Discussion: NURS 6051 Successful Implementation of Electronic Health Information Technology

Discussion: NURS 6051 Successful Implementation of Electronic Health Information Technology

Discussion 6051 Successful Implementation of Electronic Health Information Technology

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Since the inception of the HITECH Act, health organizations
have faced increased pressure to update their health information technology
(HIT) resources. As discussed last week, many believe that the increased use of
electronic health records and the quick and efficient communication afforded by
HIT can lead to improved quality of patient care. Yet there are significant
costs associated with implementing such systems. What can organizations do to
ensure that the correct system is selected and that the system will be
appropriate for those required to use it? Who should be involved in those

This week introduces the systems development life cycle and
discusses how it can guide an organization through the complexities of adopting
a new HIT system. In this Discussion, you are asked to consider the role of
nurses in the SDLC process.

To prepare:

Review the steps of the systems development life cycle.

Think about your own organization, or one with which you are
familiar, and the steps the organization goes through when purchasing and
implementing a new HIT system.

Consider what a nurse could contribute to decisions made at
each stage when planning for new health information technology. What might be
the consequences of not involving nurses?

Reflect on your own experiences with your organizationDiscussion 6051 Successful Implementation of Electronic Health Information Technology
selecting and implementing new technology. As an end user, do you feel you had
any input in the selection or and planning of the new HIT system?

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By Day 3

Post an analysis of
the ramifications of an organization not involving nurses in each stage of the
systems development life cycle when purchasing and implementing a new HIT
system. Give specific examples of potential issues at each stage and how the
inclusion of nurses could help avoid such issues.

By Day 6

Respond to at least two of your colleagues on two different
days using one or more of the following approaches:

Ask a probing question, substantiated with additional
background information, evidence or research.

Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional

Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.

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Electronic Health Record Implementation 

The utilization of electronic health records (EHRs) is increasingly gaining prominence in the current health care systems around the world. The utilization of EHRs has enormously shaped how health care is provided in various ways. For instance, health care organizations can use the EHRs meaningfully to get the data, organize, scrutinize, and present that data to the clinicians to help them make an informed patient care decision.  Besides, the adoption of EHRs has also led to massive reductions in health care costs. This cost reduction is due to advancement in the effectiveness of the decision making process and healthcare delivery. Moreover, EHRs adoption has improved the delivery of safe, high quality health care that creates positive patient experience and outcomes of the diverse patient populations (King, Patel, Jamoom & Furukawa, 2014). Therefore, it is against the backdrop of the EHRs that this paper seeks to explore the roles of registered nurse in variety of situations associated with the utilization of EHRs.  

Database to Track Opportunities for Care Improvement Information 

Essentially, apart from the expected function of the health information system which is to enable advanced efficiencies, it should also enable tracking of opportunities in healthcare (Sharfstein, 2015). Consequently, there is need for varied kinds of information to facilitate trailing of health care opportunities. Among the information needed include patient satisfaction. The HER systems ought to ease access to the data on the degree of patient satisfaction with the health care provided. On their side, the patients are also expected to give their opinions regarding the areas of improvement to enable the organization to determine areas to improve on for better services. The patient satisfaction information is crucial because it enables the organization to learn more on how it can improve services to facilitate better services that can realize diverse patient needs.  

On the other hand, the information on the patient appointment process is also required on the database. This information should always be made accessible to the target population. The kinds of information that may be contained in the details of the appointment process include the period it takes to get the actual appointment after requesting for an appointment. Besides, the database on patient appointment process should contain information that indicates the efficiency of reminders of the appointment dates including reminders in situations where a patient misses the appointment or when the appointment is canceled. Essentially, such information is vital to assess how the organization responds to its consumers. That is, the organization can implement such information to enhance excellent services for its clients from booking for appointment, the appointments, reminders, and illustrating the rationale for cancelling or missing appointments.  

Moreover, the other kind of information required in the database for tracking health care opportunities is the information about quality of treatment that is provided to patients. Ordinarily, the kind of care provided to patients should be effective, quality, and safe. Such kind of care should enhance patient outcomes by ensuring safety, quick response to medication, cost-friendly, and reduces negative impacts. As such, it is imperative for the database to include information regarding prescription, result tracking, and referral tracking to enhance quality of treatment.  

Role of Informatics in Capturing the Above Data 

Fundamentally, health informatics is vital in capturing the above data by enabling platforms where healthcare providers and patients can exchange crucial health care information to help in advancing the outcomes of healthcare. The health information can also be shared with other interdisciplinary departments, thus, it enables collaboration in delivery of health care services. Through health informatics, it is possible to have shared decision making with patients since patients are also required to be involved in their health care decisions. Moreover, health informatics is crucial in capturing the above data by helping in assessing health care opportunities. On the other side, health informatics also avails opportunities to reduce errors while using gathered data. Operationally, databases are equipped with standard information that are established to guide the construal of every category of data and its repercussion in health healthcare, thus, enhancing the meaningful use of the data collected.  

