Posted: May 21st, 2022

Electronic Health Record

Electronic Health Record
Question 1
The healthcare sector since the digital shift has been at the forefront of implementing the technology in the provision of services for improved outcomes. Electronic health records have become common since they offer a digital version of the patients’ paper files and charts. The EHR records hold the medical history of the patients, their diagnosis, treatment plans, dates of immunization, test results, and radiology images among other necessary data that physicians may find necessary.
Selecting the most efficient EHR system as well as a reliable vendor is very crucial in the entire healthcare provision process since it determines the accuracy and effectiveness of the technology towards achieving the set healthcare goals. The vendor selection process should be prepared in advance and should at least involve planning, goal setting, comparison of vendor products, request for proposal, and contract negotiation (Mayers, 2018).
The first step is planning which involves making a precise decision between the Application Service Provider and the EHR solution which is hosted locally. Licensing agreements are required when purchasing locally hosted EHR solutions. Compared to the locally hosted EHR solutions, ASPs are way cheaper as they consist of cloud modules that are hosted via the internet. The second stage is setting achievable goals through the benefits of EHRs. It is important to review the current goals and objectives of the organization which helps to determine the benefits that will be achieved through the EHR.
A matrix is very useful as it helps to make vendor evaluation hence promoting the prioritization of the key functionalities of the system. The third step is comparison of HER vendor products. The comparison is mainly between best-fit and best-of-breed software. The best-fit software provides an integrated solution as a single product while the other provides separate software solutions. The fourth step is proposal request. At this level, a request for proposal is drafted and sent to identified vendors prompting them for HER proposals.
The fifth step is contract negotiation. Vendor selection is performed at this point and then a final decision is made and then a contract negotiation is performed detailing the terms of service. The most common reason that would make a healthcare organization to change its EHR vendor is its productivity. Poor performance and interoperability would lead to undesirable outcomes hence the need to vet for a new vendor (Fletcher & Payne, 2017). An RFI document refers to a Request for Information from the vendors regarding services provided. RFP refers to a request for a proposal that is normally a follow-up of the RFI and it is more precise and describes organizational needs and goals.
Question 2
Data transfer is always accompanied by a range of risks that could lead to significant damage to the company or organization. Health data is very sensitive which calls for maximum data protection when transferring it from one EHR product to another (Saleem & Herout, 2018). The challenges reflect the difficulties that vendors face as a result of underestimating the performance of the system. The main challenge faced during data migrations is major as a result of the data size, complexity, and its condition.
The large size of data within the healthcare organizations, its complex nature, and its sensitivity may make its evaluation difficult and tiresome and in some cases, data may be lost or misplaces during the transfer process. Secondly, health information may be required in real-time hence creating a challenge of time which limits the data migration process. Thirdly, there may be difficulties when it comes to understanding how technology works among the staff.
Inadequate training among the staff on the use of the EHR systems both the new and the old makes it difficult to make use of the standard tools required to connect the data repositories and the nature of the information that is stored in them (Palojoki et al, 2016). The result of poor planning could include data loss and corruption during the migration hence compromising the quality of healthcare provided. Patient safety when interfered with leads to revenue is affected due to the negative impact on the provider trust. Poor planning may lead to poor patient satisfaction leading to a negative reputation of the facility.
Question 3
For an effective transition, it is necessary to make use of a standard procedure to implement the EHR systems. It is very important to ensure that there is synchrony across the entire organizational systems both internal and external before starting the process which helps to create a smooth transition (Merhi, 2015). The first step is pre-implementation. It involves preparing and assessing the existing state of the healthcare organization to identify the unique needs that the EHR system will be designed to meet. The decision-makers within the organization then point out the path that is to be followed in the process of implementing the systems.
At this stage, there is a need to set goals and to make a readiness analysis. The second step is implementation. After ensuring that the organization is ready for change, the decision-makers move to initiate the project. There is a need for effective project management which is achieved through developing a work plan and a resource plan. Monitoring the change is quite useful at this stage which is done by observing the beliefs and attitudes of the employees during the implementation. It is also important to understand the organizational culture during the implementation which helps to identify elements of the culture that will be affected by the change.
Training, motivation, and effective communication of the human resource at this stage will play a significant role in a smooth implementation. The third step is post implementation. Analysis of whether the objectives of the organization have been met which includes improved healthcare outcomes, improved care coordination and information security, improved transparency, and reduced cost of patient care. The fourth step is monitoring and feedback.
Ensuring that the entire implementation process in order and functioning an expected I very important as it ensures that the organization achieves its plans and goals. The major challenge faced during the implementation of the HER system is the lack of efficient technical knowledge on the side of the stakeholder on how the systems will be operated (Kruse et al., 2016). Another challenge involves the risk of data loss or damage during the implementation through hacking which may compromise the safety of the patient and the integrity of the healthcare system.
Question 4
Project management is very important as it acts as a catalyst for change within an organization. Implementing the EHR systems needs close assessment and evaluation to determine their success and effectiveness towards the achievement of the set goals. In project management, the setting of goals helps to guide the organization in planning, identifying, budgeting, and timing the entire process of the implementation (Sligo et al., 2017). Readiness analysis assesses the current state of the organization in terms of its size, financial capacity, and the human resource available.
As part of managing the implantation process, Effective planning of the data migration process requires both forward-thinking and cooperation among the stakeholders within the healthcare organization which in most cases lacks leading to poor planning. One of the major benefits of the EHRs is that they allow real-time recording hence facilitating timely treatment (Fletcher & Payne, 2017). The records provide evidence-based tools that providers can use when making decisions regarding patient care. The benefits of EHR systems can only be achieved through effective project management.
In general, electronic health records have become common since they offer a digital version of the patients’ paper files and charts. Selecting the most efficient EHR system as well as a reliable vendor is very crucial in the entire healthcare provision process since it determines the accuracy and effectiveness of the technology towards achieving the set healthcare goals. In project management, the setting of goals helps to guide the organization in planning, identifying, budgeting, and timing the entire process of the implementation.

References
Saleem, J. J., & Herout, J. (2018). Transitioning from one Electronic Health Record (EHR) to another: a narrative literature review. In Proceedings of the Human Factors and Ergonomics Society Annual Meeting (Vol. 62, No. 1, pp. 489-493). Sage CA: Los Angeles, CA: SAGE Publications.
Palojoki, S., Pajunen, T., Saranto, K., & Lehtonen, L. (2016). Electronic health record-related safety concerns: a cross-sectional survey of electronic health record users. JMIR medical informatics, 4(2), e13.
Merhi, M. (2015). A process model leading to the successful implementation of electronic health record systems.
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), 252.
Fletcher, G. S., & Payne, T. H. (2017). Selection and implementation of an electronic health record. PM&R, 9(5), S4-S12.
Mayers, H. L. (2018). Selecting a HIT/EHR Vendor that will Meet the Needs of Your Practice. Retrieved from https://www.msms.org/Portals/0/Documents/MSMS/Resources/For_Practices/HIT/HIT_ Selecting_an_EHR_Vendor.pdf
Sligo, J., Gauld, R., Roberts, V., & Villa, L. (2017). A literature review for large-scale health information system project planning, implementation, and evaluation. International journal of medical informatics, 97, 86-97.
Fletcher, G. S., & Payne, T. H. (2017). Selection and implementation of an electronic health record. PM&R, 9(5), S4-S12.

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