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The process of planning and implementing a new electronic health record system in a health unit is a difficult task. Installing the system should be conducted by experts to minimize cases of errors. EHR systems minimize the workflow and increase workers’ productivity in the health unit and the safety of the patient records. The database is a term that can describe the paper records kept by physicians in their line of work. In this case, the term describes a vast collection of computerized records that store patient information.
The HER database stores all information related to the patient’s health collected by the health unit. Some of the information in the database includes patient identifiers to facilitate the full identification of individual patients. Patient identifiers contain information such as the patient’s full name, date of birth, contacts, the name and contacts of the next of kin, emergency contacts, and their information, and insurance information if available (Bruland et al., 2016). The database also contains patient demographic information such as their age, gender, race, and ethnicity. The patient diagnoses, medication, medical procedures like radiology, surgery, laboratory tests, pathology, and vital signs should be part of the information stored in the database.
Electronic health records play a significant role in creating diagnoses, predicting outcomes, including adverse effects, and eligibility of patients for studies and research. Health informatics requires analytic platforms for collecting, examining, and comparing data from multiple sources. Data is collected from clinical, financial, genomic, and administrative systems. Experts find data useful when transformed into information and knowledge (Cuggia & Combes, 2019). The demand for skilled data analysts will create expertise and increase healthcare quality. There is also the need to introduce informatics educational programs covering important elements such as statistics, programming, communication, and domain knowledge. Concepts of analytics and appropriate coursework should be provided to individuals who want to develop their knowledge and skill in analytics.
Implementing a new systemin into the organization will require different people to take on different tasks and responsibilities to meet certain deadlines and budgets. Successful implementation also requires both administrative and financial administrative systems’ participation. The main committee members who participate in system implementation in health institutions include the project manager, application manager who migrates and cleanses data, application developer who customizes the system according to the organization’s preference, the test engineer, and the physician nurse, and nurse advocate. Other individuals involved in the project are the meaningful use managers and the super users.
The nurse advocate of any institution plays a significant role in the implementation process. The nurse advocate supports the process by providing necessary information to the informatics and specialists during the process of developing the system. This information should include the needs of the physicians, nurses, and patients. The nurse will provide the information and their view of the new system’s design to staff and patients. The nurse will also help identify possible barriers to implementation (Thomas et al., 2016). The nurse advocate is also in charge of giving suggestions for quality improvement regarding the new system. An efficient timetable is important during the training process to ensure all caregivers participate in the process without necessarily interfering with the schedule within the health unit. The nurse advocate makes sure to collect feedback from the staff to report any cases that may need corrections, customizations, or additional training.
The first step to implementing a new EHR system in a healthcare facility is to assess the ability and readiness of the unit to adopt the new system. This step involves setting a clear roadmap displaying the available infrastructure, clinical processes, education, and training. The management needs to evaluate the needs and make sure to involve high-level executives to clarify the current state of medical practices, capabilities, and all functions that the EHR will require. Implementing the plan successful requires an efficient steering team. Selecting an implementation team is the next team. The EHR team comprises a project manager, an application analyst and developer, the QA test engineer, a billing advocate, and a nurse advocate.
Step three is to prepare the budget limits and projections. It is important to aim at lowering the cost of the new system. According to the Michigan Center for Effective IT Adoption, the baseline annual budget for an EHR system is about eight thousand dollars. There is also an additional cost of six thousand dollars for implementing, maintenance, and security purposes. The budget should also include projections of costs from upgrading, training fees, cloud migration costs, and consultancy costs. The next step of this process is to prepare the infrastructure for your EHR by incorporating strong security protocol and quick disaster recovery strategies. This step also requires one to assess the hardware requirements and schedule for the implementation.
Once all the infrastructure is ready, the proceeding step is to prepare for data transfer. The key stages of this step involve converting paper records to electronic records, cleansing and verifying data, setting up the EHR database setup, transferring the data to the new system, and testing and verification of legacy data and new data inputs. Step six is to conduct staff training to get them to buy into the new EHR system. It is important to get a highly skilled training team, create a timeline for training sessions, customize the sessions according to the users, and encourage them to follow along for the practical experience. Once the staff is well versed with the system, the next step is to conduct the test and prepare to go live. Strategies like lowering patient volume will help in lowering anxiety. The clients should also receive information and education about the new system. Testing, training, and evaluation processes continue to go even after the system’s launch (Aguirre et al., 2019). This stage represents the last step of the implementation plan. EHR implementation is a continuous process that involves constant optimization and training.
