NUR 514 Week 8 Assignment Benchmark – Electronic Health Record Implementation Paper

The current health practice has evolved in multiple dimensions, including better clinical systems, increased access, and more emphasis on patient-centered care. As these developments occur, technology has been instrumental in evolving critical patient care dimensions. As a result, nursing informaticists and other healthcare practitioners should embrace innovation and guide their organizations in tracking care improvement opportunities and intervening appropriately. For innovation to succeed, healthcare facilities should have the appropriate culture and resources to support and facilitate change (Sharplin et al., 2019). Advanced practice nurses should also play their role as change leaders effectively. The purpose of this paper is to discuss an opportunity for care improvement and the necessary considerations for implementing a new electronic health record (EHR) system.

An Opportunity for Tracking Care Improvement and Database Information

When visiting healthcare facilities, patients always look forward to a comprehensive analysis of their conditions. However, such care can only be achieved if the facilities have efficient and up-to-date EHR systems and other tools for clinical decision support. Effective EHR systems improve care efficiency and reduce inconveniences occasioned by medical errors (Kehsta & Odeh, 2021). A suitable opportunity for tracking care improvement is a system’s task completion rate. In everyday practice, systems’ inefficiencies hamper care outcomes by causing treatment delays or failing to facilitate quick information sharing between providers. An upgrade of the system’s operating system can produce better results in such instances. The other option is implementing a new EHR system to capture patient data easily, enable quick analysis, and ensure that practitioners can share crucial data in real time.

A database contains essential health information to guide practitioners in decision-making. In clinical settings, a database should allow clinicians to store information in a way that can be accessed and managed easily. Appropriate data updates should also be done conveniently. Key information in the database should be primarily about patients. Such information includes patients’ demographics, problems, and current medications (CMS.gov, 2023). The other crucial information relevant to clinicians and patients includes progress notes and time spent during the care process. Further analysis of the time spent during the care process can indicate whether the new EHR system requires improvements.

Role of Informatics in Data Capturing and Project Management Strategies

Informatics is at the center of healthcare evolution and plays an instrumental role in promoting data-driven care. According to Estiri et al. (2018), informatics allows clinicians to capture information rapidly to facilitate quick decision-making. Through informatics, patient information can also be captured in multiple formats, although organizations must have highly interoperable systems to use such data effectively. The implication is that the clinical setting embracing informatics would benefit from quick information capturing, further improving collation, analysis, storage, and retrieval.

Implementing system changes typifies engaging in a project designed to improve patient outcomes. Essential project management strategies and methodologies include teamwork, planning, design, and implementation. Teamwork is crucial in improving quality in clinical practice since it allows people to share perspectives and address a common issue creatively. Regarding system changes, Aguirre et al. (2019) underlined that EHR implementation could be challenging hence the need for effective planning to minimize errors. The planning phase is broad since it entails assessing the selection criteria of teams and intended system performance, including interoperability and confidentiality. Concerning design, maximum consideration of the infrastructure is crucial to ensure clinicians are provided with a robust system and tools to transform practice (Estiri et al., 2018). Implementation denotes putting the system into use. In the current context, it should be implemented after successful piloting and when users can use it comfortably and effectively.

Systems, Staff Members, and the Role of the Advanced Registered Nurse

System implementation should be a collaborative task. Such an approach is crucial since diverse leaders and healthcare teams have different skills and competencies, which are essential in informed decision-making. In clinical practice, shared perspectives improve decision-making since information can be analyzed and critiqued (Roodbeen et al., 2021). Systems necessary in the design and implementation process include communication and health information technology (IT) systems. Communication systems are crucial for enabling healthy interaction between team members, while IT systems are valuable for data collection, analysis, and other related functions. Staff members include the organization’s management, IT department members, system analysts and designers, nurse leaders, and nurses as the end users. Involving nurses as the end users is vital since they will be interacting with the system regularly. Hence, they should understand its basic features, functionality, and how to use it for optimal patient care.

