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Consider private payers including pay for performance “bundled” payments as discussed in the Dynamic Scenario in Week 4. How do private payers play into your thinking about clinical and financial information systems strategies?A recommendation of either a best of breed or monolithic systems integration strategy. Justify your recommendation. Evaluate the issues involved in each. Describe how private payers play into your thinking about clinical and financial information systems strategies. Describe the role of vendor/client site relationships in these types of decisions.
Use the situation and continue with the thought
The current situation calls for both Medicare and commercial insurers to change their payment methods, with an emphasis on bundled payments and compensation based on results. It becomes clear that the planned acquisition of Epic's clinical EMR is a great way to adapt to these developments and improve our capabilities. Disjointed systems and fragmented clinical technologies characterize the current environment, making it difficult to fulfil HITECH Meaningful Use standards (Arlotto, et al. 2019). Skepticism may arise in response to the proposal that proposes to spend around $1.5 million to install the Epic clinical software, in addition to $300,000 per year on software maintenance. Still, they intend to standardize patient involvement, order processing, and paperwork across all medical facilities and doctor's offices, so the investment makes sense.
Efficiency advantages, better patient care, and higher reimbursements due to precise documentation and compliance with changing regulatory standards are the expected benefits, which are difficult to measure upfront. The bid may appear high, but when they think about how inefficient our existing setup is and how the competition may change, it becomes evident that they need to upgrade their HIT infrastructure. There is a sense of urgency around their decision-making process due to the rumblings in the local competitive environment, which involves the prospective acquisition of local surgical facilities by an established university institution renowned for high-quality orthopaedic treatment (Frigo, 2023). Dynamic has to improve its skills and continue to be a provider of choice in light of its declared best practices and the implications of cost-effective treatment.
My goal in developing a return on investment (ROI) plan for this purchase is to think about how things will change in the future in terms of care coordination, process simplification, and possible revenue increases due to higher compliance and patient happiness. The upfront expenditures may seem high, but they might be more than remunerated for by savings from working efficiency and higher compensations as a result of better certification and service conveyance.
Arlotto, P. W., Birch, P. C., Crockett, M. H., Irby, S. P., Arlotto, P., & Irby, S. (2019). Beyond Return on Investment: Expanding the Value of Healthcare Information Technology. Productivity Press.
Frigo, M. L. (2023). Strategic Marketing in a Digital World. Strategic Finance.