Add to the stakeholders and reconsideration

( including their clinics, outpatient, inpatient, and rehab facilities) to share similar or compatible EMR systems that can assist with the continuum of communication and care of a single patient using that system.
Rural hospitals have accessibility issues and have a complete patient history of making sure they are correctly taken care of. An example of when not having a shared EMR system can be detrimental is if and when the patient has to transfer to a large urban hospital, but the hospital may not have access to the patient’s files or know who to contact. This can lead to confusion, delay in care, and more chaos and frustration for all parties involved. Depending on the size of the healthcare organization and the needs of services and reason for the technology, it can make an organization effective and efficient.
Our goal is to create a policy that will connect most if not all EMR systems to ensure we are treating patients with quality care, evidence-based guidelines, and implementing practices that will help make better decisions that ensure patient safety. 

Problem Statement
Is the problem statement concise and a reasonable public policy problem? BANZ COMPLETED
Problem Statement:
How can we utilize EMR technology between hospitals, including rural hospitals, while keeping HIPAA integrity and access for all. 

Issue
    In the healthcare arena many advancements are taking place. These advancements include faster testing for diseases, quicker referral developments, and the processing of care plans for patients. However, one entity that is truly paralleling advancements in medicine is Electronic Medical Record (EMR). An EMR can be defined as an electronic chart of a patient’s health information. The creation of EMRs has eliminated the need for paper charts that left room for misdiagnosis and constant medical errors in the past. With EMRs in place, medical personnel can log in with secure passwords and receive information securely and quickly to care for their patients. These records can include but are not limited to labs, recent procedures/treatments, and even current medication dosing/interactions. Many organizations have converted to this new way of record-keeping, and some are still making adjustments and implementing staff training. Provider networks would help with integration because they would have a whole team of different disciplines that can help get patients taken care of. However, it can be detrimental to them to serve clients, but it makes it more difficult to treat those patients that they may have been seeing for a long time but then couldn’t because the patients are out of network. For example, in 2016, ” Medicaid and uninsured patients were also seen by most physicians82.6 percent and 75.6 percent, respectively” (AMA, 2017).
Safety and privacy are the main challenges with substantial legal and ethical questions. Legal effects. Violations of secrecy in the health sector and specific and inconsistent health privacy regulations have led to a decline in health privacy laws. Patients believe that the protection of their health records will be secured. One concerning factor of EMRs is the utilization aspect. Many communities and specific demographics do not have the same access to healthcare. With this known issue, how do we make the connection and protect the safety of our patients?
Along with this, it is to parallel the technology between hospitals while keeping HIPAA integrity and access for all. One common issue is a frequent emergency room/urgent care visits. Without proper follow-up with a set primary care physician, charts are everywhere with no solid patient history.
One of these specific electric HIPAA systems is Cloud Based EMR systems used widely in the healthcare industry due to the ability to have multiple users simultaneously editing, practice management, and improving patient information flow. This can lead to misdiagnosis, unnecessary treatment, and repeated testing that may have already been completed previously.

Rationale
Is the rationale behind the public policy problem reasonable and understood? BANZ COMPLETED
EMR is defined as Electronic Medical Records. They are the digital versions of paper charts in clinics and hospitals. EMR contains information and keynotes collected by or collected
for the clinicians in the hospital or clinic. Electronic Medical Records are generally provided for diagnosis and treatment. EMR is very valuable in comparison with paper records. EMR offers the opportunity to track the data over time and identify patients that need to visit the hospital or clinic and screening. EMR also helps in improving health care quality by monitoring patients. EMR also enables health providers to access accurate and complete information that is very important in identifying and assessing patients. Therefore, it allows patients to receive enhanced medical care. It also helps in reducing medical errors.
Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law and requires to prevent patients sensitive health information by creating national standards and prevents disclosing patients information to anyone without their consent or knowledge. HIPAA requires medical practitioners to keep patients’ data safe and exercise best administrative, technical, and physical security practices.
Vast amounts of data are always more helpful than not because you can share ideas, theories, and cures if need be! Many of the pioneers in the field are skeptical of all the technology, to begin with, but also think of the rules, regulations, policies, and updating as unnecessary or “too much.” Still, we forget that these EMRs and other Patient Information are very personal and private.  Despite many efforts from health care organizations, cybercrime can still take place. In 2016, more than 16 million patient records were stolen from healthcare organizations in the United States, and more than 150 million individuals have had their medical records stolen since 2010. Many cybercrimes happen through EMRs, and this can happen through employee negligence. It is essential not to share passwords and use hospital computers for personal business (Conaty-Buck, 2017).  There is a lot of legality through specific healthcare ethics and laws that make it safer (less med errors, more to analyze) and more effective, but overall there is still a lot to do. Patient data, diagnosis, treatment plan, and screenings depend heavily on the United States’ manual process. Converting it into Electronic Medical Records has many implications for health consultants, hospitals, and clinics. EMR training must ensure that providers are aware of the importance of protecting HIPAA. This transmits into the patient health record, which connects to reimbursement claims, prior authorizations, and eligibility. In conjunction with this goes into making sure no unauthorized information is disclosed. In information is outsourced, providers need to understand their HIPAA Privacy Rule practices to make sure information is completely protected (Muckerman, A., & Lauber, A., 2017).

