Implementing Electronic Health Records Essay

Implementing Electronic Health Records Essay

Implementing Electronic Health Records

Patient outcomes depend on the approaches that health care providers apply in health care delivery. In the past decade, massive developments have occurred in the health practice to ensure patients receive care that addresses their needs comprehensively. Integration of scientific and technological evolutions and evidence-based interventions have been common. As these advancements occur, the role of informatics in health care delivery has advanced as technology use increases. It has been instrumental in improving care quality, and more progress is expected over time. The purpose of this paper is to discuss the various considerations and requirements necessary in implementing a new electronic health record (EHR) system.

Information in the Database

Health care providers always look forward to optimizing health outcomes. As a result, they should continually examine opportunities for tracking care improvement and use innovative interventions to achieve better results. A suitable example of an opportunity that would require a database is reducing diagnosis and treatment time by ensuring real-time, accurate data and collaborative practices. To achieve this goal, health care providers need adequate and readily available data. Kruse et al. (2018) found that data use is maximized by adopting advanced EHR systems that use up-to-date software and other vital components. EPIC EHRs exemplify such systems, but it is crucial to adopt new systems to enhance efficiency.

Key information in a database varies depending on the intended use of the data. Since the goal is to track and improve care, the primary data should be patient-related. The first set of key data is patient waiting time. Waiting time affects treatment outcomes since longer waiting times increase the chances of health complications (Paling et al., 2020). The second set of key data is the time lapse from entry into the emergency department to when the patient is released or referred to a different unit. The data would be further segmented according to patients’ gender, health conditions, and age, among other factors.

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Role of Informatics in Capturing Data and Project Management Strategies

The role of informatics in data capturing, transmission, and storage has increased as the health practice continues to be data-driven. In capturing data, informatics helps capture data in real-time (Cato et al., 2020). In this case, it enhances data accuracy, improving decision-making accuracy. Informatics is also instrumental in capturing data in multiple formats. It can be captured orally, through images, or electronically fed into the EHR systems by data personnel. Some details can also be captured biometrically in advanced systems. Informatics also enables health care providers to capture all data.

Several project management strategies and methodologies can be implemented to support informatics initiatives to improve quality within the clinical practice. The first strategy is planning. There should be an elaborate plan of how informatics should be integrated into practice. Planning also involves outlining how to move from old to new processes through EHRs. The second strategy is specifying the scope. There should be limits regarding how data should be used to avoid professional and ethical risks. Other strategies include excellent design and phased implementation. The design of health information technologies should be top-notch, and implementation should be systematic. Project management also involves setting measurable objectives. The same strategy can be applied when implementing informatics activities to guide change if a goal is not achieved by the expected date.

Design and Implementation: Systems, Staff Members, and the Role of ARN

Implementing an EHR system with new features requires in-depth analysis and involving the right staff. An information management system (IMS) would be the most important to consider when designing and implementing the EHR system. IMS primarily involves software to facilitate information organization and retrieval in processes involving data. Such systems would also be required to develop a user-friendly and interoperable system. Staff members to be involved depend on the scope of the system. The nursing staff in the ED using the current EPIC system should be involved to provide experiences and the features they would like incorporated in a new EHR system. Data management specialists, data analysts, and the head of the information technology (IT) department should be involved in the design and implementation process.

System changes succeed in cultures that embrace change. The advanced registered nurse (ARN) role is essential in change promotion by promoting evidence-based practice (EBP) and leading quality and performance improvement initiatives. The ARN’s role in this setting includes collaborating with the other staff to identify practice gaps and initiate practical interventions. The ARN also plays a critical role in supporting evidence-based projects that address performance gaps in the setting. For instance, innovations to reduce waiting time and increase efficiency are critically needed in the ED. The ARN should be centrally involved in change adoption and quality improvement processes.

Strategies for Implementing the New EHR Proposal

System changes are highly challenging since they usually cause significant disruptions. As a result, it is crucial to make the necessary transformation systematically while ensuring that everything regarding change is clear and all stakeholders are involved. One of the key strategies for successful implementation is communication. Nurses and other relevant stakeholders must be informed about the new system to prepare them for the transition. Stone et al. (2020) found communication highly effective in reducing resistance to change since it helps to address fears and concerns regarding the change. Communication methods should be selected depending on the stakeholders’ characteristics.

