EHR Usage and Functionality

Identify the EHR functionalities that will be required to successfully provide care and distribute the reimbursement for a one year course of treatment for Stage III Colorectal Cancer under a bundled payments system. What are the sources of information that you require, e.g. administrative, clinical, claims, other? Who should have access to what data?

Note: Focus on:

a.the requirements of treating Colorectal Cancer,

b.what are the unique challenges in diagnosis, treatment, and payment/reimbursement associated with this disease, and

c.How does the EHR enable information integration for multiple providers and stakeholders to treat patients in a seamless manner? What specific functionalities of the EHR facilitate a smooth integration?

Hint: Think about how healthcare organizations must use the "bundled payments" system to ensure proper care coordination among multiple stakeholders involved in patient care. In other words, what types of EHR functionality must be available to provide the necessary information to ensure that "bundled payments" can be successfully implemented? Also refer to the lecture slides on bundled payments. Note that, this question is NOT about you getting into details of colorectal cancer treatment! Therefore a background on cancer treatment is not necessary (although you may do some search on it and get familiar).

Activity Counseling on need for colonoscopy Colonoscopy Biopsy Visit to review biopsy Appointment regarding surgery Resection Hospital stay and surgery (3-5 days) Review data for stage III disease Visit social worker Visit chemo nurse for teaching Decide on drug therapy Lab for pre-chemo CBC, CMP, liver, CEA Meet with clinical trial staff regarding protocol Chemotherapy and follow-up visit every two weeks (24 visits) Evaluate and treat potential problems: nausea, diarrhea, fever, etc. One month post therapy, review drug therapy and survivorship likelihood Follow-up visit every 3 months Ongoing disease and case management Person Primary care provider Gastroenterologist Pathologist Gastroenterologist Surgeon Pathologist Hospital, Surgeon and hospital staff Medical oncologist Social worker Chemotherapy nurse Medical oncologist Lab Trial staff Medical oncologist, chemo nurse Medical oncologist, nurse Medical oncologist Medical oncologist Medical oncologist and/or PCP