 2010).

Lack of connectivity

The first medical record was a paper file that was used by practitioners to scribble diagnosis this paper was never availed to patients and even with the invention of EHRs they only became digitized forms of the paper with the information still not reaching the patients. (Furukawa, 2010). By RWJF investing in this project, it will not only augment the progress made so far in developing EHRs rather it will also meet the rapid patient demands that they are allowed to access their health information  (Fonkych, 2005).

Lack of Shared goals correlated to the switching of care

Even though Personal Health Records (PHRs) were later accessed by a limited number of people for instance patients’ insurers and health care providers they ensured that patients moved from carrying binders and baskets to managing their health information, however, the digital information primarily was still held by the health care setting. RWJF believes that the development of PHR systems must be entrenched in the understanding of the health challenges and daily lives of the patients they are intended to support. The power of PHRs that RWJF intends to develop in this project will lie in their capacity to be embedded with a variety of decision support tools including reminders and alerts which will, in the end, assist patients to take action to manage their conditions or improve their health (Elizabeth, 2012).

Demand for a continuous care plan and Consumer knowledge

It has been acknowledged that consumers do not have the incentive to become active health care system members. Regrettably, many consumers are also sadly not prepared to participate because of a misunderstanding on the responsibilities and roles of each member including themselves, lack of access to information, incomplete information on the true costs of health care services and poor encouragement from the health care system By RWJF funding this project through building a customized software solution that is tailored to the specific needs of the organization than settling for something that will put patient health records at risk, it will  facilitate the easier sharing of information between medics  and patients which will translate to a dynamic platform for action  (DesRoches, 2010).

Issues of trust

In order to effectively implement health information technology, the entire system should be comprehended by both the patients they serve and the providers who make use of them. There must be a visible policy that guides managerial decisions on the access and use of health information. This policy should also be comprehended by all stakeholders. Fears of private breaches due to a misunderstanding of the current law have often caused hitches in wide Health Information Technology adoption and suitable information sharing. Patients could have fears on persons that could access their private information thus opting out of EMR (Borzekowski, 2009). However, this project innovative idea that has attracted funding from RWJF will end up developing a PHR application that will not only enhance but extend the kind of services offered by current PHRs.

The representation of the continuum of care

The software is built in this project will ensure that the problems that were encountered by patients and their families in accessing information will be a thing of the past.  Through creatively using technology under the guidance of extensive user designs the RWJF funded project will come up with software that will draw from relevant data and clinical records from medical observations made in the course of their lives (Amarasingham, 2009).

Infrastructure and Interoperability

Since RWJF will provide for free software that has the desired features and functionalities of taking EMR programs to the next level. This project will be able to enhance the exchange of electronic records not only within the USA but even beyond its boundaries, For instance, there are two documentation included in the provisional final rule; the Continuity of Care Record (CCR) and the Continuity of Care Document (CCD). While CCR is intended for transmission to consumer platforms and personal health records CCD is for exchange between the health practitioners. These documents have an updated set of the most pertinent clinical, administrative and demographic information about a patient’s health care. While none of the documents are compatible with each other or universally recognized they offer a platform for communication between patients, settings, and providers (Chaudhry, 2006).

Conclusion

The improvement of health care transition through health care information technology is a grand objective that needs motivation from many stakeholders. The Robert Wood Johnson Foundation in its funding of this project intends to address the following issues: opportunities of promoting team-based care across and within providers by involving pharmacists and case managers, the necessity for standards that are both transitions of processes of care (best practices) and relative to technology (interoperability), lack of actual incentives for the sharing of information amongst and between all care settings founded on accountability for receiving and sending information as well as the eventual transition of care outcomes.

References

Amarasingham R, Plantinga L, Diener-West M, (2009). Clinical information technologies and inpatient outcomes: a multiple hospital study. Arch Intern Med, 169(2):108–14.

Borzekowski R. (2009). Measuring the cost impact of hospital information systems: 1987–1994. J Health Econ, 28:938–949.

Chaudhry B, Wang J, Wu S, (2006). Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann Intern Med, 144(10):742–752.

DesRoches CM, Campbell EG, Vogeli C, (2010). Electronic health records’ limited successes suggest more targeted uses. Health Affair, 29(4):639–646.

Elizabeth ED, Normand SL, Wang Y, (2012). Comparison of Hospital Risk- Standardized Mortality Rates Calculated by Using In-Hospital and 30-Day Models: An Observational Study With Implications for Hospital Profiling. Intern Med: Anna:19–26.

Fonkych K, Taylor R (2005). The state and pattern of health information technology adoption. Santa Monica: RAND Corporation.

Furukawa MF, Raghu TS, Shao BB (2010). Electronic medical records, nurse staffing, and nurse-sensitive patient outcomes: evidence from California hospitals, 1998–2007. Health Serv Res, 45(4):941–62.

Himmelstein DU, Wright A, Woolhandler S. (2010). Hospital computing and the costs and quality of care: a national study. Am J Med, 123(1):40–46.

Koppel R, Metlay JP, Cohen A, Abaluck B, Localio AR, Kimmel SE, Strom BL (2005). Role of computerized physician order entry systems in facilitating medication errors. J Am Med Inform Assoc, 293:1197–1203.

Longhurst CA, Parast L, Sandborg CI, Widen E, Sullivan J, Hahn JS, Dawes CG, Sharek PJ (2010). A decrease in hospital-wide mortality rate after implementation of a commercially sold computerized physician order entry system pediatrics. Pediatrics, 126(1):14–21.

McCullough J, Casey M, Moscovice I, (2010). The effect of health information technology on quality in our hospitals. Health Aff, 29:647–654.

Moskop JC, Sklar DP, Geiderman JM, Schears RM, Bookman KJ (2009). Emergency department crowding, Part 2—Barriers to reform and strategies to overcome them. Annals of Emergency Medicin., 53:612–617.

Sharon SC, Jennifer NE, Diana R (2012) Health management associates using electronic health records to improve quality and efficiency: the experiences of leading hospitals.

Tucker C, Miller A (2011). Can healthcare IT save babies? J Polit Econ, 119:289–324.

Yu FB, Menachemi N, Berner ES, (2009). Full implementation of computerized physician order entry and medication-related quality outcomes: a study of 3,364 hospitals. Am J Med Qual, 24(4):278–286.

 

 


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