Economic Considerations
Did the team understand the economics of the policy? Was it reasonable and attainable?

Research
Was proper research conducted? Does it support the argument? MAY NEED TO ELABORATE
The factor that influences how need is determined is the protection of patient safety. Patient safety has been a concern throughout the world for many years, and although the healthcare industry has made significant strides towards the issue, there is still much more to be done.  One of those significant changes related to patient safety is the American Recovery and Reinvestment Act. This act mandated all public and private health care providers and eligible professionals to adopt and make “meaningful use” of EMR (Electronic Medical Records) systems by January 1, 2014, or penalties would incur. In 2021 many have made that switch and continue to train staff on their use and the importance to their patients. Rafferty et al. (2013) view change readiness as an individual attitude that has both cognitive and emotional (or “affective”) dimensions. “Collective readiness” for change of a group or organization is based on the shared beliefs that develop through social interaction and shared experiences. Underpinning an individual’s change readiness, therefore, are five beliefs:
Discrepancy: The belief that change is needed.
Appropriate: The belief that the proposed change is an appropriate response.
Efficacy: The individual’s perceived capability to implement the change.
Principal support: The belief that the organization (management, peers) will provide resources and information.
Valence: The individual’s evaluation of the personal costs and benefits; no benefits, no overall positive evaluation of readiness.
Normative needs relate to the gap between a person’s status and a set standard or an accepted norm. Perceived needs are those felt by individuals, which, once articulated, become expressed needs. About our policy paper regarding EMR advancements, many different races have had limited access to care, and the quality was poor. This goes against the norm of some indifferent status classes and cultures as well.  The plan is to bridge the gap where everyone has the same access and quality of care no matter their socioeconomic classification or insurance status.

Stakeholders
Are all stakeholders represented? Was sufficient research done on the respected positions of each stakeholder? Was the issue that would affect each stakeholder group well defined and accurate?
You will have the patient clientele currently in or out of network, with providers in or out of network. This means there needs to be training, education, and awareness of how there is a way to collaborate and share patient files, but it is also more accessible for the patient to be taken care of.
The best method for collecting data for several reasons, it keeps the patient’s history safe, and it does not allow anyone to exploit the patient’s history. It also helps doctors keep an eye on the patients’ history to be treated carefully.
An ideal state of this policy being implemented would have phases. Training employees to use the system can also be a challenge; some people are accustomed to things being a certain way, and changing things up can take longer for adjustment. Taking the time to train staff is an ongoing process, primarily since updates and changes can continuously occur. One of the struggles, in the beginning, was finding the right system that would accommodate the needs of the organization’s patients and was easy enough for training to be adjusted to as well.
Knowing the parts of EMR is essential to see how we can use them to help protect our patients’ health care information and improve care quality. The integration of medical information has helped prevent medical errors and set up demographics to treat patients comprehensively. PHRs (personal health records) have also been implemented to help patients keep up with their medical records to present information to other prescribers if necessary (Heart, T., Ben-Assuli, O. and Shabtai, I., 2017).
Clinical practice guidelines have now become an excellent tool for policymaking and its implementation. In this condition, national stakeholders actively participate in developing public policies to enhance the people’s primary healthcare facilities. The public healthcare procedure includes medical supplies to the people, includes physical training activities, and provides information to prevent various diseases.
The stakeholders in the healthcare system are insurance companies, doctors, and pharmaceutical companies. The public healthcare policies indicate that stakeholders had good interactions when involved meaningfully in the research process. Research (Jee & Kim, 2013) initiatives were carefully organized and coordinated with a focus on context and community. In this situation, stakeholders face many problems collaborating with an organizational system of the state. These challenges are systematic and can maintain by building a good relationship.
Stakeholder participation is essential for public health science to ensure that proposed or sponsored research is meaningful and answers critical public health issues for decision-makers, clinicians, and the public (Dorey et al., 2018).

Challenges for stakeholder participation include engaging with partnership participants who are geographically scattered, balancing conflicts in opinion between collaborators, influence gaps, overlapping interests, fewer face-to-face communication options, partners that are less committed to stakeholder engagement (Dorey et al., 2018).
To keep Native Americans away from lands that European Americans wished to settle, the Indian reservation system established it. The reservation system allowed indigenous people to rule themselves and retain some of their cultural and social practices.
The National Accreditation Board for Public Health (PHAB) was founded in September 2011 (McBeth et al., 2016).
Country-wide health programs read more PHAB and the method of accreditation, and there will be those who want to follow it. Audience multiple partners within the organization, including clinical accreditation, collaborate with other agencies and community members. It’s a considerable deal phase that needs to be considered appropriately (McBeth et al., 2016).

