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Health Information Technology, The Robert Wood Johnson Foundation (RWJF)

Health Information Technology

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Date

Health Information Technology

The Robert Wood Johnson Foundation (RWJF) a 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 being 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 to 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 to 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 bottle necks 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 care givers 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 an 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 be 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 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 projects 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 being 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 documentations 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). Decrease in hospital-wide mortality rate after implementation of a commercially sold computerized physician order entry system pediatrics. Pedriatrics, 126(1):14–21.

McCullough J, Casey M, Moscovice I, (2010). The effect of health information technology on quality in us 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.

Uses Of Water

Introduction

Water is a vital component for both plant and animal life. Research indicates that seventy percent of a human beings body is water. Seventy five percent of the earth’s surface is also being occupied by water. Scientists have found out that water is the most interesting fluid on the earth’s surface due to is importance and versatility CITATION Cha11 l 1033 (Fishman). Water is required for drinks, irrigation, recreation in form of swimming pools and several other uses. From 1950, the geological statistics by the United States put together water consumption rates by companies, homes, businesses and farms all over United States and explained how its usage has changed over time. The data has then been used to facilitate explanations on conceptualizing the impacts of activities of human beings on the country’s water resources. This paper attempts to discuss the importance of water to the American people by looking at its usage statistics previously.

Background of study

In the period ranging from 1950 and 1980 there was a balanced rise in the usage of water in the U.S.A. This period had the anticipation that as people became many; the usage of water would also increase. Converse to the anticipation, water usage reduced during 1985 and remained comparatively balanced from then despite the population increase witnessed in U.S.A. technological advancements witnessed in federal and state laws, economical factors together with improved water conservation education and awareness led to better usage of water available from United States of America water sources such as aquifers, lakes, oceans and reservoirs.

2000 water usage approximates reveal that close to four hundred and eight billion gallons were drawn for purposes of usage that single year. These estimates have changed with less than three percent from 1985 as water drawings are now stable for the two biggest consumers namely irrigation and thermo electricity CITATION Ste99 l 1033 (Thompson). Usage of fresh waters was close to eighty percent of of the whole figure, while the rest was inform of saline water.

Water usage to generate electricity

The main reference was Burke county cooling plant situated in Georgia. According to the United States geological statistics, electric power consumes close to half of the total water usage. Much of the water is sourced from water from the surface and used once only for the purposes of cooling within the power plant. Approximately fifty two percent of the surface water that is fresh drawn and close to ninety six percent of the drawn saline water are for purposes of electric power usages.

Usage of water for Irrigation

The main point of reference was at Fremont county great pipe irrigation situated in Wyoming. The natural resources conservation irrigation stands for close to a third of water usage and at the moment it is the biggest United States consumer of fresh water. Use of water for irrigation factors in use of water for farming, chemical applications, control of weeds, protection of frost, general agricultural usage together with maintenance of golf courses areas and parks. Basing on history, less water from the ground as opposed to water from the surfaces has been applied for irrigation purposes. Nevertheless, there has been a consistent rise in percentages of ground water draws from a figure of 23 during the 1950s to a figure of 42 in 2000. The total land under irrigation went beyond a double figure between the period of 1950 and 1980; from there it attained a constant figure prior to rising by close to seven percent from 1995 to 2000.

The size of land under sprinkler irrigation and that under micro-irrigation systems has over time risen and currently consist of more than one and half of the total size of land under irrigation.

Water use for supply of power

The point of reference was Bay County water intake power supply situated in Florida. As per the United States geological statistics public water supply is defined as water drawn by the general public plus private suppliers of water as opposed to personal supplied water which is drawn by individual users. Public water supply can be used for home usage, industry usage, commercial, electricity generation and some other general public use. In around 1950, just sixty two percent of the people living in U.S.A. sourced water for drinking through suppliers of the public, but then by the year 2000 close to eighty five percent had adopted this. The use of public water has risen consistently from 1950 and stood for only eleven percent of water usage in 2000 CITATION Ste99 l 1033 (Thompson).

Water use in industries

Industries that supply themselves is the basis of this. During the year 2000, personal supplied industrial water draws amounted to close to five percent of water usage. Water usage for industrial purposes factors in water used to meant fabrics, cooling, washing, processing plus water used for production of chemical materials, food plus other products resulting from paper. Water used for industrial purposes has reduced by a factor of twenty four percent from 1985 and in the year 2000 was very low from the time it began reporting in 1950 CITATION Cha11 l 1033 (Fishman).

