Supporting Mobile Health Clinics: The Children’s Health Fund of New York City

“Supporting Mobile Health Clinics: The Children’s Health Fund of New York City”

(on pp. 157-165 in the textbook).

Analyze the case study, and develop the conclusions, recommendations, and implications.·

Consider the implementation challenges in the case and the technologies used to meet them, along with the final

questions posed at the end of the case. (last paragraph on p. 165) ·

Summarize your findings in a twopage paper using proper APA formatting

Brown, C. V., DeHayes, D. W., Hoffer, J. A., Martin, E. W., & Perkins, W. C. (2012).

Managing information technology(7thed.). Upper Saddle River, NJ: Prentice Hall.

The Children’s Health Fund focuses on providing healthcare to the “nation’s most medically underserved children.” The healthcare is delivered in R –size mobile medical clinics to bring care to the people most in need, visiting low-income neighborhoods, homeless and domestic violence shelters, schools, and community centers. These mobile medical centers also respond to public health crises emergencies, including 9/11 attacks, hurricanes Rita and Katrina and Sandy as well as the Gulf of Mexico oil spill. The Children’s Health Fund prides itself on providing high quality primary care but this presents challenges.  The CHF must develop a systemized approach that is aligned with high quality services typically found in a standard physician’s office.  This involves a need for sufficient high quality electrical power, which may be difficult to obtain during a crisis. The CHF must also comply with regulatory standard set forth by health organizations and government legislation.  The computer and communications technology must be reliable and dependable, and have access to technical support. In addition, cost must be considered.

More specific challenges involve storing the electronic medical record of each patient to ensure remote access to data, while providing data security. This is key based upon the transient population that the Children’s Health Fund serves. The cloud is not mentioned, however, this might be a solution that is expansive, private, and secure.

It is also important that CHP’s technology is easy to use. Doctors and clinicians have been selected and trained for their medical knowledge, not their technological skills or expertise. The technological solution must be easy and clear to use so that correct information is stored and retrieved in a secure fashion. Due to the nature of the operation this must be achieved through a low cost option. Speed of connection is important as well, both in terms of service, as well as to avoid questioning of the service’s operational status. The case states that 4G networks have the required throughput but may not have reliable coverage. A possible solution is delayed broadband wire access but this risks the security of data and is not always possible. Asynchronous multi-master database replication is suggested as a way to transfer data but this also has flaws in that information cannot visibly be seen transmitting. Without confirmation that information has been input and transmitted successfully there is a greater chance of lost information and employee error. Also, should information be needed immediately to consult on a patient a lag would be unacceptable. Another solution would be to utilize a string of secure VPN’s, much like smartphones are now able to transmit credit card purchase information. This would enable CHF to use the extensive coverage of the network, as well as enjoy the speed of 4G or 5G network. This solution will be problematic in times of natural disaster, due to overloaded networks, but in day-to-day use it will be an efficient, economical answer.

Cooling the equipment and choosing the proper equipment are also troublesome, again due to the energy needs of the operation. This must be solved. One possible option would be to consider high power users in other fields, and “ladder up” to borrow their technology. A possible solution to consider would be the generators developed for the military overseas, used to cool important systems. While costly, these might last longer (industrial strength) and be more stable than the current options.  As well, since the program is funded through the government there is a possibility of better pricing.

CIO Wiseman is concerned that there might be newer, more affordable communications. This is certainly true. Technology continues to improve and become more affordable. It is likely that the federal government’s HITECH stimulus funds and Meaningful USE standards will lead to better software integration. Wiseman must partner with technology firms to better understand the availability and capability of solutions for his needs. The CHF operations offer a unique opportunity to test the durability and transferability of solutions. By partnering with various firms, CHF could remain on the forefront of medical electronic medical record items and practice management systems.

We are increasingly living in a flat world where CHF’s services and method of providing healthcare could become more important than ever in providing high quality care around the world. The increase in software in adoptions at physician’s offices will be unlikely to affect the staff retention at CHF. The staff at CHF is working toward a higher cause.  Rather than worry that a particular combination of conditions could emerge that would render the mobile medical clinic model obsolete, Wiseman should concentrate on fine-tuning the technology of the process to offer the best quality of care possible, thus encouraging the expansion of the service.

Reference

Supporting Mobile Health Clinics: The Children’s Health Fund of New York City. The Children’s Health Fund. Print.