Westlake Research Hospital... Submit an analysis of the organization that will use the database developed for the final project. Analyze the organization to determine the problem/challenge, business requirements, and limitations of the current system(s). Explain how the problem or challenge impacts the various departments and operations within the organization. Specifically, the following critical elements must be addressed: ·

Organization Problem:

Analyze the organization to determine the problem/challenge, business requirements, and limitations of current system(s).

Departments and Operations: Explain how the various departments and operations within the organization are impacted by the issue or challenge.

Westlake Research Hospital...

A hospital is conducting a double blind test of a new depression drug. It will involve about 20 doctors and about 400 patients. Half of the patients will get the new drug and half will get traditional Prozac. Neither the doctors nor the patients will know who is getting which drug. Only two test supervisors will know who is getting what. The test will last about 18 months. Each doctor will see 20 patients initially, though it is expected some patients will drop out over time. Each patient will be coming in twice a month for a checkup and interviews with their doctor. The drugs will be dispersed in a generic bottle by the two supervisors one of whom is a pharmacist. To track this study, the hospital will need a database. It will need to track patients’ information from their first screening through each of their interviews. In particular, they are looking at whether the patient seems more depressed or less, what their appetite is like, are they sleeping, and what kind of activities they are engaged in, if any. Also, they will be looking for specific physical side effects such as rashes, high blood pressure, irregular heart rhythms, or liver or kidney problems. Doctors need to be able to see their own patient’s information, but not that of any other doctor’s patients. They also need to be able to enter blood pressures, blood test results, the depression indicators, their own notes, and so on for each session. Patients should be able to see their own medical profile, the doctor’s notes, and nothing else. Only the two researchers should be able to see everything: all patient information, all doctors’ notes, and which drug each patient is being given. There is always some danger of spying by other companies interested in similar drugs, so in addition to the security of the blind test, the database needs to be secured against outside intrusion as well. The doctors and the directors of the study were reluctant to allow me to observe them with an actual patient, but one of the doctors, Dr. Lewis, did agree to sit with me and walk me through the process of a patient visit. “The first thing I do in the morning,” he told me, “is review the day’s appointments.” He turned on the computer and showed me the way it is currently done. The secretary sends an email with a table of the patients and times of the appointments. He points out the list and then goes to his cabinet to pull out the files of the individual patients for review. He reviews their initial medical history and the notes of previous visits. He makes some notes on a notepad for each patient. When the first patient arrives, Dr. Lewis greets them and asks how they are doing. He told me he keeps it casual, but he notes any complaints or signs of deepening depression. Then he goes through the parts of the Patient Visitation Form. The nurse has already taken the patient’s blood pressure, heart rate, and weight. He looks at them, and if the blood pressure is high, or if there has been a dramatic change in one of the measures since the last visit, he asks the patient about it. Then he asks about their depression. He doesn’t necessarily use the exact words of the form or follow it in order, but he makes sure he covers all of it. He records a few notes in a notebook while the patient talks but waits until the patient leaves to write most of the summary. He also waits until the end to make his recommendation to continue or to drop the patient from the study. I asked Dr. Lewis how he makes that determination. He told me that it is a judgment call. Most of the time it’s in the patient’s interest to continue with the study, but if the patient is showing signs of significant side effects or if the patient seems in eminent danger of doing harm to himself or herself, I would recommend the patient be dropped and given alternative or more aggressive treatment. I asked if there were any other reasons for dropping a patient. He said that some patients were dropped from the study because of lack of participation, because they didn’t show up for appointments, or were inconsistent in taking their medications. He also noted he always worried that such patients were possibly the most depressed and needed the most help. The drug study is set to begin in just a few months’ time. It is important to make some progress toward the database. It is time to gather all the materials you have collected and try to make some sense of them. It is imperative that the database be ready before the actual clinical trials begin. The staff at Westlake is anxious to see some results. It is time you show them the logical design of their database. This is the Westlake Research hospital documentation and I need you to give me what problem this research facility it faces and Analyze the organization to determine the problem/ challenge, business requirements and limitation of current system(s). And what departments and operations are involved within the organization which are impacted by the issue or challenges

Answer rating: 100% (QA)

