Read the “Electronic Health Record System Presentation” below the tasks for the context of this assessment. In your presentation, focus on one of the four functional areas in which the electronic record system will be used:
� Hospital
� Outpatient clinics
� Personal health record
� Health information exchanges
Task:
A. Create a schedule using a chart format (such as, Excel, or other type) by doing the following:
1. Create a timeline for the implementation of the electronic health record (EHR) for your chosen functional area.
� Include start-finish times, project milestones, and organizational roles for specific individual responsibilities
2. Explain how you developed the timeline and milestones.
B. Create a multimedia presentation (length of 10 slides) in which you do the following for your chosen functional area:
Note: The slides in your presentation should include only the main points you wish to make, with more extensive information included in the presenter notes section of the presentation.
1. Discuss the roles of EHR project team members.
2. Discuss the role of the project team manager.
3. Analyze how the use of the electronic record will impact work flow by changing how health information is managed.
4. Discuss possible challenges in implementing the electronic health record.
a. Recommend solutions to these challenges.
5. Explain how the use of the new technology will affect the entire organization.
C. When you use sources, include all in-text citations and references in APA format.
Note: When bulleted points are present in the task prompt, the level of detail or support called for in the rubric refers to those bulleted points.
Note: When using sources to support ideas and elements in a paper or project, the submission MUST include APA formatted in-text citations with a corresponding reference list for any direct quotes or paraphrasing. It is not necessary to list sources that were consulted if they have not been quoted or paraphrased in the text of the paper or project.
Note: No more than a combined total of 30% of a submission can be directly quoted or closely paraphrased from sources, even if cited correctly.
Electronic Health Record System Presentation
Nearly a year ago, the healthcare organization you are working for decided to invest in an electronic health record system. The organization is composed of a hospital with 50 beds and several outpatient clinics. In addition, the organization has made the decision to offer a personal health record and to become a participating member in a regional health information exchange. Your supervisor selected you to be a member of the core project team responsible for developing, organizing, and managing all phases of the adoption of the electronic health record across the organization. The project team leader is your supervisor, the manager of the health information management department.
The project team went through the process of investigating industry trends in the use of the electronic health record. The team spent months visiting with organizational leaders, medical and clinical staff, and all ancillary staff in determining current workflow needs for an electronic system. The team provided education about the electronic record and listened to staff concerns about its implementation during numerous sessions.
The project team spent several months on the vendor selection process. Requests for proposals were solicited, and vendors made demonstration presentations to the project team and selected staff members. After weeks of negotiation and discussion with the administrative team, the team has selected a vendor and is ready to begin the implementation plan.
At this time, the chief executive officer (CEO) has requested that the core project team members attend this month’s meeting of the organizational board of directors. They have been kept apprised of the project through monthly briefings by the project team manager. However, the CEO has been pleased with the leadership skills shown by all of the project team members and has requested that each member participates in a presentation to the board of directors. The CEO is eager for the board members to meet each team member in recognition of their hard work.
The presentation will take the board members through the year-long process the project team has just completed and will describe the upcoming months as the project team oversees testing the system, training the staff, and gradually adopting the new technology throughout the organization. There will be separate presentations given by several project team members that describe the impact the new technology will have on the hospital and on the outpatient clinics in the implementation of the personal health record and in the relationship with the regional health information exchange. As a member of the project team, you are one of these presenters.
Although the board of directors is knowledgeable about the healthcare organization, the CEO believes the board’s knowledge of the electronic record’s usefulness and all its components are limited. The CEO believes that they need to be informed of the full scope of its capabilities and how it will change the manner in which work is done within the organization.
The new information system will provide decision support to the medical staff and clinicians to enhance quality and safety in patient care. It will facilitate efficiency and accuracy in business functions and improve the management of all aspects of health information. It will allow administrators to more fully access health data for reports and strategic planning. It will position the organization as leaders as the future of healthcare delivery continues to be restructured through technology. Including a personal health record as an option for all patients will provide good customer service to patients and ensure the inclusion of quality data within the record. Participation in a health information exchange will allow medical staff to access healthcare data at the regional level and assist them in making clinical decisions based on the latest research and best practice, thus allowing staff members to learn from colleagues in the region.
During the past year, there have been a few board members who have expressed concern about the cost and magnitude of the project. The CEO believes that this month’s meeting and presentations will be important in gaining their support.
