Electronic Health Record Implementation Paper

 

Electronic Health Record Implementation Paper

 

 

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Healthcare systems and providers across the United States continue to implement health information technologies (HIT) to attain efficiency and improve the quality of care offered to patients. The use of these technologies like the electronic health records (EHRs) system requires effective implementation strategy that leverages expertise, includes and engages stakeholders like informatics nurses, and adheres to set regulatory guidelines. EHRs databases promote patient safety and interoperability as they facilitate retrospective analysis of errors (McGonigle & Mastrian, 2021). The process of implementing a new EHRs system is grueling one that involves different stakeholders and resources within the hospital system. The purpose of this paper is to discuss the different components and individuals with various roles required to implement an electronic health records (EHRs) system.

Important information required in Database to Track Opportunities for Care Improvement

Electronic health records impact the whole healthcare community and system based on the benefits that they provide like reducing the occurrence of medication errors and enhancing interoperability across healthcare networks and providers. EHRs are based on data and health information from patients coming to a facility for medical interventions (Heponiemi et al., 2021). The critical information required in this case include data gathered by primary caregivers that reveals the patient’s medical history, allergies and associated complexities to warrant relevant actions even without patient’s consent in emergency situations. The second critical data is the patient’s laboratory results where providers can log in to check the trends and associated health patterns based on the diagnoses.

Thirdly, the EHRs requires laboratory tests from the previous medical sessions to avoid repeating the same procedures, esp

ecially if they occurred recently based on the disease or condition under considerations. Fourthly, the EHRs database requires discharge information and follow-ups as well as prescriptive orders and medications given to the patient. Through this data, providers share information and make effective decisions on the type of care to offer based on the stages of one’s illness (DeNisco, 2019). These types of data are essential for effective development of a successful EHRs system that confers benefits to all stakeholders. The implication is that tracking care improvement for a patient requires providers to have all the data and information about the medical history, including instances of emergency care offered. Time lapses from medication order documentation in the EHR to the actual delivery to the patient should also be captured in the system to improve efficiency and quality of care offered.

Role of Informatics to Capture Data & Project Management Strategies to Support Initiatives

Health informatics, especially advanced health technologies, are a fundamental part of developing an effective EHR system to improve interoperability and efficiency in medication process and other aspects of care delivery (McGonigle & Mastrian, 2021). Informatics aids in capturing data by managing it, interpreting it and communicating the information through clinical decision support system and better sharing of the data. Informatics coordinates the information to ensure improved outcomes (DeNisco, 2019). Informatics also allows patients to participate by logging into the system and checking their medical data, trends and recommendations which empowers them in monitoring and tracking the medication journeys with a goal of improving them. Patients who have access their portals have increased chances of boosting their knowledge about diagnoses and prognoses and the overall impact of healthcare decisions on their lives. They also improve their adherence to right medical patterns and can check their symptoms and even manage adverse conditions, especially those suffering from chronic conditions. Again, they also interact with their providers in a more effective way.

Project management strategies and methodologies are a set of principles and practices that guide teams in implementing quality improvement initiatives like the electronic health records (EHRs) system in health care organizations. Project management strategies and methodologies help project managers to lead their teams and manage work while facilitating team collaboration. In this case, some of the strategies and methodologies would entail using agile approach. The agile methodology suits EHR implementation because it is appropriate for software project implementation. The agile approach seeks a collaborative approach to self-organized teams. The implementation of agile method requires adaptive planning and work management and early delivery of the intervention. The approach also allows project team and manager to make changes and necessary adjustments if they can lead to process improvement. The approach is also flexible compared to others like waterfall. Teamwork and effective communication and coordination are critical strategies to ensure quality improvement project implementation.

Systems and Staff Members Involved in the Design and Implementation

The design and implementation of an EHRs system in the organization requires different systems and staff members. The associated systems in this case would include patient portals, clinical decision support system (CDSS), electronic medical records (EMRs) and billing system. The system will also require connectivity to the pharmaceutical division and other areas like critical care units such as the intensive care unit’s data (Heponiemi et al., 2021). The system can also be linked to wearable devices and technology, especially with the aim of improving and expanding telehealth application for patients in remote locations.

The staff members will constitute a critical implementation team based on their expertise and units. The design and implementation will entail having medical staff who include representatives from nursing department, physician, laboratory technologists, pharmacists, therapists, and informatics nurses. The project will also integrate medical assistant lead, registration staff representative, patient lead, and workflow redesign lead. These members must offer input and suggestions on what should be included in the new system to enhance efficiency and workflow processes (Tsai et al., 2021). Together, these professionals will constitute a project team and the management outsource a project manager who shall identify the right vendor to implement the EHRs in the organizational system.

The advanced registered nurse will provide critical support in promoting evidence-based practice (EBP and leading quality and performance improvement initiative because advanced skills, knowledge and expertise. The nurse would offer input and train fellow nurses on the use of the new system. As a change agent, the nurse will root for improved interfaces for patients and colleagues from the system to enhance interoperability and decision making.

