Saturday, March 11, 2017

Paper Charting To Electronic Health Record Transition For Nurses And Other Health Care Professionals



Introduction
Healthcare organizations and hospitals have been increasingly working on a data-rich and information technology atmosphere that has not been integrated to ease care. In today’s high-tech era, we are constantly gathering and storing data, only to never use it because it is inaccessible, improperly formatted, or presented in an inappropriate manner. Hospitals with auxiliary offices and other specialty providers that are not in a physical proximity of their main hospitals have not had a unified system for decades. It is often a system that may have multiple charting software systems for every encounter with a provider. As a result, fragmentation of care is the foremost delinquency in patient outcome. As an informatics nurse responsible for the transition to electronic health records, it will be prudent to study the problems and possible solutions.



Problem Implementing Electronic Health Record

The implementation of organization-wide electronic health record (HER) system is a complex matter involving a range of organizational and technical factors including human skills, organizational structure, culture, technical infrastructure, financial resources, and coordination.
The phenomenon of fragmentation of patient information is costing billions of dollars and many lives.  There are multi-factorial reasons responsible for this situation. The first reason is that hospital like organization has multiple objectives such as curing and caring for patients.  They play a role educating physicians, nurses and other allied health care professionals. Second, hospitals have complex and highly varied structures and processes. Third, hospitals have a wide-ranging workforce including medical professionals who possess high levels of expertise, power, and autonomy.(Boonstra, Versluis & Vos, 2014).  

These distinct characteristics justify the complexity of implementing of an electronic health record system. For example, organizations like Baptist Health System in Jacksonville. Baptist health system  have multiple practice domains, pediatrics, adult acute care, mental health care, cancer care, primary care offices and other specialty offices .

Solution

 Every organization needs resources to operate and function effectively in providing their consumers the benefit of their services. Health care organizations in other to meet the expectations and laws of the federal, states and other regulatory agencies they must meet certain requirement established by these numerous agencies. Some of the solutions of integrating electronic health record in a hospital system will discuss below.

Finance

A hospital system must have the financial capability to pay a vendor to build and implement an electronic health record system to meet the needs of their organization. The hospital must be willing to pay vendors with credible reputations with mature products. The vendor should be committed to a long term relationship with the hospital. The hospital should not make the price as the overriding interest in a contract of such. It should pay attention to the quality of the product and service agreements as a core for purchasing a system. The initial price can be costly and cause financial burden in some hospital systems. (Boonstra, Versluis & Vos, 2014).        

Organizational Culture
 The culture of an organizational can influence the success of organizational change as it relates to electronic health records. As a recipe for change a strong culture with a history of collaboration, teamwork, and trust between different stakeholders and groups minimizes resistance to change. It is imperative an organization to have history of collaboration to ease the transition to electronic health records

Organizational Bureaucracy

  Highly bureaucratic organizational structure impedes change: The success of a transition to electronic health record will be daunting and slows. The process often leads to inter-departmental conflict due to layers of managers and a complex administrative structure. It will be necessary to   specifically appoint a multidisciplinary team to deal with EHR-related issues as a sequence conflicts will be prevented and thus stimulate collaboration among departments and other specialties areas. The multidisciplinary group should be empowered to make decisions quickly to avoid the unnecessary delays.  

Clinical staff

 The users of the system must be convinced to be part and parcel of the process of building, testing and implementation. The users’ nurses, physicians and other allied health care professionals should be recognized as the owners instead of customers of the system. Often the users of this very new electronic health record system will be discouraged because the system does not work for everyone as intended. However, the participation of all users  in building  the system will allow room for improvement.  

User-friendly Software

 It is crucial that an electronic health record system should not just be available and reliable; it should also be easy and efficient. It will allow for the functionality required for medical staff to give high quality care. If a system fails to do this, staff will not use the system and will stick to their old ways of working and makes it difficult for the transition to take place

Implication for Nursing and Others

 Electronic health records implication for nursing is fundamental to the success of the care nurses provide to patients. Hospital payment system is tied to the use of electronic heath records. Nurses will have to undergo training for the use of electronic health records via simulations and live training at the job. As a result of electronic health record use, nurses will be able to access evidenced based guidelines at the point of care. Nurses, physicians and other allied health professionals will be satisfied with the care they provide. Additional, data   can be organized in a way where it is easy to received and analyzed. More importantly, so patient outcome will be ideal. Although EHR systems are anticipated as having positive effects on the performance of hospitals, their implementation is a complex undertaking.The early involvement of nursing input and gaining their trust is critical to success.  For nursing to understand the potential capabilities of the new technology to support their work and potential beneļ¬t of delivering safe and effective patient care will be a dream come true for nurses(Kent,Redley,Wickramasinghe,Nguyen, Taylor,Moghimi & Botti,2015) Recognizing and addressing these aspects can increase the likelihood of getting an EHR system successfully implemented.



It is all about the Patient
Image result for electronic health record systems


References

Chang, C. P., Lee, T. T., Liu, C. H., & Mills, M. E. (2016). Nurses’ Experiences of an Initial and Reimplemented Electronic Health Record Use. CIN: Computers, Informatics, Nursing, 34(4), 183-190.
Boonstra, A., Versluis, A., & Vos, J. F. (2014). Implementing electronic health records in hospitals: systematic literature review. BMC Health Services Research, 14(1), 370.

Kent, B., Redley, B., Wickramasinghe, N., Nguyen, L., Taylor, N. J., Moghimi, H., & Botti, M. (2015). Exploring nurses' reactions to a novel technology to support acute health care delivery. Journal Of Clinical Nursing, 24(15/16), 2340-2351. doi:10.1111/jocn.12881