Systems and Staff Needed in the Design and Implementation Process and Team 

The selection of system primarily depends on the organizational specific needs. Nonetheless, it is recommended that the system selection should mostly be influenced by need to enhance flexibility and facilitate ease in utilization by clinicians. The system should foster ease of interaction between the patient and the health care provider sans impeding the nature of communication between the patient and the health care provider. Essentially, EHR characterizes one such system. As such, the system identified should be both insightful and easy to learn by the users. Making the system simple to use and easy to learn is vital in ensuring the system effectiveness in providing the required functions.  

According to Bullard (2016), the implementation of the health informatics system definitely requires significant input of the health care staff to succeed. Therefore, the necessary staff that would be required to design and implement this system consists of nurses, administrative staff, IT experts, physicians, medical assistants, and system user’s leader. The inputs of these staff are vital in the design process because they inform the features of the system that should be incorporated. Besides, the staff are also required at the implementation stage to help in establishing the system’s usability and ease of use. Further, the personnel are required to collaborate during the entire process from the design to evaluation of the system to realize the success of the project.  

Professional, Ethical, and Regulatory Standards that must be incorporated into Design and Implementation of the System 

It is necessary to consider aspects of ethical, professional, and regulatory standards while designing and implementing EHRs (Ben-Assuli, 2015). Regarding the professionalism aspects, the American Nurses Association insists that the information technologies used in health care should ensure both safety and positive outcomes in patients. Besides, the data accuracy and proficiency should also be considered by ensuring that the data is collected, stored, scrutinized, and reported appropriately. Similarly, the ethical aspects in the EHRs data should also be considered. The ethical principles encompass several areas such as patient privacy, confidentiality, and security of health data. The other core responsibility of health care providers includes designing, execution, and assessment of system utilization in the health care settings.  

On the other hand, it is important to integrate the regulatory standards in the EHRs design and implementation. For instance, the system’s implementation team should consider the security standards of the Health Information Technology for Economic and Clinical Health Act (HITECH) and HIPAA (Kiel, Ciamacco & Steines, 2016). HIPAA provides that health care organizations have the obligation to safeguard patients’ health data. Besides, the privacy, security, and confidentiality requirements should be taken into account to foster effective and efficient use of electronic health data. On the other hand, the HITECH Act details stern measures that applies to the requirements under the HIPAA standards. Essentially, the Act adds the legal responsibility for failing to comply with HIPAA standards in relation to the use and security of electronic health data.  

How EHR Team Will Ensure that All Order Sets Are Part of the New Record 

To ensure that all order sets are part of the new record, it is recommended that team tasked with implementing the EHRs should apply the four-step process. The four steps include designing a governance system for the structure of the order set. This step is characterized by creating a governance body that ensures effective communication and decision making for the coordination, customization, and integration of the project. The governance body may include any member of the staff and they are tasked with different responsibilities such as oversight provision, maintaining effective communication with other stakeholders, and determining the use of metrics. The second step is planning and trailing the order set’s maintenance and workflow. This stage is characterized with development of the prospects, objectives, and deadlines of the order sets. Besides, the obtainable order sets are perfected and integrated into the new systems.  

The third stage encompasses establishing and effectively utilizing the style guides that ensure reliability. The style guide basically entails the formulation of an approach capable of enhancing the reliability of various aspects such as design, order set sequencing, naming, size threshold, and types of evidence. Essentially, reliability here is crucial because it fosters search, use, retrieval of data, and standardization. Finally, the fourth step is advocating for practices that make order set more efficient for application in the clinical environment. This stage is mostly focused on staff engagement whereby the employees involved in the utilization of order sets are asked to appraise the system. They may employ the use of different approaches such as meetings to create awareness in the organization. Involving health care professionals is vital because it ensures that the system is effectively adopted in the organization.  

How to Communicate Changes in the Plan 

The organization can communicate the design and adoption of the EHRs using the official communication mechanisms. These mechanisms may include one-on-one dialogue, posters, emails, and organizing meetings with staff to brief about the progress, requirements, and any changes. These official communication approaches are vital in ensuring that clinicians are made aware of EHRs system requirements, thus, helping in reducing the possibility of resistance by the staff to accept EHRs changes (Sinsky, Beasley, Simmons & Baron, 2014). To ensure success, the communication should be updated and provided in good time to enable the staff to be well versed with it. The management should also ensure that the organization environment is conducive for open and free communication. The employees should be free to provide their perspectives on the design and execution of the proposed EHRs system.  