Implementing an EHR system into a health unit can introduce new dangers to patient information. The Privacy Act of 1974 makes sure that all federal agencies provide public notice of their record systems in the federal register. This law also applies to all health informatics. This Act also requires the institutions to provide consent forms to the subjects and processes through which they can access their private information. Important regulations in health include the Institutional Review Board, which protects the welfare, rights, and well-being of individuals and patients who participate in research programs. The Joint Commission on Accreditation of Healthcare Organizations ascertains the worthiness of hospitals and organizations to give Medicare. The federal government regulates the Confidentiality of Alcohol and Drug Abuse Patient Records, which assure patients their privacy and protection in substance abuse treatment programs.
The code of ethics explains that the ethical obligations of health information management (HIM) for professionals should ensure the privacy and security of patient health (Jacquemard et al., 2021). The code of ethics in healthcare aims to promote high standards, identify core values in healthcare, guide decisions and actions of professionals, and provide opportunities for new practitioners to learn from professionals. The core of ethics also provides staff with a framework to resolve conflicts and ethical issues within the profession. Patient information should only be released by the physician and under the authority and permission of the patient concerned. All information shared between the patient and their physician is considered confidential unless the patient is doe not have the capacity to do so because of age, mental status. in this case, either the legal representative or the legal guarding should choose whether to disclose the information.
Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 promotes the adoption of health information technology. The Act is part of the American Recovery and Reinvestment to ensure organizations’ compliance on an institutional level. The Food and Drug Administration Safety and Innovation Act (FDASIA) strengthened the FDA’s ability to access patients their records in a fast and safe way. The Act also improves the safety of drugs, biological products, and medical services. The privacy and protection of patients towards sharing private information relating to the information is governed by the Health Insurance Portability and Accountability Act (HIPAA) (Aguirre et al., 2019). The 21st century Act accelerates the development of medical history. The is law was enacted in 2016 by the federal government to help improve patient access to technological advancements in the health industry.
Health professions play a significant role by demonstrating leadership skills that help provide, facilitate, and promote efficient care to all patients. In addition to this role, their leadership skills are also supposed to project when collaborating with other professionals within the unit. Leaders should learn how to portray knowledge in their position (Forman, 2020). Understanding the overall healthcare system and specific functions is the leading key to delivering outstanding healthcare, meeting financial outcomes, and managing and resolving conflicts within the workplace. Knowledge also plays a significant role when it comes to designing new healthcare systems in the unit. Administrators should also lead by example. This trait helps the leaders demonstrate respect, humility, confidence, and integrity. Leading by example will help create a positive attitude within the workplace and encourage employees to achieve certain goals and objectives of the unit.
The new system should undergo evaluation usually three to four weeks after the go-live date. After implementation, continual evaluations of the EHR will make sure workflow continues to improve to achieve goals and objectives and reap the new system’s benefits. Post-implementation evaluation should ensure that the staff in the health unit are still intact and the workflow is continuing smoothly. All unresolved issues with the vendors, staff training, and the interface are supposed to be complete. The staff can experience problems with the system in their day-to-day work even after implementation. The health unit should encourage the staff to give feedback, suggestions, and their concerns. Hosting regular meetings is one of the best ways to identify the staff is experiencing. Areas, where confusion occurs may require additional retraining sessions. Regular evaluation is important to avoid any failures in the system, which can force the whole unit to revert to using cumbersome paperwork.
References
Aguirre, R. R., Suarez, O., Fuentes, M., & Sanchez-Gonzalez, M. A. (2019). Electronic health record implementation: A review of resources and tools. Cureus. https://doi.org/10.7759/cureus.5649
Bruland, P., McGilchrist, M., Zapletal, E., Acosta, D., Proeve, J., Askin, S., Ganslandt, T., Doods, J., & Dugas, M. (2016). Common data elements for secondary use of electronic health record data for clinical trial execution and serious adverse event reporting. BMC Medical Research Methodology, 16(1). https://doi.org/10.1186/s12874-016-0259-3
Cuggia, M., & Combes, S. (2019). The French health data hub and the German medical informatics initiatives: Two national projects to promote data sharing in healthcare. Yearbook of Medical Informatics, 28(01), 195-202. https://doi.org/10.1055/s-0039-1677917
Forman, D. (2020). Developing and maintaining leadership, resilience, and sustainability in interprofessional collaboration. Sustainability and Interprofessional Collaboration, 3-24. https://doi.org/10.1007/978-3-030-40281-5_1
Jacquemard, T., Doherty, C. P., & Fitzsimons, M. B. (2021). The anatomy of electronic patient record ethics: A framework to guide design, development, implementation, and use. BMC Medical Ethics, 22(1). https://doi.org/10.1186/s12910-021-00574-x
Thomas, T., Seifert, P., & Joyner, J. (2016). Registered nurses leading innovative changes. OJIN: The Online Journal of Issues in Nursing, 21(3). https://doi.org/10.3912/ojin.vol21no03man03
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