Successful organizations should be open to change and support innovation. Consequently, they should promote evidence-based practice (EBP) and support quality improvement initiatives. As Sharplin et al. (2019) suggested, EBP thrives in a culture ready for change and in organizations that support and reward innovation. In this setting, advanced registered nurses are mandated to identify opportunities for quality improvement and propose interventions for enhancing outcomes. For instance, advanced practice nurses design education programs to reduce infections and improve health literacy. This implies that they are pivotal in practice transformation and ensuring progressive improvement in healthcare processes and outcomes.

Strategies for Implementing the New EHR Proposal

The new EHR system is expected to improve clinical outcomes and have new features, including design, themes, and layout. As a result, communication about the proposed changes is essential to ensure its targeted users are mentally ready for it. Readiness for change reduces possible resistance hence quick implementation (Sharplin et al., 2019). When everyone is ready, a transition to the new system can occur. Here, clinicians would start using the new EHR system to perform tasks quicker than the previous system. A crucial component of the transitioning process is user education to ensure nurses and other users can use the system competently and confidently. Teamwork should also be encouraged before everyone is conversant with the new system. Change leaders should also monitor nurses’ experience with the new system and intervene in areas where user challenges are witnessed. Doing so would allow leaders to design post-implementation support for the sustainable use of the new EHR system.

Professional, Ethical, and Regulatory Standards

EHRs are the foundation of health information exchange. They facilitate the exchange of protected health information (PHI) hence the need for compliance with the established standards. Professional standards that must be incorporated into the system’s design and implementation include user-centeredness and interoperability. User-centeredness can be achieved by an institutive design that is user-friendly to encourage healthcare professionals to use a system (Micheal et al., 2021). Interoperability entails a system’s capacity to share information among different users. It should also be a priority area since interoperable systems should be convenient and safe to use.

The most crucial ethical standards to consider are security, privacy, and confidentiality. The system should be secure from internal and external attacks that can hamper its efficiency. Effective system security is achieved by implementing appropriate safety measures. A secure EHR system is also able to protect patients’ private information (Kehsta & Odeh, 2021). Confidentiality is achieved by ensuring identifiable health information is inaccessible to unauthorized users. Regarding regulatory standards, the EHR system should adhere to the principles of meaningful use. In this case, all the design considerations should enable healthcare professionals to use the system to improve care outcomes such as quality and safety. For instance, quick information sharing would improve care quality and patient satisfaction due to timely care.

Success Evaluation

EHR system implementation can be tedious and time-consuming. Evaluating outcomes would help to determine whether the desired goals were achieved. From a staff perspective, the EHR system should improve communication and teamwork between clinicians. Effective communication and sustained teamwork are the foundation of interprofessional collaboration (Schot et al., 2020). Other outcome measures include improved efficiency (task completion speed) and patient care characterized by minimal errors and treatment delays. The setting would benefit from teamwork and efficiency to increase its productivity, leading to higher revenue. Efficient systems also enhance job satisfaction, reducing fatigue and other potential causes of staff burnout. From a patient perspective, the system’s success could be evaluated by increased satisfaction, reduced treatment delays, and better patient-provider interaction. The implication is that patient experience would improve, and failure to achieve these goals would necessitate further practice improvements.

Leadership Skills and Theories for Collaboration and Evidence-Based, Patient-Centered Care

An interprofessional team comprises members with diverse skills and roles. Keeping such a team motivated and glued to accomplishing its role is a critical success factor. Leadership skills crucial in facilitating collaboration with the interprofessional team include open communication, dialogue, and respect. It is crucial for all team members to be respected, irrespective of their ranks and roles. Open communication and dialogue encourage sharing information and ensure all perspectives are incorporated in decision-making (Albert et al., 2020). The transformational leadership theory would facilitate collaboration with the team and provide evidence-based, patient-centered care. According to Collins et al. (2020), transformational leadership focuses on empowering and motivating the team by utilizing a leader’s influential attributes and behaviors. In a transformative approach, the leader carries the team’s vision and inspires the team to work together for a shared purpose. A similar approach would be required in the EHR system implementation due to the diverse nature of team members.

