Hospital Electronic Media Records Implementation
Completeness and Relevance for Learning Assessment
Apparently, the main objective of the integration of technological applications to solve user needs, such as handling institutional records through the application of information systems, is improvement of efficiency, accuracy and precision (Chaudhry, Wang and Wu, 2006). An EMR within the hospital setting touches on the actual integrity of the medical profession in terms of how health procedures dependent on patient data proceed. It is expected that the information system proposed by the proposed EMR model must pass the fundamental criteria of efficiency, accuracy and precision improvement when compared to the manual system. Alternatively, the implementation plan must fit in the expected standard that takes care of smooth technological integration, institutional organizational compatibility, transition management, flexibility, knowledge, and software solution.
Assessing the status of the application of the EMR at Betsy Johnson Regional Hospital for its relevance in terms of learning outcomes, there are several missing items for a standard model. On one hand, the time used to put together the EMR design is just six months which could implicate the rest of the system implementation. On the other hand, internal expertise was entirely applied in the completion which poses questions on the competitiveness of the final product. It could have taken a better direction if an assessment was conducted to reveal cost benefit analysis position interrogating outsourcing alternatives. In this respect, only EMR software is reported to have involved a vendor from outside the hospital, with unclear role and connection o the set team. Internal design issues however may have prompted the use of internal resources and expertise to the advantage of the institution. Relevance and completeness can therefore be assessed on the generation of resources and competence applied amid successes elsewhere in the generation of the best possible product.
Implementation Weaknesses
Apparently, the most talked about constraint in any information system such as EMR involves financial inadequacy by the implementing institution. Once the funding obstacle is overcome at some level however, the most potent challenge is usually the integration into the existing system as well as the acceptability with which the human resource adopts the new system (Blumenthal and Glaser, 2007). At Betsy Johnson Regional Hospital, the system challenge of implementation and possible resistance of the sudden change is not highlighted. Whereas approval or rejection may not necessarily be a measure of openly aired views as sought by the institution during discussion forums, evidence of a deeper approach to facilitate actual delivery of expected response is not availed. Alternatively, a systematic rolling out of the implementation is usually required in such systems which are apparently not present in the detail of actual implementation.
Generally, phases of implementation assist the management to cater for system failures during the transition and such cautionary element is lacking in the approach taken at Betsy Johnson Regional Hospital. The access of the information on the established EMR potentially seemed risky in terms of unauthorized access where it was alleged that unauthorized access could compromise the privacy of the patients on the database. However, the improvement of the site can be approached from the security of the system, which would dispel any fears of intrusion. The safety of the system is paramount to the performance of the entire EMR adopted and available technologies deal with the issue of intrusion pretty well. It therefore follows that if the final product which the team came up with was not able to cater for the security of private information, it needed an overhaul that would raise the confidence levels.
Inhibition of Assessment
In terms of assessment of the product after the implementation phase was kicked off, there are specific and inherent challenges that Betsy Johnson Regional Hospital must have anticipated. The initial challenge expected in the assessment of the EMR progress touches on the determination of the success of integration during the transition period from the old to the new system that embraces information system. During the interim period, success may not be guaranteed and system failures are generally supposed to be expected. Whereas failure should not be a positive aspect in any project, the anticipation and the responses launched thereon may determine the success of assessment for the entire implementation of the new system (Cusack, McGowan and Poon, 2008). The authors recommend formative assessment which may not necessarily reflect positive results in the interim, rather the process effectiveness.
Inhibition of such a smooth transition in the implementation is largely expected to be in form of the attitude and preparedness that all employees cultivate in case of failures. It is usually advisable to facilitate a program that takes care of such failure such as gradual introduction of the system through phased implementation. Contingency allowance in such a system is equally important in the implementation just as it is in the incorporation of all needs of the EMR. Apparently, the management of the implementation aspect is supposed to be cautiously handled as it can result in a crisis where the old and the new systems are not working at all and the institution is caught up in the mess. It may be important to expect that old system rejection of change particularly with the employees may hinder a smooth implementation. Alternatively, assessment of the implementation may face similar resistance from the old system resulting to false results. To cater for such resistance inhibiting a smooth implementation, staffing reorganization might be implemented (Miller, 2009).
Adapting the EMR (additions, subtractions, emphasis)
According to Miller (2009), the new system proposed for EMR implementation is expected to face some laxity of employee embrace attitude, face challenges of organizational structure and routines as well as slow integration into the system. The EMR product for Betsy Johnson Regional Hospital must be approached on the perspective that takes care of the internal needs of the hospital with special treatment to the missing links for a successful implementation. In the optimization element for design and its implementation, it would have been advisable for the Betsy Johnson Regional Hospital EMR technical team to ensure the addition of; outsourcing of experienced personnel in order to reduce risks of failure, a detailed structure of phases of the implementation program, specific staff reorganization plan to handle risks of rejection and possible failure and distinct reviews for the separate implementation phases.
The assumption that the IT team composing the technical team was competent enough would have been abandoned and a review past experiences with design and implementation of EMR systems used to guide in new project staffing needs. In terms of subtractions to be effected in the implementation of the program at the Betsy Johnson Regional Hospital, the entire implementation program would be wiped off and replaced with one responsive to the proposed additions and implementation program. Emphasis would need to be focused on the expertise in the initial design where the best possible experience in such programs will be sought. To back up the expertise element, it will equally be important for a thorough analysis of the current internal system and base the design and the implementation program on the findings of the analysis.
Roles of Hospital Officials in EMR Implementation
The implementation program must bring on board the top most leadership of the Betsy Johnson Regional Hospital in order to rally behind the best possible response from all the employees.
i) CEO (Chief Executive Officer)
It is the mandate of the CEO to ensure that the management and the entire institution back the proposal to have a new system based on EMR. Whereas this might be more meaningful in the beginning than at any other point in the implementation, constant assurance of the support of all the management levels may favor a successful implementation than when there is no assurance at all. The CEO must at all time follow up the progress of the EMR processing to show the seriousness with which the institution holds the project. Provision of resources to the program is the responsibility of the CEO with the relevant authority in charge of resource allocation.
ii) CIO (Chief Information Officer)
In terms of technical assistance concerning the internal information needs, the CIO must be an integral player in the determination of the progress of implementation. The role of the CIO in the determination of the team composed to handle issues of the EMR is important since technical matters of the task ahead must pass through the office. Constitution of the relevant team and rallying resources needed in the implementation may require the assistance and input of the CIO as the best official understanding the process. Other roles during routine implementation and reviews for the CIO may include; system configuration, access authorization, usage monitoring and advising the institution on the necessary system changes (Miller. 2009).
iii) Nursing Administrator
Integration of the system into the medical aspects of the institutional service delivery must have word and advice of the nursing administrator. Implications on the health of patients upon the reliance on the system must be handled by the nursing administrator.
References
Blumenthal, D. & Glaser, J. (2007). “Information Technology Comes to Medicine,” N Eng J Med, 356:2527-2534
Chaudhry, B., Wang, J. & Wu, S. (2006). “Systematic Review: Impact of health information technology on Quality, Efficiency and Costs of Medical Care,” Annual International Medical Journal, 144: 742-752
Cusack, C., McGOwan, J. & Poon, E. (2008) “Formative Evaluation: A Critical Component in HER Implementation,” American Medical Informatics Association, 15(3):297-301
Miller, L. (2009). Planning and managing an electronic records management programme: Module 2. London, UK: IRMT
