Posted: May 21st, 2022

Electronic Health Record

Electronic Health Record: Selecting the Right System and Ensuring Successful Implementation

Introduction

The healthcare sector has been at the forefront of implementing digital technologies to enhance service delivery and improve patient outcomes. Electronic Health Records (EHRs) have become increasingly prevalent as they provide a digital version of patients’ paper records and charts. EHRs contain essential medical information, including medical history, diagnoses, treatment plans, immunization dates, test results, and radiology images, among other data that physicians deem necessary.

Selecting the most efficient EHR system and a reliable vendor is crucial for the entire healthcare provision process, as it determines the accuracy and effectiveness of the technology in achieving healthcare goals. The vendor selection process should be well-prepared and involve planning, goal setting, vendor product comparison, request for proposal (RFP), and contract negotiation stages (Mayers, 2018).

Step 1: Planning

The planning stage involves making a precise decision between the Application Service Provider (ASP) and the locally hosted EHR solution. Licensing agreements are necessary for purchasing locally hosted EHR solutions. ASPs, on the other hand, are cost-effective as they utilize cloud modules hosted via the internet. Step 1 also includes setting achievable goals by identifying the benefits of EHRs. Evaluating the organization’s current objectives helps determine the benefits that can be attained through EHR implementation.

Step 2: Vendor Product Comparison

Creating a matrix for vendor Assessment is highly beneficial as it enables prioritization of the key functionalities of the EHR system. In the vendor product comparison stage, the focus is primarily on evaluating the best-fit and best-of-breed software options. The best-fit software provides an integrated solution as a single product, while the best-of-breed software offers separate software solutions.

Step 3: Request for Proposal

During the proposal request stage, a request for proposal is drafted and sent to identified vendors, prompting them to provide their EHR proposals. This stage enables organizations to gather more detailed information about the vendors’ offerings and assess their compatibility with the organization’s requirements.

Step 4: Contract Negotiation

Vendor selection is finalized in this stage, followed by contract negotiation, where the terms of service are outlined. Organizations may consider changing their EHR vendor due to issues with productivity, poor performance, and interoperability, which can lead to unfavorable outcomes. The Request for Information (RFI) document serves as an initial inquiry to vendors about their services, while the Request for Proposal (RFP) is a more precise document describing the organization’s needs and goals (Fletcher & Payne, 2017).

Data Migration Challenges

Transferring health data between EHR products poses significant risks that can cause substantial harm to a company or organization. Health data is highly sensitive, necessitating optimal data security during the transfer process (Saleem & Herout, 2018). Challenges associated with data migration are often a result of underestimating the system’s performance. The main challenges faced during data migrations are related to the size, complexity, and condition of the data.

The large size and complexity of healthcare data, along with its sensitivity, can make analysis during the transfer process difficult and arduous. In some cases, data may be lost or misplaced during the transfer. Real-time requirements for accessing health records can pose a time challenge, limiting the data migration process. Additionally, there may be difficulties in understanding how the technology works among employees.

Insufficient training in using both the new and old EHR systems makes it difficult to utilize the standard tools required to connect the data repositories and access the stored information (Palojoki et al., 2016). Poor planning can lead to data loss and corruption during migration, compromising the quality of healthcare provided. Interference with patient safety can impact revenue due to the negative effect on provider trust. Inadequate planning may result in poor patient satisfaction and a tarnished facility reputation.

Effective EHR Implementation Process

To ensure an effective transition, it is essential to follow a standardized procedure for implementing EHR systems. Synchronizing all organizational systems, both internal and external, is crucial before initiating the implementation process to create a seamless transition (Merhi, 2015).

Step 1: Pre-Implementation

The pre-implementation stage involves preparing and assessing the organization’s current state to identify the unique needs that the EHR system will address. Decision-makers within the organization then outline the path to be followed during the implementation process. This stage requires goal setting and readiness assessment.

Step 2: Implementation

Once the organization is deemed ready for change, decision-makers initiate the project. Effective project management is essential and involves developing a work plan and a resource plan. Monitoring the change is valuable during this stage, observing staff beliefs and attitudes throughout the implementation process. Understanding the organizational culture during implementation helps identify areas of culture that may be affected by the change. Training, motivation, and effective communication of the human resources play a significant role in a smooth implementation.

Step 3: Post-Implementation

The post-implementation stage involves evaluating whether the organization’s objectives have been met. This includes improved healthcare outcomes, care coordination, data security, transparency, and reduced patient care costs.

Step 4: Monitoring and Feedback

Ensuring the implementation process is functioning as expected is crucial to achieving the organization’s plans and goals. One of the major challenges during the implementation of EHR systems is the lack of efficient technical knowledge among stakeholders regarding system operations (Kruse et al., 2016). Another challenge involves the risk of data loss or damage during implementation due to hacking, which can compromise patient safety and the integrity of the healthcare system.

Conclusion

Effective management of the implementation process is crucial for successfully transitioning to EHR systems. Implementing EHRs requires careful analysis and Assessment to determine their success and effectiveness in achieving organizational goals. Setting goals and conducting readiness assessments guide the organization in planning, identifying resources, budgeting, and timing the implementation process.

Digital health records have become common due to their ability to provide a digital version of patients’ paper records and charts. Selecting the most efficient EHR system and a reliable vendor is essential for achieving accurate and effective healthcare outcomes. Setting goals is crucial in guiding the organization’s planning, identification, budgeting, and timing throughout the implementation process.

References

Fletcher, G. S., & Payne, T. H. (2017). Selection and implementation of an electronic health record. PM&R, 9(5), S4-S12.

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.

Mayers, H. L. (2018). Selecting a HIT/EHR Vendor that can 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

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.

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

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