For “The GrAde” – 4 DQ

 DQ should cite at least one source and should be approximately 250-300 words each.

DQ #1- 
 Read as much as you can about the Health Information Exchanges (HIE). From your readings, what are the one or two problems that people seem to refer to the most?Given the January 1, 2014 target date for having the HIE’s live, I’d like for each of you to present and defend your thoughts on the following HIE related topics:
-What are the major technical and non-technical issues faced by states in making their HIE functional and useful?
-Are those issues the same in lightly populated states like Wyoming as they are in densely populated states like California?
-In the state where you reside, do you think that there is a better approach instead of trying to undertake the entire state at one time? If so, what is it and why do you feel this way?
-What harm is done if the deadline for HIE availability is pushed back to Jan. 1, 2015?
-Given that the most recent estimate is that 20-30 million people in this country still will not have health insurance when the exchanges come on line, is it worth the cost to invest in them?
-Has the HIE project in your state been started? Is there a set of clear goals in terms of what they expect to achieve?
-What is the anticipated cost of the HIE in your state?
-Would a single payer system of health insurance run by the federal government make more sense than a state run HIE’s?
-What did you learn or discover that was surprising to you? 

Reference:  Davis, J. (2015). HIE and interoperability trends to watch in 2016. Retrieved December 10, 2016. 

DQ #2-
While we have focused on technical, managerial and organizational issues around information technology, there are also some social issues that ought not to be ignored as well. These include:
-At what cost should healthcare technology be pursued? Can the high cost potentially lead to a rationing of health care services and is this good or bad? How can small healthcare organizations stay current with technology when the cost keeps going up?
-Who should define standardization in a free market and is competition in health care information technology a good thing or a bad thing? Can or should healthcare entities work together on this or is that collusion?
-At what point does the technology become too overwhelming for the population who uses it, particularly when you see that the population most in need of health care (e.g. the elderly) is often the receptive to more technology?
-Where is all this leading and should the health care IT industry be more regulated, (and if so, by whom?) or should the free market be left to its own devices to resolve the future direction?

Reference:  Hofilena, J. (2013). Japan pushing for low-cost nursing home robots to care for elderly. Retrieved December 10, 2016 

DQ #3-
 How does your organization measure ROI for its IT systems? Does your organization develop TCO for IT investments prior to beginning and then compare to the ROI, and if so, how many years in the future does your organization typically look forward to realize the ROI? If your organization does not, what would you recommend? 

Reference:  Hofilena, J. (2013). Japan pushing for low-cost nursing home robots to care for elderly. Retrieved December 10, 2016 

DQ #4-
Excluding the eHR, what other systems are out there and what do they do? How do they benefit organizations? What are the challenges with these systems? On average, how many different applications, whether thick client, citrix or thin client, and ASPs do you believe a 4 physician clinic/practice might have? How about a 200 bed hospital versus a 700 bed hospital? What about supporting organizations? Insurance, medical devices, etc? 

Reference:  Gerald Glandon, Detlev Smaltz, and Donna Slovensky. (2013). Information Systems for Healthcare Management, Eighth Edition. Health Administration Press.
Chapters 2 and 13

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