Case studies assist in understanding key areas of concern in a healthcare environment. A case study is a real-world experience that allows the student to apply their knowledge. Case studies provides a comprehensive view of diverse theories and the complexity of administrative actions in resolving issues that occur in healthcare operations.
CASE 64
Cultural Competence in Telehealth
Jenn Block
Moon is a practice manager at the White Plains Family Practice clinic just outside of Boston, Massachusetts. There are 10 providers in the clinic, including six physicians and four advanced practice nurses. The practice also has approximately 24 support staff, including four schedulers/front desk staff, two billers and coders/back-office staff, one registered nurse, two licensed practical nurses, and 15 medical assistants. The practice is extremely busy and provides care for almost 40,000 patients. Many are Medicare/Medicaid patients, although the commercial population has been growing as large new corporations have moved into the area. The demographics are varied and include the following:
Male: 48%; Female: 52%
65 & older: 32.2%; and under 18: 21.7%
White: 42.2%; White, not Hispanic or Latino: 18.1%
Hispanic or Latino: 29.3%
Black or African-American: 33.2%
Asian or Pacific Islander: 2.4%
Other: 1.1%
Two or more races: 4.8%
The clinic transitioned approximately two years ago to a cloud-based electronic medical record (EMR). This new system allowed them to connect and share data with pharmacies, hospitals, and insurance companies (payors). It also has a robust patient portal module; however that and the telehealth module have yet to be implemented. Productivity after the EMR implementation suffered for more than six months, and the clinic lost two providers because of the additional stress it caused them. However, with the Medical Director’s support, they finally succeeded in creating the integrated team-based care that they had dreamed of by leveraging the accessibility to the patient records by all members of the care team—simultaneously.
Now, the Medical Director approaches Moon and asks to explore a new telehealth program for patient visits as a way to leverage the technology within the practice. The Medical Director indicates that many of the large medical groups in the area have started using telehealth for these purposes. Moon has had no experience in implementing telehealth. In fact, there was a struggle transitioning to the EMR with other staff. Moon is concerned that implementing a new technology innovation project might cause the practice to lose further productivity, cause more turnover, and have a negative impact on patient experience. Specifically, Moon is concerned their patient population might not have the ability or desire to use telehealth services. The clinic staff are educated in cultural competence; however, this education has been more about race and ethnic health disparities as it pertains to chronic diseases—not technology gaps. Moon isn’t aware of what, if anything, exists for the use of telehealth in the patient population and is not sure of where to start.
TIP: When reviewing your case study summarize key areas to that should be addressed. Keep in mind the expectation of regulatory bodies to ensure compliance of appropriate care planning.
References:
American Medical Association. (2020). Telehealth implementation playbook. https://www.ama-assn.org/system/files/2020-04/ama-telehealth-playbook.pdfLinks to an external site.
Buchbinder, S., Shanks, N., Buchbinder, D. & Kite, B. (2023). Cases in Health Care Management. 2nd Ed.; Jones & Bartlett Learning.
Center for Substance Abuse Treatment. (2014). Improving cultural competence. Substance Abuse and Mental Health Services Administration. https://www.ncbi.nlm.nih.gov/books/NBK248428/Links to an external site.
Instructions
In this activity you will complete an analysis of the identified case study. Your analysis should include a discussion of the issues in the case which detail the contributory factors and the impact should the issue go unaddressed. In addition please address the following:
Identify the issue
Identify the relevant parties
Review policies and procedure and regulations that may impact your decision
Conduct additional research to support your decision making.
Provide a description on how you arrived at your recommended solution.
Discuss one to two ways to minimize future occurrences, including how you would measure the effectiveness of solution.
TIP: An analysis is supported by research of your identified problem using trade journals and peer reviewed articles.
Requirements:
(1) page paper plus (1) title page and reference page
Format your paper using APA style
Include (2) scholarly references used as in-text citations to support your writing (these should be under 5 years old)
(Assignment) Submission
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Rubric
On the Case
On the Case
Criteria Ratings Pts
This criterion is linked to a Learning Outcome
Analyze the issue of the case and relevant parties
Identify the issue
Identify the relevant parties
25 pts
Full Marks
0 pts
No Marks
25 pts
This criterion is linked to a Learning Outcome
Recommended Solution
Provide a description on how you arrived at your recommended solution.
25 pts
Full Marks
0 pts
No Marks
25 pts
This criterion is linked to a Learning Outcome
Minimize Future Occurrences
Discuss one to two ways to minimize future occurrences, including how you would measure the effectiveness of solution.
25 pts
Full Marks
0 pts
No Marks
25 pts
This criterion is linked to a Learning Outcome
Supporting Documentation
Review and identify policies, procedures and regulations that may impact your decision
Conduct additional research to support your decision making.
15 pts
Full Marks
0 pts
No Marks
15 pts
This criterion is linked to a Learning Outcome
Mechanics
Responses are written at the college level. Assignment is free of spelling and grammar errors. Follows APA guidelines set forth in the instructions.
10 pts
Full Marks
0 pts
No Marks
10 pts
Total Points: 100
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