Measures and Steps to Evaluate the Success of EHR Implementation from Staff Setting and Patient’s Perspective 

Fundamentally, numerous measures can be used to determine the success of implementation of the EHRs (Yen et al., 2017). The common measures may include incidences of medical errors, the process of adoption, changes in the organizational culture, efficiency in the infrastructure and network, and the level of patient contentment with the system. On the other hand, the steps that can be used in the EHRs evaluation process include adequate preparation, determining the return on investment, examining the data quality and input, monitoring the efficiency of the system, and evaluating the quality of care the EHRs adoption. The profitability of the EHRs system to the patients and the organization can be determined by performing a cost-benefit analysis. Consequently, the efficiency of the EHRs can be assessed by relying on the patient data entirely. Similarly, the quality of healthcare can be gauged through surveys on patient satisfaction. On the other hand, the level of health care providers’ satisfaction and adoption process of the EHRs can be equally determined by the survey. Finally, the scope of error should be established to help in examining the quality of data input. In a nutshell, by looking into these techniques, it is likely to appraise the EHRs implementation.  

Leadership Skills and Theories 

Undeniably, the EHRs implementation process is intricate and marred with enormous challenges. As such, effective leadership skills are necessary for the success of the implementation process (Aldosari, 2017). On that note, the leadership skills needed in this case include excellent communication skills, effective critical thinking and problem-solving techniques, outstanding technical abilities, and project management. Some aspects of skills such as open communication is crucial because ensures that stakeholders are kept informed on the progress throughout the implementation process. Creating an environment of open communication also ensures that stakeholders voice their concerns and possibly suggest ways in which the outcomes can be improved. During this process, critical thinking and problem-solving skills are necessary to effectively manage the diverse team. Notably, successful EHR design and implementation require staff with diverse expertise, experience, and viewpoints. However, this diversity increases the possibility of contradictions, thus, the need for a people with outstanding experience in problem solving. The team members also need project management skills because the EHR design and implementation often require the establishment and appraisal of different deliverables. The technical skills on the other hand are vital to ease the understanding of the technical terms related to the information technology used in EHR implementation.  

Regarding the necessary leadership theories, the transformative leadership and anticipatory leadership theories are appropriate for EHRs implementation and design process. The transformative leadership style is majorly concerned with ensuring that people collaborate to achieve a goal in question. In this content, the leaders have the obligation to lead the employees by motivating, stimulating, and moving them to discover the essence of innovation in performing their roles and responsibilities. On the other hand, the participatory leadership style is appropriate in this context because it is characterized by inspiring stakeholders to play their role in the EHRs implementation project to realize success. The style requires that the leader should empower the implementation team to achieve the desired goals.  


In conclusion, it has been established that EHRs are vital in enhancing quality of care and also recognizing different opportunities in the health care system. Through the EHRs system, it is possible to identify developments that can be used meaningfully to increase the benefits for the organization. Besides, input of teamwork is vital for design and implementation of the EHRs. That is, there is need to integrate views from different stakeholders including nurses, IT experts, and doctors. Most importantly, it is imperative to incorporate effective leadership skills and theories to help in the design and implementation of EHRs.  



Aldosari, B. (2017). Causes of EHR projects stalling or failing: A study of EHR projects in Saudi Arabia. Computers in biology and medicine, 91, 372-381. 

Ben-Assuli, O. (2015). Electronic health records, adoption, quality of care, legal and privacy issues and their implementation in emergency departments. Health policy, 119(3), 287-297. 

Bullard, K. L. (2016). Cost-effective staffing for an EHR implementation. Nursing Economics, 34(2), 72. 

Kiel, J. M., Ciamacco, F. A., & Steines, B. T. (2016). Privacy and data security: HIPAA and HITECH. In Healthcare information management systems (pp. 437-449). Springer, Cham. 

King, J., Patel, V., Jamoom, E. W., & Furukawa, M. F. (2014). Clinical benefits of electronic health record use: national findings. Health services research, 49(1pt2), 392-404. 

Sharfstein, J. M. (2015). Using health care data to track and improve public health. Jama, 313(20), 2012-2013. 

Sinsky, C. A., Beasley, J. W., Simmons, G. E., & Baron, R. J. (2014). Electronic health records: design, implementation, and policy for higher-value primary care. Annals of internal medicine, 160(10), 727-728. 

Yen, P. Y., McAlearney, A. S., Sieck, C. J., Hefner, J. L., & Huerta, T. R. (2017). Health information technology (HIT) adaptation: refocusing on the journey to successful HIT implementation. JMIR medical informatics, 5(3), e28.