Recommendations
Are the recommendations ethical, legal, and possible? Did the recommendations get well developed and have appropriate supportive data? MAY NEED TO ELABORATE
This parallels our policy paper by making EMR systems mandatory there have been both benefits and challenges. Some of the benefits consist of a reduction in medication errors by eliminating handwritten prescriptions. The system can check for drug interactions whenever a new medication is prescribed, and it sends an alert of potential conflict. Another benefit that is offered is it lists life-threatening allergies and information that the staff in the emergency department will be able to access to help in the case of a patient being unconscious. A few of the challenges are these systems can potentially break down, which can cause you to lose access to patient information.
Reference BANZ COMPLETED
2016 Report to Congress on Health Information Technology Progress. (2016). Retrieved January 28, 2021, from https://dashboard.healthit.gov/report-to-congress/2016-report-congress-examining-hitech-era-future-health-information-technology.php
Alex T Ramsey, Ami Chiu, Timothy Baker, Nina Smock, Jingling Chen, Tina Lester, Douglas E Jorenby, Graham A Colditz, Laura J Bierut, Li-Shiun Chen, Care-paradigm shift promoting smoking cessation treatment among cancer center patients via a low-burden strategy, Electronic Health Record-Enabled Evidence-Based Smoking Cessation Treatment, Translational Behavioral Medicine, Volume 10, Issue 6, December 2020, Pages 15041514, https://doi.org/10.1093/tbm/ibz107
AMA-PATIENT SUPPORT & ADVOCACY (OCT 30, 2017). Physician data offer new insights into ACA’s coverage impact. https://www.ama-assn.org/delivering-care/patient-support-advocacy/physician-data-offer-new-insights-aca-s-coverage-impact
Conaty-Buck, S. (2017). Cybersecurity and healthcare records- American Nurse Today. Retrieved January 27, 2021, from https://www.americannursetoday.com/cybersecurity-healthcare-records/
Geyer, R., & Cairney, P. (Eds.). (2015). Handbook on the complexity and public policy. Edward Elgar Publishing.
Grundmann, R., & Stehr, N. (2012). The power of scientific knowledge: from research to public policy. Cambridge University Press.
Heart, T., Ben-Assuli, O. and Shabtai, I., 2017. A review of PHR, EMR and EHR integration: A more personalized healthcare and public health policy. Health Policy and Technology, 6(1), pp.20-25.
Kettner, P; Maroney, R; and Martin, L. (2017). Designing and Managing Programs. 5th Edition. [Vitalsource] https://online.vitalsource.com/#/books/9781483388328/cfi/6/28!/4/2/14/10@0:99.2
Muckerman, A., & Lauber, A. (2017). Revenue Cycle Management: Patient-Focused Compliance Issues. Retrieved January 27, 2021, from https://www.ecgmc.com/thought-leadership/blog/top-revenue-cycle-management-issues-that-impact-compliance
Palmer, I., Dunford, R. & Buchanan, D. (2017). Managing Organizational Change: A Multiple Perspectives Approach, 3 rd ed. New York: McGraw Hill Ed
Peters, B. G., & Zittoun, P. (2016). Contemporary approaches to public policy. Theories, controversies, and perspectives. UK: Palgrave Macmillan.
Rafferty, A. E., Jimmieson, N. L., & Armenakis, A. A. (2013). Change Readiness: A Multilevel Review. Journal of Management, 39(1), 110135. https://doi.org/10.1177/0149206312457417
Scott, C. (2012). Risk Assessments What’s the Big Deal? Your Responsibilities If You Adopt Electronic Health Records: risk assessments for electronic health records. Retrieved January 28, 2021, from https://www.beckershospitalreview.com/healthcare-information-technology/risk-assessments-whats-the-big-deal-your-responsibilities-if-you-adopt-electronic-health-records.html

Jee, K., & Kim, G. H. (2013). The potentiality of big data in the medical sector: focus on how to reshape the healthcare system: Healthcare informatics research, 19(2), 79.
Dorey, C. M., Baumann, H., & Biller-Andorno, N. (2018). Patient data and patient rights: Swiss healthcare stakeholders’ ethical awareness regarding large patient data setsa qualitative study. BMC medical ethics, 19(1), 1-14.
McBeth, M. K., Lybecker, D. L., & Stoutenborough, J. W. (2016). Do stakeholders analyze their audience? The communication switch and stakeholder personal versus public communication choices. Policy Sciences, 49(4), 421-444.