Conclusion

Healthcare organizations require efficient systems for the continuous delivery of high patient outcomes. As a result, appropriate system changes should be encouraged to ensure clinical settings benefit from technology and informatics as they strive to optimize patient outcomes. When designing and implementing a new EHR system, nurses and other change leaders should be guided by professional, ethical, and regulatory standards. Adherence to these standards would ensure the system complies with the foundation principles of standard practice. Since system design and implementation require teamwork, transformational leadership should be highly recommended. A transformational approach encourages shared decision-making as the team work together to achieve a shared vision.

 

References

Aguirre, R. R., Suarez, O., Fuentes, M., & Sanchez-Gonzalez, M. A. (2019). Electronic health record implementation: a review of resources and tools. Cureus, 11(9), e5649. https://doi.org/10.7759/cureus.5649

Albert, N. M., Pappas, S., Porter-O’Grady, T., & Malloch, K. (2020). Quantum leadership: Creating sustainable value in health care. Jones & Bartlett Learning.

CMS.gov. (2023). Electronic health records. https://www.cms.gov/Medicare/E-Health/EHealthRecords#:~:text=An%20Electronic%20Health%20Record%20(EHR,progress%20notes%2C%20problems%2C%20medications%2C

Collins, E., Owen, P., Digan, J., & Dunn, F. (2020). Applying transformational leadership in nursing practice. Nursing Standard (Royal College of Nursing (Great Britain): 1987), 35(5), 59–66. https://doi.org/10.7748/ns.2019.e11408

Estiri, H., Patel, C. J., & Murphy, S. N. (2018). Informatics can help providers incorporate context into care. Jamia Open, 1(1), 3-6. https://doi.org/10.1093/jamiaopen/ooy025

Keshta, I., & Odeh, A. (2021). Security and privacy of electronic health records: Concerns and challenges. Egyptian Informatics Journal, 22(2), 177-183. https://doi.org/10.1016/j.eij.2020.07.003

Michael, C. L., Mittelstaedt, H., Chen, Y., Desai, A. V., & Kuperman, G. J. (2021). Applying user-centered design in the electronic health record (EHR) to facilitate patient-centered care in oncology. AMIA … Annual Symposium Proceedings. AMIA Symposium, 2020, 833–839. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8075506/

Schot, E., Tummers, L., & Noordegraaf, M. (2020). Working on working together. A systematic review on how healthcare professionals contribute to interprofessional collaboration. Journal of Interprofessional Care, 34(3), 332-342.

Roodbeen, R. T. J., Noordman, J., Boland, G., & van Dulmen, S. (2021). Shared decision making in practice and the perspectives of health care professionals on video-recorded consultations with patients with low health literacy in the palliative phase of their disease. MDM Policy & Practice, 6(1), 23814683211023472. https://doi.org/10.1177/23814683211023472

Sharplin, G., Adelson, P., Kennedy, K., Williams, N., Hewlett, R., Wood, J., Bonner, R., Dabars, E., & Eckert, M. (2019). Establishing and sustaining a culture of evidence-based practice: an evaluation of barriers and facilitators to implementing the best practice spotlight organization program in the Australian healthcare context. Healthcare (Basel, Switzerland), 7(4), 142. https://doi.org/10.3390/healthcare7040142

Sample Answer 2 for NUR 514 Week 8 Assignment Benchmark – Electronic Health Record Implementation Paper

The advent of health information technology has resulted in significant transformation in the healthcare system in America. Healthcare technologies have made it possible for health organizations and providers to offer high quality, efficient and safe care to their populations. Healthcare providers play a critical role in ensuring that efficient technologies are implemented for use in their organizations. Healthcare providers explore the available evidence on the efficient technologies in health and recommend adoption in their organizations. Therefore, this essay examines various aspects related to health information technology and role of healthcare providers in its use.

