NUR 514 Week 8 Assignment Benchmark – Electronic Health Record Implementation Paper
NUR 514 Week 8 Assignment Benchmark – Electronic Health Record Implementation Paper
The process of implementing a new electronic health record (EHR) system is not an easy task for the various stakeholders involved in a healthcare setting, that is, from the decision-makers to the emergency department (Bushman, 2018). The purpose of this paper is to evaluate the significance for effective leadership skills to coordinate an interprofessional team and offer evidence-oriented, patient-based care and application of professional, legal and ethical standards of practice that would provide effective and safe healthcare services. Appropriate utilization of leadership competencies and change management models are critical for effective implementation of the EHR system (Health IT, 2019).
Informatics tools such as electronic health record systems (EHRs) are critical in recording adverse events. At the patient level, EHR enhances communication since unrecorded events will not be communicated (de Hoon et al., 2017). This communication is crucial when multiple healthcare providers are involved in patient care, especially since patient care becomes more complex. Moreover, Rochefort et al. (2015) highlight that natural language processing (NLP) of dictated electronic radiology reports or discharge summaries are informatics tools that can be used to report adverse events. NLP refers to automated methods for converting free-text data into a computer-understandable format.
A computerized database system is an essential requirement to receive litigable and structured data that is easy to search and trace healthcare environment opportunities. EHR as a diagnostic information system is an extensive system that involves simple access to patient data at the point of care, organized and litigates information that can be readily searched and is suitable for data mining and analysis; and enhanced patient safety, in particular preventing adverse drug reactions and identifying health risk factors such as falling (DeNisco& Barker, 2015). Florence Nightingale’s days are pre-dated by nursing records. Information on nursing has improved its significance to nurses and medical practitioners over time and its effect on patient care and results (Bushman, 2018). The documentation method, from a trail of evidence to an electronic trail, has changed. Health information systems involve the management of health information and utilize IT to organize health records to enhance health results and handle data gathering from patient records (Creasey, 2018). Health informatics staffs are responsible for managing, interpreting, and sharing health information with the main aim of enhancing care efficiency (Hodgkins, 2015).
Patient care begins with collecting the health history of clients, predisposing factors, history of allergies, and the recent list of medications. In the electronic database, this data is gathered and recorded. Health data can be collected and recorded in real-time by nurses as well as other health experts (DeNisco& Barker, 2015). Reducing prescription failures with the inclusion of “soft stops,” drug allergy alerts and interaction medicines are, therefore, one of the ways to enhance patient safety and have an extensive clinical scheme, which is a wonderful opportunity (Bushman, 2018).
Necessary Regulations for Application of the EHR System
A collaborative team strategy will be needed to guarantee that all the required laws from security and privacy
regulation imposed by the federally, design practice business processes, training of care providers and handling the application process for the application of EHR systems are followed. To maintain an interdisciplinary team, a leader is required (DeNisco& Barker, 2015). The type of innovative management that contributes to achievement is servant leadership. As health care and servant management are essential partners, servant leadership is not a fresh concept (Rupp, 2014). Guiding the interdisciplinary team is an efficient way of management. First, the servant leader is a leader whose deliberate decision enables him/her to manage the multidisciplinary team that will involve shareholders from within and outside (Health IT, 2019). Internal participants are doctors, nurses, health and caring personnel, IT employees, developers of EHR, and organizational employees. Patients, domestic EHR suppliers, and technology firms are external shareholders (Hodgkins, 2015).
“Patient care” is complex by the legislative privacy laws and ethical considerations. Health Insurance Portability and Accountability Act (HIPPA) of 1996 is a federal law protecting health data. The HIPAA rules on privacy and safety preserve the confidentiality of protected information health data (DeNisco& Barker, 2015). The Data protection rule applies to protected patient information in any form of expression, while the safety rule applies to electronic protected health data. Within the United States, the web of complex moral and ethical statutes has made it incredibly difficult in the expanding field of health-related research in this area of customer-centered results research. This may be the foundation of affirmative consent practice (Bushman, 2018). The confidentiality process to any medical attention or analysis cooperation must also include relevant information for the patient or facilitator to comprehend the course of treatment, risks, rewards, alternate solution courses offered and the reality that consent may be revoked at any time (Hodgkins, 2015).