Electronic health record
- Create a schedule using a chart format (such as, Excel, or other type) by doing the following:
1. Create a timeline for the implementation of the electronic health record (EHR) for your chosen functional area.
• Include start-finish times, project milestones, and organizational roles for specific individual responsibilities
| Step | Time line | Organizational roles | Milestones |
| Creating the project team; the team is important in the adoption of EHR. However, the project team might be assigned in later stages of implementation, but the executive sponsor and project manager should be assigned before the commencement of the project. | 3months before deployment of EHR | Executive EHR sponsor; in charge of overall project success. With the project manager, they help the entire hospital to embrace change and manage any resistance to change. Project manager; being a senior manager proficient in multi-faceted implementation groups, the manager is responsible of making decision to do with the adoption of EHR and daily management of the system during adoption. Project team; they are in charge of all areas of EHR adoption focusing on management of information technology, budget or agreement management, business change, data migration, training, communication, security and privacy. | To ensure that the project deliverables are met and the project is on the right course. |
| Project activities: such as Engagement meetings, that brings together all key parties involved in the project. During meetings project milestones are reviewed, allocation of resources, roles, and management issues. In addition, this is the initial project planning discussion with the functional. Assessment; technical and business leads are allocated during this phase. Comprehensive analysis of needs is done to evaluate the hospital technical as well as operation readiness. Planning and preparation; included activities such as creating project work plan, assessments of results from technical needs analysis, data migration and exchange, documenting current workflow and so forth. Deployment; includes all aspects necessary in the project such as data migration assessment, preparing employees for the new EHR, training, demonstrations and supplier engagement. Deployment weekend involves validation of data conversion, final readiness checklist. Post-adoption; involves validation of data by the end users, support from peer leaders, transitioning to implementation or operation stage. | 1 month 4 -5 months | Peer leaders in charge of championing the use of EHR. Project team in charge of developing project work plan, preparing EHR adoption budget, and order equipment, network services and infrastructural upgrade. | To provide regular updates to reduce challenges in the adoption of EHR. Contract negotiation Supplier selection for office wiring and cabling requirements that are not integrated in EHR package Selection of hardware supplier Selection of EHR supplier |
| Planning for change; The new EHR system will lead to considerable change. To help plan the change management transition team will work with staff to design a strategy that help in managing process, technology and people. | 4months before EHR Go-live | Management transition team; Set strategic direction that describes objectives of the EHR to support as well as ensure patient-based care. Hospital manager; in charge of mapping current processes by identifying process, people and technology used in caring for the patients. Operation support; describe to-be process through reevaluating process to guarantee a patient-based practice. This | To provide opportunities for planning for change in daily workflows based on increased efficiency of EHR. EHR objectives and related system functions are listed Development of business plan including -measureable EHR objectives -estimation s of EHR budget -target adoption timeframe |
| Communication planning This stage in the implementation focuses on engaging and informing all the staff and stakeholders about the EHR. | 4 months before deployment of EHR | Communication manager; is accountable of ensuring that the staff and stakeholders are aware of the changes from the implementation of EHR. Project team; charged with providing a comprehensive guide and communication template. | To create awareness as well as understanding of the changes. To ensure users and stakeholders are informed concerning the progress of the project. |
| Data migration and retention; this is the most important step in the adoption of electronic health record. Without correct transfer, the system might fail to support efficiency in patient care. | 3 months before EHR Go-live | Project team; charged with providing computerized charts based on technology and guides. Data migration coordinator; in charge of assisting in data preparation and migration. | To ensure data migration occurs in centralized settings supporting pre-adoption practices functions and validation. Completion of data transfer and testing Contract negotiation and funding |
| Training; all persons who will use EHR require training. Advanced training will be vital for super users including data management coordinators, system administrators and financial personnel. | 3 months before EHR Go-live | Project team; responsible for providing tools to design training strategies that meet both long and short term needs. EHR supplier charged with the role of providing onsite training of staff. Peer leader support; to ensure clinical personnel from other centers act as tutors to new users. | To encourage implementation of electronic health record and help in the attainment of the required benefits of the system. Completion of adoption plan Supplier will the key player of this step, as such they are thoroughly involved in all implementation areas. |
| Identifying EHR reporting needs; the system presents pre-defined reports to handle main requirements of the functional area. | 3months before EHR deployment to 6 months of continuous operational activity. | Business change team; in charge of comparing the practice reporting needs | To ensure that reporting needs meet the standard reporting system. Plan further staff training Population based quality reports are produced Data capture verification completed by the supplier Post-deployment reviews for electronic health record objectives, adoption and further staff training accomplished |
| Executing and validating deployment: the most vital phase in the implementation, it is intense activity for both the supplier project teams and the hospital. | 3 days before deployment of EHR | IT team; responsible for making database copies and send them to a centralized migration setting. | To meet validation requirements, get rid of inaccuracies. |
| Executive approval; Approval is necessary for the new system to be deployed | 3 days | Project manager will be responsible for seeking consensus from all the involved parties in the project (EHR supplier, hospital) and make recommendation for the executive project sponsor. | To provide the authenticity of the new system, before deployment. Re-evaluation of clinical as well as administrative procedures Identification of quality improvement opportunities Assessment of performance reports |
| Evaluation of post-deployment activities and support; basically this phase includes information validation by clinicians that carry out spot evaluation of patient records to ensure they are accurate. | Continuous after deployment of EHR | Supplier project teams; responsible for addressing post-deployment issues and increase standard supports. Peer leaders in charge of responding to questions and offer further support. | To provide any support to new users as they become accustomed to the new system. |
