Planning for EHR implementation
St. Augustine’s Medical Services is one such hospital that is designed as an inpatient care for surgical as well as Maternity and emergency admission. In order to cover lack of appropriate documentation and other medical issues, electronic health record must be implemented to improve quality of care. System development usually has five elements such as planning, analysis, design, Implementation and maintenance (Wager, Lee & Glaser 2021). The steps will be used for implementing electronic health records in the hospital.
1) Planning:
Initially the planning can be obtaining the approval of electronic health record from the committee and local government. The planning can focus on governance structure for implementing electronic health record strategies in making, program management and implementation approach (Wager, Lee & Glaser, 2021). The hospital leaders can involve in first meeting regarding components in order to implement electronic health records.
2) Analysis:
Analysis can focus on current state of the hospital technological monitoring human resources and floors to implement EHR systems. In this case, the organization can focus on auditing and survey in order to understand the knowledge resources and budgeting. Since organizational culture is important in influencing social beliefs, and motivation which is reflected in communication and coordination within the workplace, the user-friendly service can be developed for improving workflow (Wager, Lee & Glaser, 2021). Hence, IT professionals can be involved in this process who will focus on IT governance, budget and technology.
3) Design:
Choosing the appropriate EHR software crucial for meeting confirmation needs. Hence, St. Augustine’s Hospital Focus on improving interface while reducing customization because customization increases errors while taking advantage of new versions (Wager, Lee & Glaser, 2021). The current data and data accuracy must be top priorities in the conversion process.
4) Implementation:
In order to implement electronic health record, human resources can focus on individual motivation especially barriers in saturated of electronic health record and provide incentives to improve motivation. On the other hand, Kurt Lewin’s change management can be used for implementing EHR system . Lack of communication has resulted in many project failures; the leaders must demonstrate effective communication skills during implementation. In this case training and education can be provided to each employee for improving expertise and knowledge of the users regarding data security, data mining and documentation ((Wager, Lee & Glaser, 2021). Other components of implementation will be Allocating resources for electronic health record updated computer system in the hospital, IT professionals for the issues and continuous monitoring. A pilot study for six months can be implemented through building new strategies that should be guided by the strategic decisions as a part of testing program (Wager, Lee & Glaser, 2021).
5)Maintenance:
After implementation, feedback must be taken in the early stage regarding organization workflow delay in addressing patient issues and ability to improve first-hand experience (Wager, Lee & Glaser, 2021). In this case, the result of the survey and incidence report will result in appropriate upgradation of the system, implementation of mandatory training and workshop. After 6 months, security policy will be developed to ensure confidentiality and protect disclosure.
Analysis of current state
Kruse et al. (2016), suggested that most widely observed challenges encountered in clinical setting are limited technical support and technical concern, funding for implementing electronic health records and resistance to the change. The lack of capital resources to invest in electronic health records and financial challenges limit the ability of the hospital to improve the quality of care. However, St. Augustine’s Hospital tends to have more health care professionals compared to other technical support which limited use of advanced technologies like electronic health record. The employees often exhibit resistance to the changes due to pattern lack of skills and lack of desire to deal with emerging issues. The complexity of the system and limitations for upgrade prevent the organization employees to adopt the changes and improve patient information documentation (Kruse et al., 2016). In this case the first strategy for addressing the issue is to improve government funding for implementing EHR in St. Augustine’s Hospital because government funding will ensure appropriate policies and distribution of resources. The second strategy can be implementation of a strict encrypted interface to improve technical support in St. Augustine’s Hospital while professionals can be provided with training and resources to address privacy concerns and workflow related concerns (Akhu?Zaheya, Al?Maaitah & Bany Hani, 2018). The resistance can be reduced by increasing financial incentives and workshops to reduce challenges in the workflow.
From the scientific perception, meaningful use of electronic health records is to improve efficiency, safety and overall quality of care. At this juncture, the first major use of the health information is to document appropriate information which can assist in identifying the patient information, especially patient history, medication that will further support in developing treatment regimen (Huang, Gibson & Terry, 2018). Therefore, it supports effective communication and reduces the risk of errors associated with documentation. The second meaningful use of health information document the continuous course of treatment and result in order to track the prognosis. It is common instances where patients tend to experience limited access to continuity of care which results in poor prognosis followed by premature mortality (Huang, Gibson & Terry, 2018)). Meaningful use of health information can ensure person centredness and continuity of care in St. Augustine’s Hospital by documenting each patient information and health progress using separate data id and data accuracy ((Sadoughi, Nasiri & Ahmadi, 2018). Therefore, it further supports the diagnosis as well as justify the treatment based on patient history of the patient who received care in St. Augustine’s Hospital. Hand written papers for medical records are poorly legible and resulted in medical errors where issues in documentation of the administration of medication are significant. In this current context, electronic health records ensure standardization of forms, terminology, and data input (Sadoughi, Nasiri & Ahmadi, 2018). It can also be used in statistical reporting in terms of quality improvement, resource management and indication of possible errors in the clinical system of St. Augustine’s Hospital. Digital formatting enables information to be used and shared over secure networks while triggers and warning reduce deterioration of the care in St. Augustine’s Hospital. Hence, electronic health record is suitable for reducing human errors.
