Part 1

1. How does HMIS affect or influence the different departments within a healthcare services organization?

2. Why is it difficult to integrate IT and medicine? Discuss the need for an integrated management perspective of HMIS.

3. List the five major components of integrated HMIS. Discuss which component deserves the most attention in today's HIT environment and why. Provide specific examples of each component in the context of your work.

4. If you were a CIO, which of the four types of IT cultures would you pursue, and why?

5. List and illustrate the basic functions of an HMIS. How may these basic functions be extended to accommodate complex health information processing tasks such as medical diagnosis and teleconsultation?

Part 2

Mini-Case: MinuteClinic

MinuteClinic, owned by pharmacy giant CVS, is a retail healthcare provider with more than 500 locations established throughout the country. The centers are designed to treat patients with minor injuries or sicknesses, and more than 1.8 million patient visits have been documented since the company's inception in 2000. By creating a healthcare delivery model that responds to consumer demand, MinuteClinic makes access to high-quality medical treatment easier for more Americans.

As more patients used MinuteClinic resources, one issue the company faced was how to pass medical information to primary care physicians. As Cris Ross, chief information officer of MinuteClinic, explains, "There are a number of things we do very well with physicians, except connect electronically. We've been looking for a business-to-business exchange."

As a solution to this problem, MinuteClinic recently turned to ePrescribing connectivity network SureScripts to facilitate this exchange. It is the first time the SureScripts network has been used for anything other than pharmacy orders and related transactions.

"The idea is that we already have pharmacies connected," acting SureScripts CEO Rick Ratliff told Digital Healthcare & Productivity by telephone. "We have an ability to identify a physician uniquely on the network."

As part of this connection, MinuteClinic will convert records from its proprietary electronic medical records system into Continuity of Care Record (CCR) standard format. Ratliff adds that this record "can be moved around almost like a piece of mail" from provider to provider and into personal health records (PHR).

Now with every visit, MinuteClinic practitioners stress the importance of maintaining a medical home for each patient by making information accessible to primary care providers. If a patient doesn't have a primary care provider, MinuteClinic provides a list of physicians in the area who are accepting new patients. Practitioners are then able to use a multipurpose software-based approach at the conclusion of each visit that generates educational material, an invoice, and a prescription (when clinically appropriate) for the patient, as well as a diagnostic record that is automatically sent to the patient's primary care provider's office (with the patient's consent) to facilitate continuity of care.

Mini-Case Questions

1. How might embracing the CCR standard benefit and/or damage MinuteClinic's overall profitability?

2. Why does MinuteClinic choose to promote the patient/primary care provider relationship?

3. What patient issues might MinuteClinic face in implementing an electronic record that can be easily transferred from clinic to physician?