Key Information Needed in the Database

The database should have a number of information to enable the tracking of opportunities for care improvement. One of the data that should be contained in the database is information about patient registries. The database should have patient-related information such as demographics, health status, treatment interventions, and results of the care approaches utilized in patient care. The information would enable the healthcare providers to track the effectiveness of the interventions of care that the healthcare providers adopt. The other information that should be contained in the database is record keeping. The database should keep patient records for a long period to enable the tracking of health-related trends for patients in an organization. The database should also contain the information related to the response of the patients to the different treatments (Kaipio et al., 2020). The system should also provide a link for inter-professional collaboration. The collaboration should enable sharing of information between healthcare providers to aid in the decision-making processes.

Role of Informatics

Informatics plays a critical role in the capturing of the above data in the database. Firstly, informatics facilitates the acquisition and storage of the vital information that is needed in the database. Informatics ensures that careful methods of data collection and storage of private and confidential data are utilized in the organization. The other role of informatics is data analysis. Informatics facilitates the analysis of the voluminous and complex data to make meaning for the healthcare providers. Healthcare providers use the analyzed data to make informed decisions on the care needs of the patients and the effectiveness of the adopted interventions. Informatics analyzes the data by assigning them value and predicting the values that make sense to healthcare providers to minimize errors in practice. The other role of informatics is the protection of data integrity. Informatics ensures that the collected and stored data is kept private and confidential (Hanna & Pantanowitz, 2017). Systems that limit access of data by unauthorized parties are used to enhance the overall safety and integrity of data in the organization.

Systems and Staff Members

The design and implementation of the system requires qualified staff as well as electronic health systems. One of the systems that is needed in the design and implementation is the clinical decision support system. The clinical decision support system is used to undertake activities such as diagnosis, treatment and prevention interventions. The system has algorithms, e-tools, and reminders that facilitate the undertaking of the above activities. The other system is the personal health records. Personal health records will enable the interaction between the medical personal and patients. It will also collect and store patient information for easy retrieval and use. Besides the systems, qualified personnel are needed for the successful design and implementation of the new system. The personnel include system developers who will assemble the software and hardware needed for the system. The other personnel are the administrators who will oversee the use and access of the system. The third personnel are the users that comprise of the healthcare providers who will use the system for the provision of patient care (Meyerhoefer et al., 2018). Active involvement of the above personnel is needed to ensure the optimum realization of the desired outcomes of system design and implementation.

Professional, Ethical and Regulatory Standards

The use of health informatics in health organizations requires the consideration of a number of professional, ethical and regulatory standards. Standards have been developed to guide the use of electronic health records and health information systems in health. Nurses and other healthcare providers have the professional obligation of ensuring the protection of the patient information. They also have the responsibility of abiding with the institutional rules and regulations that guide the use of patient information in the provision of healthcare. There is also a need to take into consideration the ethical principles that guide the use of electronic health records. The ethical principles that must be safeguarded include informed consent, privacy and confidentiality, non-maleficence, benevolence, and autonomy. There is also the need for the healthcare providers to ensure responsibility, accountability, and openness in the access and use of patient data in making decisions related to healthcare (Kaipio et al., 2020). Regulatory standards have also been developed to promote the safe use of health information technologies. Accordingly, health organizations and providers have the responsibility to adhere to provisions of regulations such as the Health Insurance Portability and Accountability Act (HIPAA), the 21^st Century Act, Affordable Care Act, and Food and Drug Administration Safety and Innovation Act (FDASIA). Healthcare providers also have to abide with the standards set by their professional bodies such as the American Nurses Association and Medical Laws that guide the use of patient information.

Ensuring Order Sets are Part of New Record

The successful use of the electronic health records requires that the order sets are part of the new records of the system being adopted. One of the ways in which the electronic health records team can ensure that the order sets are part of the new record is ensuring there is compatibility in systems with the new records. The order sets should be compatible to enable efficient sharing of data. The second way in which the team would ensure the new sets are part of the new records is ensuring that the system is tested for its effectiveness prior to full implementation in the organization. Testing will enable the determination of compatibility issues in the implementation of the system. The third way is ensuring systematic implementation of the new systems (Brown et al., 2017). Systematic implementation will enable the determination of issues in the order sets that must be addressed prior to organization wide implementation of the order sets.

