Exercises in Measurement and validity For this assignment, you will be working through questions regarding measurement and validity.. Your answers should be written in complete sentences. Some of the answers may require you to show your work. 1. You have just started a new diet program. To mark your progress, you start weighing yourself three times a day. You also notice that each time you weigh yourself in a given day, the number of pounds is different. Based on the rules regarding the scales of measurement, why is it wrong to weigh yourself more than once a day? 2. Your hospital administration has received several phone complaints from patients about rude behavior from registration staff and long wait times to register in both the Dermatology and Audiology Outpatient Clinics. A decision is made to send a patient satisfaction survey to all Outpatient Clinic patients to determine overall patient satisfaction in the hospital’s Clinic setting. The survey developed uses this type of scoring: 1 = strongly disagree and 5 = strongly agree. What type of scale of measurement is this? 3. Your hospital wants to study patients readmitted within 30-days. What measures (e.g. Medicare patients only) would you recommend be included in the study (identify at least 3)? Where would you locate the data elements (e.g. admission records)? 4. Your hospital’s Pharmacy and Therapeutics Committee undertook a quality review of Medication forms from discharges in the first quarter of the year and identified the errors by 5 general categories and then calculated the percentage of the total errors by category. The results were: Dosage Form 6%, Name confusion 13%, Communication 19%, Labeling 20%, and Human Factors 42%. As the HIM Director you are a member of the P&T Committee, the Chair asks you to prepare a graphic display of the error results for Medical Staff review. What is the best choice of a graphic display to present this data to the Medical Staff? And why a. Line Graph b. Bar Graph c. Pie chart d. Data Table 5. Provide a definition and example for the following terms: a. Content validity b. Construct validity c. Criterion validity Running head: BUSINESS AND USER REQUIREMENTS DOCUMENT DRAFT 1 BUSINESS AND USER REQUIREMENTS DOCUMENT DRAFT 6 Business and User Requirements Document Draft thanks for your Draft report on the EHR project and requirements.  There are 3 main parts to cover: Sources of information, departments affected: Provide more information about the clinical departments. HIM is not the "most important" department for this system.  Clean up some of the writing possible errors or misunderstandings, too. 5 /7 Methods to gather information: Glad you mentioned interviews, focus groups, and questionnaires and explained all three. 7  /7 Requirements statements:3 /6   You are not quite understanding what Requirements are yet.  They are what the system must do. We will get later on in the class, onto project implementation tasks such ...

1. Exercises in Measurement and validity
For this assignment, you will be working through questions
regarding measurement and validity.. Your answers should be
written in complete sentences. Some of the answers may require
you to show your work.
1. You have just started a new diet program. To mark your
progress, you start weighing yourself three times a day. You
also notice that each time you weigh yourself in a given day, the
number of pounds is different. Based on the rules regarding the
scales of measurement, why is it wrong to weigh yourself more
than once a day?
2. Your hospital administration has received several phone
complaints from patients about rude behavior from registration
staff and long wait times to register in both the Dermatology
and Audiology Outpatient Clinics. A decision is made to send a
patient satisfaction survey to all Outpatient Clinic patients to
determine overall patient satisfaction in the hospital’s Clinic
setting. The survey developed uses this type of scoring: 1 =
strongly disagree and 5 = strongly agree. What type of scale of
measurement is this?
3. Your hospital wants to study patients readmitted within 30-
days. What measures (e.g. Medicare patients only) would you
recommend be included in the study (identify at least 3)? Where
would you locate the data elements (e.g. admission records)?
4. Your hospital’s Pharmacy and Therapeutics Committee
undertook a quality review of Medication forms from discharges
in the first quarter of the year and identified the errors by 5
general categories and then calculated the percentage of the
total errors by category. The results were: Dosage Form 6%,

2. Name confusion 13%, Communication 19%, Labeling 20%, and
Human Factors 42%. As the HIM Director you are a member of
the P&T Committee, the Chair asks you to prepare a graphic
display of the error results for Medical Staff review. What is the
best choice of a graphic display to present this data to the
Medical Staff? And why
a. Line Graph
b. Bar Graph
c. Pie chart
d. Data Table
5. Provide a definition and example for the following terms:
a. Content validity
b. Construct validity
c. Criterion validity
Running head: BUSINESS AND USER REQUIREMENTS
DOCUMENT DRAFT 1
BUSINESS AND USER REQUIREMENTS DOCUMENT
DRAFT 6
Business and User Requirements Document Draft
thanks for your Draft report on the EHR project and
requirements. There are 3 main parts to cover: Sources of
information, departments affected: Provide more information
about the clinical departments. HIM is not the "most important"
department for this system. Clean up some of the writing

