RUNNING HEAD: EHR Implementation in Health Care Systems 1

EHR Implementation in Health Care Systems

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EHR Implementation in Health Care Systems

Many organizations have embraced technology, but not all have adopted enterprise

resource planning, ERP, systems which span the entire organization. The ERP systems

incorporate all the functions of the institution and ensure that information can be accessed

from a client point of the group. Our organization, in this case, is a large multi-campus

hospital which seeks to implement the new Electronic Health Record, EHR, system. Most

hospitals run paper-based recording or filing systems to manage patient information or

records.

The EHR is a digital or electronic version of the patient's history chart done on paper.

The recording table holds critical information on the health and improvement trends of a

patient observing parameters such as heartbeat rates, blood pressure, weight, and temperature.

The new system being implemented provides for real time patient-centred records that make

information available instantly and securely to authorized users.

The EHR contains a patient's medical record, previous diagnoses, medication and

prohibitions, treatment plans, immunization dates, sensitivities, laboratory and test results,

and radiology images. Since the information is collected and stored digitally, it is easy to do

analytics and have real-time reports. The patient information stored is secured as only the

doctors can access the information and there is a security constraint, maintaining logs, put to

ensure that only authorized people to access the records. The analytics performed on a

patient's data are used to make decisions regarding particular medication, or the medics could

take action when the case is too critical. There is a paramount feature added to the EHR

system that allows health care institutions to share patient information with each other in

different functions of an organization. For instance, a patient sent to the laboratory for tests

does not need to explain their issues again as the laboratory personnel can view the

information from the system using the patient's unique key identifier.
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Each hospital runs its functions and transacts differently from the other. An EHR

system may be modeled to have standard features, but it can also be customized to fit the

current situation in the hospitals. A critical assessment is done in the hospital to analyze the

feasibility of implementing the system over running the current paper-based system. The

analysis may revolve around technical, budgetary, time, and human resource constraints.

Some concerns need to be addressed before the idea is fully accepted. Some of the questions

the planners need to answer are:-

(a) Is the implementation of the new system going to disrupt the daily hospital activities?
(b) Can the hospital afford to install and maintain the system once implemented?
(c) Does the hospital have enough technical personnel to implement, monitor, manage,

and train others how to use the system?

(d) Is the human resource in the hospital able to interact with the system so as to make the

hospital functions more efficient? Are they computer literate or would they know how

to work with such a system?

A feasibility study is the first stage of this project. A report is generated after the

critical assessment of all the listed factors to consider as well as any other concerns that may

be raised by stakeholders. The current system runs in a certain way, and the new regime

should try to improve but not drastically change the current transactions, so as to ensure that

the system is readily accepted by the users.

Quality management tools

The hospital runs very many activities. It has the in-patient and out-patient

departments. All these departments need to be monitored so that operations run smoothly. The

hospitals operate on a given process where a patient goes from one stage to the next in a

systematic order. The current system has a guideline of the steps followed as shown in the

diagram below. It is imperative to highlight the critical steps that a patient goes through from

the moment they walk into the hospital to the time they walk out.
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Quality management ensures that all the processes that are critical are carried out

within the shortest time and as efficiently as possible. A Pareto chart displays independent

variables on the horizontal axis and the dependent variables as heights or bars. It focusses on

the cumulative relative frequency superimposed on the bar graphs. The Ishikawa, cause and

effect diagram, identifies possible causes for an effect or problem.

Performance management measures

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In planning for the implementation of the system, it is prudent to look into the future.

Several goals that are specific, measurable, attainable, and relevant to the case study here,

must be set. These goals may need to be re-assessed throughout the EHR implementation to

ensure a seamless transition. A steering committee should be mandated the task of overseeing

the planning process, resource mobilization and management, and the project application in

the hospital. The goals set indicate several milestones that need to be accomplished in a given

timeline. A scorecard or dashboard or record card is used to monitor the activities done during

the project implementation to ensure that the product is delivered as per the set objectives.

These performance management measures ensure that the internal processes and policies are

upheld per the plans made. The project plan is carried out and any risks encountered are

managed as fast as possible.

Workflow concepts

A use case diagram shows all the stakeholders that interact with the system on a day

to day basis. The system spans the entire organization capturing the principal transactions and

pooling the largest resources in the institution. The workflow charts and diagrams show the

efficiency brought out when an EHR system is incorporated. The workflow organizes the

tasks, approval levels, stages, and milestones for a given project. It provides a measure of the

time taken for each section of the project.

Project management techniques

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A project goes through several stages before it is completed. At the end of each stage,

the goals and objectives are reviewed, and a report is drawn up. Gantt charts are used to

develop the plan and give timelines for the implementation process. Each process is allocated

a time span could be in days or weeks or months. The project manager identifies the critical

tasks and using fishbone diagrams one can determine the amount of time needed to

implement the entire system. The project is only successful if the medics and other hospital

employees are trained on how to use the system. Each employee is granted a set of

credentials fit for their security level. Documentation is critical to the project planning affair.

Uncertainties are part of the plan, and they need to be designed for adequately to ensure that

there are means to mitigate them. Certain plans are put in place to anticipate risks, and a

rollback plan is made. Some standard tools used in project management include work
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breakdown structure, Gantt chart, a logic network, product breakdown structure, and PERT

charts.
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References

Hartley, C. P., & Jones, E. (2012). EHR implementation: a step-by-step guide for the medical

practice. Chicago, IL: American Medical Association.

Pecoraro, F., Luzi, D., & Ricci, F. L. (2013). Secondary uses of EHR systems: A feasibility

study. 2013 E-Health and Bioengineering Conference (EHB).

doi:10.1109/ehb.2013.6707295

Pond, R., & Tseng, W. (1994). Project management techniques. Wantirna South: Outer

Eastern College of TAFE.

Watson, A. R. (2016). The impact of the Digital Age on Transforming Healthcare. Health

Informatics Healthcare Information Management Systems, 219-233. doi:10.1007/978-

3-319-20765-0_13