The information about the users and functions of hospital medical records has been delivered to administration. Now it is essential to look at the components of the medical record within the other entities operated by Smalltown Health Center. The center owns and operates the following:
• A rehabilitation center where speech, physical, and occupational therapies are available for patients with strokes, joint replacements, and other types of injuries
• Manor Nursing Home, where long-term care is provided
• United Home Health, which provides home health services and maintains an office in the hospital
• Smalltown Physician Clinic, where patients receive primary care
Each of these facilities has its own paper-based medical records and has specific documentation requirements. All of these medical records will have to be converted to electronic health records. You will visit each facility to obtain the list of documents for each type of medical record.
You will prepare a 2-page document that will detail the various needs for documentation and a chart that will show which documents would be mutually used.
Step 1: The first page will have the following for the hospital, rehab center, nursing home, home health, and clinic:
• 1 paragraph for each facility that will explain briefly any special needs
• An explanation of why the documentation is needed.
Step 2: The second page will have a chart to show the list of the facilities with the required documents.
Step 3: What clinical information systems might be implemented that can be used by all entities?