Subsidiary usage of water

Total draws for personal supplied home usage, agriculture, animals and naturals resources mining stood for close to three percent of all the water draws for 2000. Individual supplied home draws factor in water that is use for home usage that is not sourced from public supply. Close to forty three million persons in the U.S.A. individual supply their home water requirements, normally from wells. Animals water use factor in drinking, feedlots plus other farming requirements for animals like pigs, poultry, horses, cattle and sheep. Water is also used for fishing purposes such as fish farms, shellfish firms and fish hatcheries. Water used in mining natural resources includes water that is used for minerals extraction such as coal solids, liquids, ores, gases like natural gas and crude petrol. There is also water used for the general mining processes which is mostly saline water as at 2000.

Works Cited

BIBLIOGRAPHY Fishman, Charles. The Big Thirst: The Secret Life and Turbulent Future of Water. April 2011. 7 April 2013 <http://www.fastcompany.com/1748537/big-thirst-secret-revolution-us-water-use>.

Thompson, Stephen A. Water use, management, and planning in the United States. San Diego: Academic, 1999.

Health Information Technology (HIT)

Health Information Technology

Student’s Name

Date

Health Information Technology

Health Information Technology (HIT) is considered widely as a tool that can be used in improving the quality of care, Improvement in care outcomes for both family and patient and family experience while reducing care disparities. The ability of HIT to augment information and communication sharing makes it a significant instrument for addressing quality and safety threats in times of care transitions. Consequently it has received substantial acknowledgement by numerous stakeholders in the US health sector including leading investors in the sector such as the Robert Wood Johnson Foundation (RWJF) multi-billion dollar philanthropy dedicated to improving health and health care for all Americans (Yu, 2009).

The 2009 American reinvestment and recovery reinvestment Act (ARRA) acknowledged HIT’s significance through allocating $18 billion to enhance the development of electronic medical records in physician offices and hospitals. Consequently, researchers, health systems, computing companies and professional organizations have began investing their energy, financial resources and time in an effort to determine an electronic system that will add convenience, improve quality and increase efficiency (Tucker,2011).

The National Coalition of Care transition believes that for there to be a tangible effect in care transition, the technology should deal with a number of important steps. Its constituents include: strong care coordination, standardized processes, established accountability, good communication and necessary performance measures. If these components are not addressed HIT’s impact and general transition will not be realized (Sharon, 2012).

There are various bottle necks 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. 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 care givers and their patients tend to encounter numerous challenges every time they come into contact with the health care system. 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 an 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. 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. Particularly during transition, all health care team members including family care givers and their patients need to access fundamental information to make their transition not only, smooth and safe but also successful. To achieve this kind of information sharing there is a need for stakeholders to improve communication between family care givers, health care providers, community support systems and patients (Himmelstein, 2010).

Lack of connectivity

It is recognized nationally that there is no connectivity between the long term care system and providers in the health care system. Institutions of medicine point out that the quality of health care in the US suffers not because the treatments are ineffective but because the healthcare delivery systems do not deliver the treatments. Fragmented health care raise health care costs for the patient and the hospitals (Furukawa, 2010). These inefficiencies unnecessarily increase costs for employers, patients, payers and providers. In spite of the fact that other sectors of the US economy have embraced technology as a cost of doing their business the US health care system is yet to roll it out on a wide-scale to enhance the provision of care (Fonkych, 2005).

Lack of Shared goals correlated to the switching of care

Since there is so much in the health care systems, objectives for care transition are in silos; where each department only worries about itself. There is no incentive to synchronize with the next or previous care site to establish what should be done. A study about coordination between family care givers and formal providers realized that interventions that emphasized on supportive relationships and communication quality that included shared goals and mutual respect for patient care was positively related to patients’ mental health, their freedom from pain and an augmented functional status (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. It is projected that over eighty million US citizens face difficulties in comprehending and utilizing health information. Health Information Technology (HIT) could be fundamental in reaching caregivers and individuals in an effort to increase health literacy (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 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).

The representation of the continuum of care

Electronic communication will be successful if all stakeholders in the continuum can access the information. At the continuum’s heart are patients and their families. Policy should be enacted to ensure that the patient is the focal point of the care continuum and that families and their patients can access care information. Apart from that HIT should clearly outline that the wide care continuum which includes all health care service providers, physician offices, hospice, hospitals, rehabilitation centers, nursing homes and home health care organizations are included in wide ranging policy changes (Amarasingham, 2009).

Infrastructure and Interoperability

Health Information Technology (HIT) should be facilitated to export patients’ data to external providers and systems in a succinct and meaningful format. For instance there are two documentations 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 will thus collaborate with other stakeholders 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.