Strategies for Implementing the New EHR Proposal

The implementation of the new EHR system will require the organization and its management to develop certain strategies or approaches for successful outcomes. The first strategy is to have a project timeline or schedule developed by the project manager and team. Secondly, the project team and the manager should have a communication liaison who shall offer feedback periodically on the progress and milestones attained. Communicating changes during this process is essential and it entails using the right project change model (Tsai et al., 2021). For instance, the use of Lewin’s change theory and stages may lead to increased acceptability of the changes. The order sets for communication must focus on the targeted stakeholders and audiences to attain a buy-in from all affected individuals and stakeholders.

The new EHRs system should ensure that all data sets are a part of the new records by scrutinizing and backing up the information so that incase of any deletion or interference, it can be retrieved through protected means. The team should also develop a transition plan and communicate in advance to avoid resistance and possible fear of the new interventions by nurses. The project team should inform all stakeholders about the changes and the effects on the current processes, practices and procedures in the setting. The team must also manage resources in the most effective way to reduce wastage and pilferage (DeNisco, 2019). The team should seek experts in EHRs through the identification of efficient and highly competent system vendors. Human resource, fiscal management and development of teamwork are strategies that will help implement the new project.

Professional, Ethical, & Regulatory Standards in Design and Implementation of the System

In designing and implementing this new project, the team and the organization must comply with professional standards developed by the American Nurses Association and federal healthcare agencies. The team should also adhere to ethical values like honesty and confidentiality as well as comply with biomedical ethics like informed consent and beneficence, non-maleficence, justice and autonomy. For instance, ethical values dictate that such information should be kept confidential and protected from unauthorized access or use without the express authority of concerned patients. Professional standards like collaboration and following the medical processes as well as effective communication are essential in developing an acceptable system.

Regulatory standards like compliance to the Health Information Portability and Accountability Act (HIPAA) are essential when implementing this initiative to improve efficiency and quality care. Therefore, the team should comply with these legal mandates on protected health information (PHI) and other aspects of the care process. The project should develop requisite safeguards to protect all information and data that will be transferred to the new system to avoid any potential legal issues.

Measures to Evaluate the Success of the EHR implementation

Evaluating the success of the EHRs implementation is important to the overall usage of this new initiative based on the stakeholders that it will impact. These include the staff, the setting and the patient. From a staff’s perspective, the project would be successful if it has a friendly interface and captures all relevant data to aid making decisions and developing effective care plans. From the setting’s perspective, the EHRs project would be successful if it will streamline all processes and increase interoperability and accuracy in decision making (DeNisco, 2019). The project will be successful if it will offer benefits to reduce adverse events like medication errors. The level of satisfaction from all these stakeholders would be an indication of the successful implementation of the EHRs in the organization. Continuous improvement would entail assessing areas that have problems and developing relevant solutions to enhance overall success of the project. The team will also develop metrics that align with quality measures proposed by the Centers for Medicare and Medicaid Services (CMS) to improve clinical decision support interventions for providers under the value-based healthcare model.

Leadership Skills and Theories

The attainment of the expected benefits from the EHRs implementation will require leaders to demonstrate effective skills and apply ethical certain theories on project success. These skills will entail embracing effective leadership styles that include transformational and servant leadership. These two approaches will ensure that the leaders in the organization motivate and inspire changes while seeking to improve overall care delivery for patients.

The team should also embrace the diffusion of innovation theory by focusing on the relative advantage of the new system, reliability of the database, triability, usability and outcomes to be attained from the project. This theory would be effective in helping people adopt the new system (Balas & Chapman, 2018). Again, the application of change models like Lewin’s change approach or lean system approach will be vital in the attainment of the goals for the project team and the organization.

Conclusion

The electronic health records (EHRs) are the future of healthcare and have proved effective in helping organizations manage big data while improving interoperability. The implementation of the EHRs in the organization will lead to significant changes and benefits in different aspects for all stakeholders affected the new system. The system will also improve care delivery and allow providers to integrate different components of patient preferences leading to patient-centered care improvement.

 

 

 

 

 

 

 

 

 

 

 

References

Balas, E. A., & Chapman, W. W. (2018). Road map for diffusion of innovation in health care.

Health Affairs, 37(2), 198-204. DOI: 10.1377/hlthaff.2017.1155

DeNisco, S. M. (2019). Advanced Practice Nursing: Essential Knowledge for the Profession:

            Essential Knowledge for the Profession. Jones & Bartlett Learning.

Heponiemi, T., Gluschkoff, K., Vehko, T., Kaihlanen, A. M., Saranto, K., Nissinen, S., … &

Kujala, S. (2021). Electronic Health Record Implementations and Insufficient Training Endanger Nurses’ Well-being: Cross-sectional Survey Study. Journal of medical Internet research, 23(12), e27096. DOI: 10.2196/27096

McGonigle, D., & Mastrian, K. (2021). Nursing informatics and the foundation of knowledge.

Jones & Bartlett Publishers.

Tsai, C. H., Eghdam, A., Davoody, N., Wright, G., Flowerday, S., & Koch, S. (2020). Effects of

electronic health record implementation and barriers to adoption and use: a scoping review and qualitative analysis of the content. Life, 10(12), 327. https://doi.org/10.3390/life10120327

Weberg, D., Mangold, K., Porter-O’Grady, T., & Malloch, K. (2019). Leadership in

Nursing Practice Changing the Landscape of Health Care. Burlington, MA: Jones & Bartlett Learning. ISBN 97812841465

 

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