2. Explain how you developed the timeline and milestones.
This is a ten-stage procedure that helps in understanding necessary activities for the adoption of electronic health record. Timeline and milestones are developed based on the opportunities of advanced planning, resource allocation and operational activities. Since, EHR implementation is a collaborative activity comprising project teams, EHR supplier and other stakeholders working the project, timeline and milestone differs. Nevertheless, the executive directors or responsible senior manager assesses the timeline and milestone aspects to understand resource assignment and funding and assign project teams to EHR project appropriately (Ash & Bates, 2005). Regarded as a stage by stage planning strategy, it presents important data that help in decision making with respect to timing of the technology, deployment date and resource allocation for successful implementation of EHR. In spite of implementation challenges, timing and milestones help in providing insights of what is required for successive adoption. Consequently, milestones and timeline were developed based on the EHR deployment date. Incorporating these aspects will facilitate the implementation and use of the system, that aid in determining the needs comprehensively including resources and budget requirements.++
B. Create a multimedia presentation (length of 10 slides) in which you do the following for your chosen functional area:
1. Discuss the roles of EHR project team members.
In the HER project team members are in charge of many roles including;
- Creating a detailed schedule for EHR and describing the template to clinicians, management of clinical workflow, documentation as well as other vital decisions in the selection and adoption of the suitable EHR technology (Ash & Bates, 2005).
- Identify and prioritize the necessary requirement for the EHR system and effectively assess the abilities of the supplier in fulfilling the requirements.
- Developing the network flow, templates and design for building and evaluation, coding platforms, hardware and devices to assure all adoption is correct before going live. The members are charged with training coordination in the practice on how to use the EHR application.
- Ensuring that all tools, security aspect, hardware and equipment adopted are function correctly.
- Ensuring that users comprehend how to use EHR system effectively.
2. Discuss the role of the project team manager.
In EHR project, the team manager is in charge of coordinating, facilitate and act as a task master to assure all supplier and tasks are correctly completed within specified time frame.
3. Analyze how the use of the electronic record will impact work flow by changing how health information is managed.
Implementing EHR considerably impacts on organizations workflow. Redesigning workflow is a procedure that should be completed before adoption of electronic health record. EHR is likely to affect health information in how messages are managed; carrying out examinations; patient check in and out; patient schedules and medication renewals. In any given practice workflow is lifeblood, as such its efficiency impacts on the quality of service delivery and profitability level. An electronic health record workflow developed in proven procedures can considerably increase proficiency as well as practice efficiency. The electronic health record establishes the staff to carry out a certain task, at a level that is easier and suitable for the involved parties. Such level of clarity ensures smooth workflow that increases the efficiency in turn increasing the throughput of patients. Evidently, practice that have adopted electronic health record can enjoy the benefit of simplicity and convenience of accessing health information, a faster channel of requesting patients to make payments, and best options integrated in the workflow so that modification can be executed. Moreover, electronic health record aids in the regular recording of prescribed tasks, an effective basis of gathering data necessary to meet several program requirements.
4. Discuss possible challenges in implementing the electronic health record.
Implementing an electronic health record is challenging, complex and tedious. There are many challenges associated with the adoption of EHR including;
- Lack of proper policies in the implementation of EHR; management need to adopt a standardized procedure for designing, modifying and implementing policies. Inappropriate policies, the issues of unrealistic expectations on adoption scope, timeframe and funding affect implementation. Because information technology is important in electronic health record, departments in charge of policy implementation need to keep the pace with IT section. In addition, standardized IT procedures to have a management policy to guarantee that changes are standard and appropriately tested. All these aspects are expensive to put in place hence affect the implementation of the system. This may also lead to revenue reduction during adoption process. (Vishwanath, Singh & Winkelstein 2010).