St. Augustine’s Hospital is one such hospital that require implementation of EHR system for improving quality of care. In this case, clinical most recent certification criteria that must be followed for implementation are following:
The major 8 criteria for implementation:
- clinical process optimization such as computerized provider order entry, drug and drug allergy interactions checks (Holmgren, Adler-Milstein & McCullough, 2018).
- care-coordination for improving how patient should be transmitted as patient exchange data is crucial to improve quality of care.
- Clinical quality measurement for reporting hospital results
- Privacy and security for determining health data access and elimination of
- Patient engagement for supporting data mining, download and transit common clinical set
- Public health- supporting public health reporting such as laboratory tests and results (Wager, Lee & Glaser, 2021)
- Designing and performance for improving user friendly interface and improved quality of care ((Wager, Lee & Glaser, 2021).
- Efficient Electronic exchange for transmitting messaging using direct process
Other criteria are
- Patient-specific Education Resources
- Implantable Device List
- Transitions of Care data (Huang, Gibson & Terry, 2018).
- Personalized care plan
- Emergency Access
- End-User Device Encryption
- Auditing Actions on Health Information
As discussed above, electronic health record has a significant impact on patient diagnosis and reduction of disease. The underlying reason is that electronic health record can improve ability of the professionals to improve diagnosis by detecting differential diagnosis and improving disease detection. The second impact is that it enables professionals to improve care by increasing screening and monitoring of the patients as EHR is built to meet the clinical standards and accessibility of the data necessary for developing appropriate clinical plan ((Huang, Gibson & Terry, 2018). Other impacts of the program are improvement of listing comprehensive problem, improvement of medication record, improvement of progress note and orders, improvement of procedure and treatment by appropriate licensed practitioner. Hence, it has significant impact on wellbeing and quality of care of the patient.
Conclusion:
On a concluding note, it can be said that EHR system plays fundamental role in improving the quality of care. electronic health record has a significant impact on patient diagnosis and reduction of disease. However, that most widely observed challenges encountered in clinical setting are limited technical support and technical concern, funding for implementing electronic health records and resistance to the change. In this case, certification must be used for improving quality of care and implementing electronic health record.
References:
Akhu?Zaheya, L., Al?Maaitah, R., & Bany Hani, S. (2018). Quality of nursing documentation: Paper?based health records versus electronic?based health records. Journal of clinical nursing, 27(3-4), e578-e589.
Galli, B. J. (2018). Change management models: A comparative analysis and concerns. IEEE Engineering Management Review, 46(3), 124-132.
https://ieeexplore.ieee.org/abstract/document/8486843/
Huang, M. Z., Gibson, C. J., & Terry, A. L. (2018). Measuring electronic health record use in primary care: a scoping review. Applied clinical informatics, 9(01), 015-033. https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0037-1615807
Kruse, C. S., Kristof, C., Jones, B., Mitchell, E., & Martinez, A. (2016). Barriers to electronic health record adoption: a systematic literature review. Journal of medical systems, 40(12), 1-7. https://link.springer.com/article/10.1007/s10916-016-0628-9
Sadoughi, F., Nasiri, S., & Ahmadi, H. (2018). The impact of health information exchange on healthcare quality and cost-effectiveness: A systematic literature review. Computer methods and programs in biomedicine, 161, 209-232. https://www.sciencedirect.com/science/article/abs/pii/S0169260718300907
Wager, K. A., Lee, F. W., & Glaser, J. P. (2021). Health care information systems: a practical approach for health care management. John Wiley & Sons. https://books.google.co.in/books?hl=en&lr=&id=io1SEAAAQBAJ&oi=fnd&pg=PR15&dq=+Healthcare+Information+Systems:+A+practical+Approach+to+Healthcare+Management&ots=X5Jfqnac9h&sig=1FoKm1cV697M_5dU4TKHnOqvXWY&redir_esc=y#v=onepage&q=Healthcare%20Information%20Systems%3A%20A%20practical%20Approach%20to%20Healthcare%20Management&f=false
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