After communication, it is crucial to ensure that the nursing staff understands the essentials of the new EHR proposal. Such essentials include the rationale, change in work dynamics, and possible risks. A system-wide or setting-based presentation can be achieved to achieve this goal. Besides a presentation, nurses should also be trained on how to use the new EHR system. The next step involves transitioning to the new EHR. Here, the old model would be discarded, and the new model adopted to ensure that patients are served better and highly satisfied. Progressive evaluation is also necessary to determine areas that require further improvement. Sustenance strategies should also be devised, such as regular staff training to ensure they can use the system proficiently.

Professional, Ethical, and Regulatory Standards

The design and implementation of a system determine its features and how it will be used. Regarding professional standards, interoperability must be prioritized. Li et al. (2021) defined interoperability of EHRs as their ability to facilitate electronic sharing of patient information between health care providers. It is among the primary consideration when adopting health care technologies since it improves the ease with which nurses and other health care professionals provide care. The other crucial standard is user-friendliness. The best way to accomplish this goal is to ensure that the EHR has a basic design and does not have many complicated functionalities.

Ethical and regulatory standards are somewhat related. A leading ethical standard is the system’s security to ensure that private patient information is not accessible to unauthorized users (Chen et al., 2021). It helps to observe the confidentiality principle of health care ethics. Security is also a regulatory standard since protected patient information must be kept securely as much as possible. Therefore, the design must ensure that the EHR system is secure and can be upgraded as situations necessitate. The other crucial regulatory standard is meaningful use. Stage 1 of meaningful use involves data capture and sharing (Lite et al., 2020). It should also be prioritized to ensure that health care providers can share patient data quickly to reduce the time spent during critical processes such as diagnosis and treatment.

Evaluating the Success of the EHR Implementation

Adopting new processes in health care seeks to introduce beneficial change. Technology-based changes consume massive resources and time; hence, they should achieve the desired outcomes. Evaluation helps determine whether the set objectives were achieved and identify inefficiencies requiring corrective actions. From a staff dimension, nurses using the new EHR system should work more efficiently, accurately, and confidently. Data capturing, analysis, and sharing should be quicker since the system should be more interoperable and user-friendly. Nurses should also access the data when needed and securely.

Evaluation from a setting dimension focuses on the differences in outcomes linked to the newsystem. Efficient systems that promote data-driven care and interprofessional collaboration help nurses to serve patients better. High patient satisfaction improves an organizational reputation. Efficient systems also facilitate cost-effective care, saving massive organizational resources. Overall, there should be a qualitative or quantitative change in outcomes. Data can be compared and processes observed to determine the success of the EHR implementation.

Leadership Skills and Theories

Successful transition from old to new practice models requires health care professionals to work collaboratively towards a shared goal. In this case, the interprofessional team involved in facilitating change to provide evidence-based, patient-centered care must be highly inspired, understand its purpose, and remain united. One of the leadership skills needed to foster collaboration is open communication. When leading teams, open communication encourages team members to share their thoughts without intimidation or fear of repercussions (Prentice et al., 2020). It is a leadership skill for building trust and keeping the team together to work or address issues. Engagement is also crucial to ensure that every team member feels valued and respected. Regarding leadership theories, change requires a lot of drive and motivation. As a result, the transformational leadership theory would be the most appropriate. Its central tenet is envisioning the desired outcome and inspiring team members to achieve the vision (Seliemo et al., 2020). It is among the leading theories for transforming organizations via positive cultural change.

Conclusion

Informatics is among the highly advancing health care fields. As its use intensifies, health care providers should adopt it for beneficial use. Shifting to new EHRs to enhance patient safety and other critical outcomes typifies the beneficial use of informatics. As discussed in this paper, the entire process starts with identifying opportunities that require technological or scientific intervention. Such opportunities also enable data tracking to improve patient outcomes, such as reducing waiting time in the ED. Interprofessional collaboration and inspirational leadership are vital to facilitate a smooth transition.