Communication and Order Sets
The proof-based technique is the current reality in the field of healthcare coverage. The present use of diagnostic order, consistent with EHR proof-based requirements, has shown a significant decrease in failures and enhanced results. The EHR group will also have to guarantee that all order sets have been integrated into the scheme for appropriate and modified order sets. A structured governance system spurred by the Lead Physician should be maintained to make it useful in this undertaking, afford-in, and contentment from physicians (Creasey, 2018). Diagnostic order sets should reflect policies and procedures and organizational regulations, including the identification and selection of sources of data material, information review, retention, and updating. This is particularly when diagnostic information is sharply tailored, as it will allow considerably more time and commitment to preserving personalized information (DeNisco& Barker, 2015).
Communication is a very significant instrument (Creasey, 2018). Change management is a collection of principles, methods, and prescription medications applied to the human elements of implementing considerable change programs. To make change occur, it enables if the whole organization wishes it to occur. This might assist organizations to spark the original motive to get things moving. To introduce a new EHR scheme, various means of communication are required to inform participants of the modifications that are taking place (Bushman, 2018).
Analysis of the Progress of EHR Implementation
A set of variables of what achievement will sound like should be created before execution. John Kotter’s 8-step framework for efficient transition can provide a directive for deliverables at every stage of performance. Short wins and deliverables are some of the objectives that can be set throughout the original plan subject to implementation (Creasey, 2018). Some of the achievements and priorities which can be set are the evaluation of internal stakeholders ‘ willingness to transform, the scheduling on how to “go-live” based on the evaluation, and the achievement of productive use (Bushman, 2018). Vigilant training at the start is essential to the effective execution of the EHR, but following a set of reasonable expectations and a controllable schedule is crucial. Once implementation is completed, ongoing monitoring is required to assess how inner participants are using the new scheme. This monitoring will guarantee the continuing effective execution of the EHR (DeNisco& Barker, 2015).
Implementation of a new EHR scheme will require considerable planning, buy-in from all decision-makers, and use performance management instruments to move the shift forward. Mapping the application of this fresh EHR scheme as a trip, not just a departure point, will guarantee achievement. Effective communication and successful management are essential considerations in the successful application of an innovative EHR scheme. A computerized database system is a crucial requirement to receive litigable and structured data that is easy to search and trace healthcare environment opportunities.
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Creasey, T.(2018). What is change management? Retrieved from http://www.howtochangemanagement.com/p/what-is-change-management.html
DeNisco, S. M., & Barker, A. M. (2015).Advanced Practice Nursing (3rd ed.). Burlington, MA: Jones & Bartlett Publishers.
Health IT.(2019). Health IT Legislation | HealthIT.gov. Retrieved from https://www.healthit.gov/topic/laws-regulation-and-policy/health-it-legislation
Hodgkins, M. (2015, March 29). Electronic Health Record (EHR) Implementation. Retrieved from https://edhub.ama-assn.org/steps-forward/module/2702512
Kushan, D. (2017, December 4). How to Track and Measure Success During an EHR System Transition. Retrieved from https://www.healthcareis.com/blog/how-to-track-and-measure-success-during-a-transition
Mind Tools Content Team.(2019). Kotter’s 8-step change model. Retrieved from https://www.mindtools.com/pages/article/newPPM_82.htm
Rupp, S. (2014, November 14). How Nurses Are Using Health Informatics to Improve Patient Care. Retrieved from https://electronichealthreporter.com/nurses-using-health-informatics-improve-patient-care/