3. possible errors or misunderstandings, too. 5 /7 Methods to
gather information: Glad you mentioned interviews, focus
groups, and questionnaires and explained all three. 7 /7
Requirements statements:3 /6 You are not quite understanding
what Requirements are yet. They are what the system must do.
We will get later on in the class, onto project implementation
tasks such as training and transitions. For this paper, focus on
what the system itself needs to have as its functions; what must
the EHR do? See attached comments on draft:
Business and User Requirements Document Draft
Gathering business and user requirements
To implement the EHRS system, some departments will be more
involved than others. As such, they will be the most important
sources of information for the planning stages. The first among
these is the information and communications technology.
Comment by Judy Johnson: That is not a department name.
Not sure what you were trying to say here about it. That is the
title for the class, instead.
The nursing department will also be crucial in collecting the
information needed to determine business and user
requirements. For nurses to be more efficient at doing their
jobs, they need to have the backing of reliable and readily
available information at their disposal. Since nursing care is
such a core element in the providing of quality care, their needs
and requirements will be useful to consider. In this department
too is the medical staff, led by the Chief Medical Officer. The
EHRS will be extensively used by the physicians to provide
accurate information and to enter details of diagnosis, apart
from other relevant information. As a result, their views should
be considered as the hospital boards on the implementation of
this system (Terry et al, 2008). Comment by Judy Johnson:
Medical staff is not part of “nursing department.” Your sentence

4. here seems to be saying it is part of nursing when you say, “in
this department too…” Comment by Judy Johnson: Yes, this
is correct.
The Health Information Management department is the most
important of these departments in the implementation of the
process. The department possesses unique expertise in the
management of health information and is well aware of the
regulations that such information should be managed with. As
the custodians and managers of the information, the HIM
department will be able to understand the particular needs of
each of the other departments. The department is also heavily
involved in billing as well, which the EHRS will view as one of
the major operations in need of streamlining (Zeng, 2016).
Comment by Judy Johnson: That is not actually the “most
important” department. The clinical staff (physicians, nurses)
have more hands-on with the EHR than other departments.
While the senior management of every function will be
extensively involved in the project overview and
implementation process, their subordinates also have an
important role to play in ensuring that the project is a success.
Within the operations department, for instance, the personnel in
the laboratory, radiology, and pharmacy will be using the
system, in collaboration with medical personnel such as the
doctors and nurses. Their input will, therefore, be highly
valued. Also important will be the business development
officers, who will have information on what competitors are
doing or using, and thereby provide information that will be
used to make the same enhanced (Zeng, 2016).
List of business and user requirements for the project
Comment by Judy Johnson: Title does not seem to fit with
what is below. Your information gathering process is what is
just below this heading.
The data collection process will be designed in a way which
ensures that the information collected is reliable accurate and
complete. As such, a combination of several data – collection

5. techniques will be used, depending on the particular
characteristics of the department. Interviews will be used to
collect information from the senior management, since they are
few, and time limitations do not allow for interviews with all
potential suppliers of information. While interviews will be
useful in giving the necessary information in a better way than
questionnaires and other methods, they are costly to conduct,
and will only be used carefully (Zeng, 2016). Comment by Judy
Johnson: Yes, interviews can be time-consuming or costly.
Making a poor decision on an EHR can be even more costly,
though.
To better collect information from the end users of the system –
the HIM department, physicians, and nurses, conveniently -
timed focus groups will be deployed. The groups will be helpful
in helping the potential users come up with further information
that would not be captured in a survey, or an interview, due to
the lack of interaction with other users.
Additionally, the use of focus groups will be amplified by
the use of questionnaires, which will ensure that no information
has been lost on the information collectors. After conducting
the face to face interviews and focus group discussions, a
meeting in which everyone is encouraged to attend will be held.
During the meeting, additional views will be invited, as the
findings are presented and members present air their opinions if
contrary to what is proposed (Terry et al, 2008). Comment by
Judy Johnson: How will you use these questionnaires? Who will
be sent the questionnaires, what will be the topics?
Requirements to be met for project to address project overview
needs
The cost of the system should be transparent and affordable. For
instance, the cost of maintenance should be clearly spelled out,
as well as other add-ons such as license agreements. The cost
should be within the budget of the institution, to ensure smooth
implementation.
The system should be able to leave a clear audit trail. Due to the