- Process change: with all new adoption, the most common is workflow based change and electronic health record is included. All staff such as physicians, nurses, administrators and ancillary employees starts to exchange, capture and retrieve information electronically. This relies heavily on how fast users are in position to use the technology successfully and efficiently. In some case, there is the challenge of resistance to change because they do not fully understand the benefits of electronic health record over paper based records, and how to get minimum benefits form the technology. Such change requires training of staff, security and communication requirements that are likely to take a lot of time and huge investments.
- Technological change; electronic health record is completely reliant on complex as well as compatible functional elements of several software and hardware. Thus, ensuring that all the elements work effectively is intricate and challenging. In addition getting technical expertise with best practices can be hard. Experts either internal or outsourced have to be around for many months or a year to ensure the system works properly. Since, EHR require technical experts, when the system fails, when they are not available this can be catastrophic. Conversely, information security and confidentiality of patients can be compromised due to increased investigation of policy markers and health canters. Integration of legacy infrastructures in the current systems might be challenging for institutions that are not ready to embrace technological change (Vishwanath, Singh & Winkelstein 2010).
- Cost; electronic health record is associated with high implementation costs, maintenance with respect to software and hardware that must be replaced regularly discourage medical facilities to adopt it. In addition, electronic health records are associated with the issue of affecting workflows leading to transitory loss in productivity. Productivity loss results from end user attempting to understand the new system leading to huge losses.
a. Recommend solutions to these challenges.
Adopting EHR takes collaborative efforts, and huge funds. Medical facilities need to learn from the originators to increase adoption speed as well as chances of success. Therefore, to eliminate the challenges of EHR medical facilities should;
Ensure that staff have basic computer skills; training should be provided as part of implementation process; it is vital to address this gap prior to getting training on electronic health record.
Change management; organizations adopting EHR should be committed to embrace change. This is because electronic health record affects processes and workflows.
Change management aids institutions affected by the adoption of the electronic health record understand the significance for the new system and present feasible techniques and tools to assist adapt to new technology. In addition, the project team can be instrument in the management of change by providing guides, tools and expertise assistance (Ash & Bates, 2005).
Leadership; project and executive level managers should champion this process, but physician should take the leading role throughout the project adoption. As such, leadership should not be unwavering.
Remediation; regularly, electronic health record implementation challenges can be minimized, practical comprises and workarounds can get rid of the problems. EHR suppliers do not like the idea of their clients failing to use the system as such they take criticism seriously to correct the issue.
Technical improvement; no technology is perfect. Majority of supplier improvement entail feedback from clients. A responsible supplier sees a challenge of EHR implementation as opportunity to increase or improve the system. Though, it can take a long time for the supplier to make necessary improvements, the wait is useful considering the benefits of EHR (Littlejohns Wyatt, Garvican, 2003).
Responsive; supplier responsiveness is important aspect to consider since results relies on the willingness of the supplier to be accountable to guarantee the effectiveness of the technology. It is extremely intricate to remediate the challenge if the supplier does not take the responsibility.
5. Explain how the use of the new technology will affect the entire organization.
There are several ways in which the entire organization will be affected by the new technology. To begin, patients they will enjoy the benefits of improved treatment and diagnosis procedures; considerably few inaccuracies will be encountered in their personal health records; and quick decision making from their physicians (Coile, 2000).
With respect to doctors and other health care practitioners, there are many benefits involved in the adoption of EHR such as:
- Easy exchange of patients health information from one department to the the other a vital asset
- Abilities to ultimately enhance patient numbers attended to on a daily basis for high patient workflow increases productivity
- Because information is electronically stored, space issues are taken care of
- Increases management of results and patient care with elimination of errors in health practice.
- Reduces operational expenses like transcription costs as well as labor expenditures
- Tailored and scalable computerized health records that is likely to increase with medical practice
- Advanced electronic prescribing and clinical decision support that leads to increased efficiency
In addition the technology will improve patient safety; the aspect of safety for EHR with regards to diagnosis as well as privacy of their health information is one of the key benefits. The decrease of medical inaccuracies is important for the entire organization and the patients. Electronic health record system of information exchange in a health practice naturally minimizes unnecessary paper-based inaccuracies. Moreover, the issues of lost or even misplaced patient information is substantially reduced. In turn, electronic health record aids in generating medical safety of patients. Since EHR and patient care is tantamount such that the network allows users to oblige to terms of use in gaining access to certain information, this protects privacy of patients. Lastly, contributes to quality service delivery. This means that it is done at the right time and place. This leads to faster information exchange in turn contributing to effectiveness, safety of patients and efficiency in care provision (Coile, 2000).
References Ash, J. S., & Bates, D. W. (2005), “Factors and Forces Affecting EHR System Adoption: Report of a 2004 ACMI Discussion”. J Am Med Inform Assoc, 12, 8-12.