References

Cato, K. D., McGrow, K., & Rossetti, S. C. (2020).Transforming clinical data into wisdom. Nursing Management, 51(11), 24-30. https://doi.org/10.1097/01.NUMA.0000719396.83518.d6

Chen, Y. W., Tanaka, S., Howlett, R., & Jain, L. (2021). Innovation in medicine and healthcare.Springer Singapore.

Keshta, I., &Odeh, A. (2021). Security and privacy of electronic health records: Concerns and challenges. Egyptian Informatics Journal, 22(2), 177-183. https://doi.org/10.1016/j.eij.2020.07.003

Kruse, C. S., Stein, A., Thomas, H., &Kaur, H. (2018). The use of electronic health records to support population health: a systematic review of the literature. Journal of Medical Systems, 42(11), 1-16. https://doi.org/10.1007/s10916-018-1075-6

Li, E., Clarke, J., Neves, A. L., Ashrafian, H., &Darzi, A. (2021). Electronic health records, interoperability and patient safety in health systems of high-income countries: A systematic review protocol. BMJ Open, 11(7), e044941. http://dx.doi.org/10.1136/bmjopen-2020-044941

Lite, S., Gordon, W. J., & Stern, A. D. (2020).Association of the meaningful use electronic health record incentive program with health information technology venture capital funding. JAMA Network Open, 3(3), e201402-e201402. https://doi.org/10.1001/jamanetworkopen.2020.1402

Paling, S., Lambert, J., Clouting, J., González-Esquerré, J., &Auterson, T. (2020). Waiting times in emergency departments: Exploring the factors associated with longer patient waits for emergency care in England using routinely collected daily data. Emergency Medicine Journal, 37(12), 781-786. http://dx.doi.org/10.1136/emermed-2019-208849

Prentice, J. C., Bell, S. K., Thomas, E. J., Schneider, E. C., Weingart, S. N., Weissman, J. S., & Schlesinger, M. J. (2020).Association of open communication and the emotional and behavioural impact of medical error on patients and families: state-wide cross-sectional survey. BMJ Quality & Safety, 29(11), 883-894. https://doi.org/10.1136/bmjqs-2019-010367

Seljemo, C., Viksveen, P., &Ree, E. (2020). The role of transformational leadership, job demands and job resources for patient safety culture in Norwegian nursing homes: a cross-sectional study. BMC Health Services Research, 20(1), 1-8. https://doi.org/10.1186/s12913-020-05671-y

Stone, R. J., Cox, A., & Gavin, M. (2020). Human resource management.John Wiley & Sons.

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One way informatics can be especially valuable is in capturing data to inspire improvements and quality change in practice. The Agency for Healthcare Research and Quality (AHRQ) collects data related to adverse events and safety concerns. If you are working within a practice setting to implement a new electronic health record (EHR) system, this is just one of the many considerations your team would need to plan for during the rollout process.

In a paper of 1,500-1,750 words, discuss the following:

Consider an opportunity for tracking care improvement. What key information would be needed in the database? Example: Time lapse from medication order documented in the EHR to delivery of medication to the patient for the cardiology service.
Describe the role informatics plays in the ability to capture this data. What type of project management strategies and methodologies can be implemented to support informatics initiatives to help improve quality within the clinical practice?
Discuss which systems and staff members would need to be involved in the design and implementation process. What is the role of the advanced registered nurse in promoting evidence-based practice and leading quality and performance improvement initiatives within this setting?
Outline strategies for implementing the new EHR proposal. Consider communication changes, transitioning to the new EHR, and managing resources (human, fiscal, and health care resources).
Discuss what professional, ethical, and regulatory standards must be incorporated into the design and implementation of the system.
Describe the measures and steps you would take to evaluate the success of the EHR implementation from a staff, setting, and patient perspective to measure effectiveness and ensure continuous quality improvement in practice?
Explain what leadership skills and theories would be needed to facilitate collaboration with the interprofessional team and provide evidence-based, patient-centered care?
You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing

2.3: Develop leadership skills to collaborate on interprofessional teams in the provision of evidence-based, patient-centered care.

5.2: Apply professional, ethical, and regulatory standards of p