Question

Implementing an Electronic Health Record (EHR) system in a hospital is a process that requires many stages. Explain the different stages that need to be followed for successful implementation of the EHR.

500 -1000 word

Answer 1

Implementing an electronic health record in (EHR) is a multi-step process that will in impact all staff members. As with any new process, a learning curve is involved. Having a solid plan can save hours of stress for everyone on on the team.

10 steps to successful electronic health record implementation

1.build your Electronic Health Record (EHR)implementation team.

As you implement your EHR you will need a strong team to help the process go as smoothly as possible .The team can include staff members such as physicians, nurses ,medical assistants and administrative staff. Team members will assist the process by teaching colleagues EHR skills and serving as messengers to the implementation team to identify challenges along the way. A lead super user,lead physician and project manager at three essential roles to consider while building your team.

Lead super user

The lead super user is the resident in house EHR expert .A few duties may include template creation and developing work flows. This position may also be responsible for creating standard operating procedures to address problems users come across as they use the system.

Lead physician

The late physician's role is to guide the organisation through EHR implementation by serving as a link between the front line users of the system and the technical staff consider utilizing a tech- savvy physician who welcomes the new process as the lead physician.

Project manager

The project manager will become the main point of contact with the EHR vendor and staff .This position will also help everyone keep focused on implementation timelines,track progress and deal with user issues.

2. Prepare the software

When implementing your EHR ensure security measures are met to not violate HIPPA. Your organisation may need to conduct a HIPPA risk assessment .You can work with your health IT vendor to make sure the software is compliant.

3. Determine your hardware needs

Your hardware choices will have a significant impact on the time and money your practice uses .For example having a printer in every room can save physicians up to 30 minutes a day. Some practices provide each staff member with their on tablet or laptop to save time logging in and out between each patient interaction .If the idea of doing all this seems overwhelming ,IT service companies can help practices with system hardware needs by helping find the correct equipment at the best price .Many companies will also install and troubleshoot the devices ,taking the burden of your office staff.

4. Consider the patient treatment room layout

As the EHR program requires electronic data entry, the room layout can have a substantial impact on patient engagement and satisfaction. If the Staff and physician face away from the patient while entering data ,patients may feel like they are not being heard. One way to solve this is by using the "triangle of Trust".This is a room configuration where the patient, physician, and computer form a virtual triangle ,allowing the patient and physician to see each other .This layout helps because the staff member or physician only has to turn slightly while entering data ,were helping the patient feel they are being seen. Consider placing semi circular shaped desk in a patient room or use moveable carts to help the patient feel at ease during their appointment .

5. Transfer data

Once your hardware and software are ready to go,the next step in EHR implementation is to transfer the data. To begin you will need to determine how to migrate data from your former record system to your new EHR .There are a couple ways to do this step. You can assign existing staff ,or hire additional or temporary staff to upload information into the new EHR. To take this process as smooth as possible, you will want to prepare a checklist of information to be entered into the EHR. Having a process in place will help ensure no critical information is missed.

6.Create workflows

Speaking of process, now is the time to get solid workflows in place.It is vital to establish workflows prior to EHR implementation to decrease the amount of stress your team will face. Having inefficient workflows including at an insufficient number of staff members who are trained and ready to use the EHR will exacerbate issues during the implementation process.

Consider these questions ask to create workflows

*Is this necessary?

*Does this add value for the patient?

*Does this Increase efficiency for the staff?

*Is this the right order?

*Is the right person doing this step?

7. What to do when your EHR is down

As with any type of technology you must be prepared for the occasional glitch. Start by brainstorming issues and come up with a Solid game plan for how to handle potential problems .For example what will you do when the power goes out? what if there is a system wide malfunction that requires the help of IT to fix? you will want to develop procedures that give clear instruction to physicians and staff on what to do when the EHR is unavailable.Having electronic and paper procedures available to Staff will increase their confidence on how to handle any EHR downtime. Some medical practices compile the instructions in three ring binders and store copies is both in-house and offsite. Also consider store in PDF copies on a secure cloud ,so staff members have multiple options to get the instructions quickly

8 . Have a training program in place

Extensive training is imperative to ensure success with EHR implementation. create a training plan so that all physicians and staff, current and future can gain the knowledge and skills to use the EHR successfully when you are ready to launch.

Here are a few principles to consider:

start slow

provide physician and staff with basic skills before launching. It can be difficult for users to fully understand the system until they are able to use the program. once users are able to drive for at least a week,additional training can be introduced to increase skills ,learn time saving tricks and get more comfortable with the technology.

let colleague teach colleagues

consider training super users in each speciality and for each role. for example , nurses teach best and surgeons teach surgeons best. Besides if you have a Superuser in each speciality, they can become an ongoing resource for their colleague.

map out ongoing training needs

Have a plan for ongoing training. As time passes users will find shortcuts and new ways to use the tools and will want to share these findings with their colleagues.In addition the EHR will need to be updated with a new and improved functionality that will require extra training.

9. Decide on launch approach-" Big Bang" or incremental?

Once your EHR implementation plan is ready to go, it's time to decide how to launch .There are typically two ways to do this ,all at once the Big bang or slowly in an incremental approach.

Some practices used the big bang approach and role out the EHR system for all patients and functions on the same day. These approaches minimize time spent managing paper records as well as the new EHR system at the same time. This disadvantages is it can be very disruptive and small problems can seem monumental.

Some practices take a slower approach and implement the EHR incrementally .By introducing EHR functions one at a time such as e-prescribing to begin and then introducing other features later. some practices and the disruption easier to manage. Larger practices and Organisation may implement slowly by Rolling out the EHR in specific sites or departments first and introducing the program to the rest of the organisation later.

10. Gather feedback for continual improvement.

Now that you have successfully implemented the EHR, be sure to gather feedback from the users to continually improve the process .Be sure to keep the lines of communication open so staff members and physician feel comfortable providing feedback. if everyone works together,the EHR system will be an improvement to the practice.

Implementing an EHR is a multistep process that requires advanced planning .Use this step to help make the transition as smooth as possible.