6. sensitivity of health information, it is important to have a
system that clearly shows who accessed the system, at what
time, and what they viewed.
It should be easy to change from whatever old system is being
used to the new one. For this to happen, the system will need to
have a user – friendly design that all members of the hospital,
regardless of their computer proficiency, can easily use. The
system should also be well documented so that any bugs can be
easily detected and eliminated. Comment by Judy Johnson:
You are talking about the transition needs. Before thinking of
that though, we need to specify what this system must DO.
What are its functions? That is how we specify systems
Requirements.
The system should be well secured. This is appreciative of the
sensitivity of health information, and the need to ensure it from
cyber breaches and attacks which might compromise the
integrity of the information.
Due to the widespread use of such systems, whereby they are
currently government policy in all American hospitals, it is
important for the system to be easily integrated with other
systems, and other IT solutions currently used by the hospital.
Server options should be specified. If possible, the server
should be hosted on the hospital’s premises. This will ensure
that the hospital has total authority over the system and that as a
result, there is no possibility for jeopardizing the data that is
stored within the system.
Since most of the users are not experts, the system should come
with ample training opportunities for potential users. The
training should be tailored to cover the relevant areas for each
department and individual personnel.
The system should be well – versed in modern technology. For
instance, the system should be enabled with instant sharing
services such as text message. This should, however, be ensured
to be secure and avoid unnecessarily compromising patient
information.

7. References
Terry, A. L., Thorpe, C. F., Giles, G., Brown, J. B., Harris, S.
B., Reid, G. J., Stewart, M. (2008). Implementing electronic
health records: Key factors in primary care. Canadian Family
Physician, 54(5), 730–736.
Zeng, X. (2016). The Impacts of Electronic Health Record
Implementation on the Health Care Workforce. North Carolina
Medical Journal, 77 (2), 112-114.
The Good Apples Group EHRS Project
Summary
You are an employee of the Good Apples Group, a healthcare
organization which runs MacIntosh Manor Hospital. The CEO
of the hospital has made a priority for the hospital to enter the
21st century by converting its operations to an Electronic
Health Records System. You have been assigned the role of
project manager for this effort, and are therefore responsibility
for ensuring that the needs of the hospital have been carefully
assessed and that the planning process for bringing an EHRS
online is effective.
The Organization
At first glance, MacIntosh Manor Hospital looks like any small
town hospital, where the quality of care is certainly modern but
the staff and patients still come to know each other and expect a
down-to-earth pace. The Good Apples Group, a parent
corporation maintaining several local clinics in addition to

8. MacIntosh Manor, has worked hard over the years to maintain
that balance of customer service and cutting edge patient care.
MacIntosh Manor Hospital is a 500-bed, critical access
hospital in Shiminy, Pennsylvania. It is the largest hospital
within 100 miles, and schedules between 22,000 to 26,000 visits
a year. MMH provides surgical, medical and acute care, 24-
hour emergency room services, outpatient services, health
education, behavioral services, and home and hospice care to a
primarily suburban region of about 124,000 residents. It
employs 2200 people, including 275 physicians, and as a
hospital is managed by its own CEO.
MMH’s mission is to provide for the residents of Shiminy high
quality services that enhance the quality of life and promote
healthy lifestyles for patients, clients, employees, organization
and communities. In its community MMH seeks to lead by
example through compassionate, caring and comprehensive
health care services.
The direction of MacIntosh Manor’s strategic vision change
greatly in 2010 when Dr. Phillip Kapp was named CEO of the
Good Apples Group and made it clear that his own successes
with implementing EHRS and related technologies in healthcare
facilities in the Philadelphia area would be the kind of
challenge he wished to take on again with MacIntosh Manor
Hospital. Kapp formed a strategic planning committee to assess
the use of technology and what MMH should implement, and to
determine and monitor a migration path.
Around the same time that Dr. Kapp took charge of the Good
Apples Group, a federal mandate was issued that hospitals
nationwide need to be using electronic medical records by 2015,
giving Kapp and the strategic planning committee even more
incentive to act quickly. The committee recommended
beginning the transition to EHRS immediately and

9. implementing both financial and clinical solutions.
“Creating a ubiquitous and common platform for timely access
to clinical information is crucial for patient care and patient
safety. By giving physicians and nursing staff access to the
information they need at the point of care, we will eliminate
unnecessary tests, and reduce patients’ exposure to medical
errors and drug allergies.”
Thomas Lytle
Chief Information Officer at MacIntosh Manor Hospital
Key Business Processes
Clinical Decision Support
A key business process to be addressed by the EHRS should be
clinical decision support. When staff enter orders electronically,
doctors should gain quick access to their patients’ medication
history and be provided real-time potential adverse drug event
alerts such as drug-drug and drug allergy. “Currently if a doctor
adds a medication on paper they won’t necessarily see what
other medications their patients are on unless they carefully go
back and flip through the paper-based patient record,” noted
Sam Guder, Head of Nursing.
Nursing documentation
Nursing admission assessments for inpatient and outpatient care
are now a chaotic mess, as each member of the nursing staff has
a different level of experience and often prepare records based
on best practices at a facility where they had previously worked.
Clinicians should be able to view historical patient information,
ensuring appropriate and continuous care. Nursing shift
assessment should be able to be pulled forward for review or
editing prior to being accepted as part of the patient record.