Communicating Changes

Effective communication methods should be used to create organization wide awareness about system changes. One of the ways in which the changes will be communicated is by using the existing channels of communication (Woiceshyn et al., 2020). The existing channels of formal communication in the organization will be used to raise awareness among the healthcare providers. The other way in which the changes will be communicated is by using the organizational leadership to communicate the change. Influencers in the organization can be used to create awareness and increase sense of urgency related to the change (Alqahtani et al., 2017). The last way is by destabilizing the existing status quo. Destabilization will increase the need for change in the organization.

Evaluating Success

Process and outcome measures will be used in evaluating the success of the electronic health records implementation. The analysis of process measures will provide the organizational stakeholders with insights into the effectiveness of the interventions that were utilized in implementing the system. A focus is placed on the analysis of methods such as resource utilization, stakeholder involvement, and restructuring of the existing systems in the organization. The analysis of outcome measures provides insights into whether the desired outcomes of the system were achieved or not (Nelson-Brantley & Ford, 2017). Measures such as the hospital costs, efficiency, and provider perception towards the system are used to determine whether the outcomes of the system implementation were achieved or not.

Leadership Skills and Theories

Effective leadership skills and use of theories are needed to facilitate collaboration with the inter-professional team and provide evidence-based, patient-centered care. One of the skills is sharing vision with the inter-professional team members. The inter-professional team members to promote safety, quality and efficiency in health should share vision for providing evidence-based, patient-centered care. The other skill is innovation. The leaders should promote innovation in the implementation of the change by the team members to achieve the desired excellence in system use (Nelson-Brantley & Ford, 2017). Leadership theories such as transformational and participative leadership are needed to motivate the healthcare providers to play a proactive role in promoting the realization of the diverse needs of their patients.

Conclusion

Overall, electronic health records have transformed significantly the healthcare system. Healthcare providers have a critical role to play in system development and implementation. The adoption of electronic health records in health should take into consideration the ethical, professional, and regulatory standards that relate to the use of patient data. The evaluation of electronic health records may focus on process and outcome measures. Most importantly, effective leadership styles should be embraced to ensure optimum health outcomes for the patients in the use of electronic health records.

References

Alqahtani, A., Crowder, R., & Wills, G. (2017). Barriers to the adoption of EHR systems in the kingdom of saudi arabia: an exploratory study using a systematic literature review. Journal of Health Informatics in Developing Countries, 11(2), Article 2. https://www.jhidc.org/index.php/jhidc/article/view/160

Brown, J. N., Britnell, S. R., Stivers, A. P., & Cruz, J. L. (2017). Medication safety in clinical trials: role of the pharmacist in optimizing practice, collaboration, and education to reduce errors. The Yale Journal of Biology and Medicine, 90(1), 125–133.

Hanna, M. G., & Pantanowitz, L. (2017). The role of informatics in patient-centered care and personalized medicine. Cancer Cytopathology, 125(S6), 494–501. https://doi.org/10.1002/cncy.21833

Kaipio, J., Kuusisto, A., Hyppönen, H., Heponiemi, T., & Lääveri, T. (2020). Physicians’ and nurses’ experiences on EHR usability: Comparison between the professional groups by employment sector and system brand. International Journal of Medical Informatics, 134, 104018. https://doi.org/10.1016/j.ijmedinf.2019.104018

Meyerhoefer, C. D., Sherer, S. A., Deily, M. E., Chou, S.-Y., Guo, X., Chen, J., Sheinberg, M., & Levick, D. (2018). Provider and patient satisfaction with the integration of ambulatory and hospital EHR systems. Journal of the American Medical Informatics Association, 25(8), 1054–1063. https://doi.org/10.1093/jamia/ocy048

Nelson-Brantley, H. V., & Ford, D. J. (2017). Leading change: A concept analysis. Journal of Advanced Nursing, 73(4), 834–846. https://doi.org/10.1111/jan.13223

Woiceshyn, J., Huq, J.-L., Blades, K., & Pendharkar, S. R. (2020). Microdynamics of Implementing Planned Change on Organizations’ Front Line. Journal of Change Management, 20(1), 59–80. https://doi.org/10.1080/14697017.2019.1602553