Audit Trails AT square measure elementary to data security so as to ensure access traceability however can even be accustomed improve Health data Systems HIS quality particularly to assess however theyre used or exploited This paper aims at analyzing the existence and quality of AT describing eventualities in hospitals and creating some recommendations to enhance the standard of knowledge Methods The responsible of HIS for eight Portuguese hospitals were contacted so as to rearrange associate degree interview concerning the importance of AT and to gather audit path information from their HIS 5 establishments united to participate during this study four of them accepted to be interviewed and 4 sent AT information The interviews were performed in 2011 and audit path information sent in 2011 and 2012 Every AT was evaluated and compared in respect to information quality standards particularly for completeness understandability traceability among others Only 1 of the AT had enough data for North American nation to use a consistency analysis by modeling user behavior Results The interviewees in these hospitals solely knew a number of AT average of one AT per hospital in associate degree estimate of twenty one existing HIS though all of them acknowledge some benefits of analyzing AT Four hospitals sent a complete of seven AT a pair of from Radiology data system RIS a pair of from image Archiving and Communication System PACS three from Patient Records 3 of the AT were perceivable and 3 of the AT were complete The AT from the patient records square measure higher structured and a lot of complete than the RISPACS Conclusions Existing AT doesnt have enough quality to ensure traceability or be employed in HIS improvement Its quality reflects the importance given to them by the Congress of Industrial Organizations of tending establishments Existing standards eg ASTM E2147 ISOTS 183082004 ISOIEC 270012006 square measure still not loosely employed in Portugal Background The observe of drugs has been delineate as being dominated by however well data is collected processed retrieved and communicated 1 A crucial challenge is to ensure the nice operating conditions for health professionals to access clinical information whereas Hospital data Systems HIS square measure still being developed 2 Though nice advances are remodeled the years ondemand access to clinical data remains inadequate in several settings contributory to duplication of effort excess prices adverse events and reduced potency 3 Shapiro et al 4 found that though doctors from emergency department believe their patients would get pleasure from the employment of longitudinal records they solely attempt to acquire such information in ten of the cases what is more Hripcsak et al 5 delineate access rates to Clinical data system WebCIS within the emergency department 5 indicating that information generated before this emergency visit square measure accessed typically however by no means that in an exceedingly majority of times only fivehitter to twenty of the encounters even once the user was notified of the provision of such information CruzCorreia et al 6 have shown that not several clinical reports square measure still used one year once creation no matter the context within which they were created though vital variations existed in reports created throughout distinct hospital encounter sorts Also the usage of patients past data data from previous encounters varied in step with the setting of tending and content this sort of analysis is barely attainable once records with retention necessities that show United Nations agency has accessed what in an exceedingly HIS once and what operations were concerned square measure properly collected These records square measure known as Audit Trails AT 7 Although AT square measure usually simply supposed to trace user events once a happening happens theyll even be accustomed improve HIS Some attention as already been given outline the necessities of AT in tending particularly by RFC 3881 IHEATNA DICOM These standards square measure being documented in a number of the foremost necessary comes nowadays eg epSOS or Meaningful use stage 2 planned rule Aim This paper aims to handle the problems involving the existence and quality of AT relating to patient records to explain the Hospitals situation and to supply recommendations It includes studies on The opinions of Hospital Chief data Officer CIO relating to AT The data components to incorporate in AT Quality of information dimensions to use in AT and An associate degree analysis of the prevailing AT inside Portuguese Hospitals State of art The most common AT operate is that the access management 8 Even so different relevant functions exist admire the observation of worker behavior and laptop data system failures associate degree AT will be used and analyzed with many various functions though with the next impact once used as proof in tending practices lawsuits or within the internal validation of latest practices just like the introduction of a brand new IS The simplest thanks to assess the answerability in lawsuits would be to return the records to their state at the purpose of care therefore a path is necessary 9 On the clinical purpose of read connation has been given to the importance of AT parenthetically within the validation of clinical call support systems in medical specialty vital care 10 or within the integration of multicentric test information management 11 Creating associate degree AT implies the implementation of many audit controls 8 probably integrated among multiple IS eg Radiology data system RIS Electronic Health Record EHR and film Archiving and Communication System PACS RIS square measure one in every of the teams of systems wherever this integration has been higher audited 12 The ensuing audit files probably distributed within the network square measure what in engineering science is often known as log files of associate degree IS However log files square measure most of the days gently outlined by code corporations having solely debugging functions The notion of AT extends that of a log file within the sense that it can even be accustomed monitor the event of electronic health records the import and export of protected health data from and to external entities the modification viewing and deletion of knowledge creating it attainable to have confidence the integrity of the records in health data exchanges and also the information fed into personal health records 8 completely different establishments as EuroRec 13 the ISOHL7 21731 RIM 14 customary and IHE 15 have approached this issue data Technology IT governance practices eg IT Infrastructure Library ITIL that recommends on the employment of AT for correct service level management square measure being introduced in several Hospitals to subsume increasing levels of knowledge quality and safety necessities however the ... 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