10. "I can envision using a wireless LAN with laptop computers at
each nursing unit to provide access to EHRS at the point of
care, reducing the potential for transcription errors, saving
everyone’s time, and eliminating lag time between gathering
information and entry into the system. Ideally we would want to
decrease nursing time for regular and overtime staff from 1.5
hour to 1.0 hour per day per nurse. Admission assessment
should be reduced by two minutes per patient and shift
assessment by seven minutes," says a member of the nursing
staff interviewed for this project.
Specific Need: Prevention of bedsores, falls and hospital-based
infections
Good Apples Group has recently been asked to comply with new
patient safety and pay-for-performance standards. Medicare will
stop reimbursing hospitals for treating eight “reasonably
preventable” conditions patients acquire at hospitals. These
conditions include pressure ulcers, better known as bedsores,
patient falls and urinary tract infections. We need software that
has built-in bedsore and patient fall risk assessments into the
electronic nursing assessment, so that if certain elements are
documented during the assessment, the EHRS will trigger
electronic alerts to clinicians."
Additional Business Processes
Dr. Kapp has indicated that his experience demonstrates the
value of a phased rollout of EHRS software. At one clinic where
he had attempted a wholesale overhaul of the clinic’s business
practices with an EHRS he saw an immediate decrease in the
quality of care, combined with a great deal of swearing from the
staff and anger among the facility’s managers. In order to
phase in the EHRS carefully, Dr. Kapp has suggested that the
following units within the organization be addressed first:
Targeted Organizational Units

11. · Pharmacy
· Radiology Unit
· Respiratory Therapy
· Food and Nutrition Services
· Mom-Baby and Labor & Delivery
MacIntosh Manor Hospital Organizational Chart
“Many of our physicians are reluctant to adopt EHRS
technology if it does not mirror their current workflow,” Dr.
Phil Kapp, CEO of the Good Apples Group says. “An intuitive,
easy-to-use system is the key to making something work here.”
MacIntosh Manor Hospital at a glance
Beds– inpatient: 500
Number of physicians: 275
Number of nurses: 7000
Annual inpatient visits: 24,480
Annual Emergency Room visits per year: 93,702

12. Desired Results
• Real-time access to patient data
• Improve quality and continuity of care
• Enhance patient safety
• Enterprise-wide connectivity
• Improve physician recruitment
Project Overview
Throughout the course you will build a plan for delivering an
EHRS system to a healthcare facility. This plan will cover
several of the phases of the project lifecycle, from establishing
business requirements to planning what will be required to
support and maintain the system once it is up and running.
In order to complete this project, please read the attached
document Good Apples Group Case. This document describes
the Good Apples Group facility, the way they do business, and
the need they have for an EHRS. Each component of the project
is based on the needs of the Good Apples Group. You will be

13. building a plan for delivering an EHRS system to Good Apples
Group.
Read the document attached below as Good apples group case
Business and User Requirements
Review the course project description above Introduction page
in order to understand the overall needs of the organization and
the specific business processes which the project should
address. In response to these needs, prepare a draft requirements
document which describes the following:
· The sources of information within the organization which
would be used to gather business and user requirements. Show
your understanding of the departments that are in a typical
hospital; be specific and include a variety. Explain what
departments could be affected most by an EHR system
implementation. Include not only Senior management levels, but
also staff level of the organization, as part of your information
gathering plans.
· The methods that you would use to prepare a comprehensive
list of business and user requirements for the project. Explain
which methods you would use to gather information from each
department you have decided on. Conduct your own background
research on the web or in our library, on effectively using
information gathering techniques including structured
interviews, focus groups, and surveys, in order to effectively
address this section.
· 8-12 requirements that should be met in order for this project
to satisfactorily address the needs expressed in the project
overview. Requirements should be specific to an EHR system
development. Remember that a requirement is not the same as a
general "goal."

14. Note that these requirements must focus on the needs of the
facility and of the people who will be using the project as an
alternative means of performing business processes they already
perform.
Your paper should be approximately 4 pages in length. APA
format