NUR 514 Benchmark Electronic Health Record Implementation Paper

NUR 514 Benchmark Electronic Health Record Implementation Paper

NUR 514 Benchmark Electronic Health Record Implementation Paper

The utilization of electronic health records (EHRs) is increasingly gaining prominence in the current health care systems around the world. The utilization of EHRs has enormously shaped how health care is provided in various ways. For instance, health care organizations can use the EHRs meaningfully to get the data, organize, scrutinize, and present that data to the clinicians to help them make an informed patient care decision.  Besides, the adoption of EHRs has also led to massive reductions in health care costs. This cost reduction is due to advancement in the effectiveness of the decision making process and healthcare delivery. Moreover, EHRs adoption has improved the delivery of safe, high quality health care that creates positive patient experience and outcomes of the diverse patient populations (King, Patel, Jamoom & Furukawa, 2014). Therefore, it is against the backdrop of the EHRs that this paper seeks to explore the roles of registered nurse in variety of situations associated with the utilization of EHRs.

Database to Track Opportunities for Care Improvement Information

Essentially, apart from the expected function of the health information system which is to enable advanced efficiencies, it should also enable tracking of opportunities in healthcare (Sharfstein, 2015). Consequently, there is need for varied kinds of information to facilitate trailing of health care opportunities. Among the information needed include patient satisfaction. The HER systems ought to ease access to the data on the degree of patient satisfaction with the health care provided. On their side, the patients are also expected to give their opinions regarding the areas of improvement to enable the organization to determine areas to improve on for better services. The patient satisfaction information is crucial because it enables the organization to learn more on how it can improve services to facilitate better services that can realize diverse patient needs.

On the other hand, the information on the patient appointment process is also required on the database. This information should always be made accessible to the target population. The kinds of information that may be contained in the details of the appointment process include the period it takes to get the actual appointment after requesting for an appointment. Besides, the database on patient appointment process should contain information that indicates the efficiency of reminders of the appointment dates including reminders in situations where a patient misses the appointment or when the appointment is canceled. Essentially, such information is vital to assess how the organization responds to its consumers. That is, the organization can implement such information to enhance excellent services for its clients from booking for appointment, the appointments, reminders, and illustrating the rationale for cancelling or missing appointments.

Moreover, the other kind of information required in the database for tracking health care opportunities is the information about quality of treatment that is provided to patients. Ordinarily, the kind of care provided to patients should be effective, quality, and safe. Such kind of care should enhance patient outcomes by ensuring safety, quick response to medication, cost-friendly, and reduces negative impacts. As such, it is imperative for the database to include information regarding prescription, result tracking, and referral tracking to enhance quality of treatment.

Role of Informatics in Capturing the Above Data

Fundamentally, health informatics is vital in capturing the above data by enabling platforms where healthcare providers and patients can exchange crucial health care information to help in advancing the outcomes of healthcare. The health information can also be shared with other interdisciplinary departments, thus, it enables collaboration in delivery of health care services. Through health informatics, it is possible to have shared decision making with patients since patients are also required to be involved in their health care decisions. Moreover, health informatics is crucial in capturing the above data by helping in assessing health care opportunities. On the other side, health informatics also avails opportunities to reduce errors while using gathered data. Operationally, databases are equipped with standard information that are established to guide the construal of every category of data and its repercussion in health healthcare, thus, enhancing the meaningful use of the data collected.

Systems and Staff Needed in the Design and Implementation Process and Team

The selection of system primarily depends on the organizational specific needs. Nonetheless, it is recommended that the system selection should mostly be influenced by need to enhance flexibility and facilitate ease in utilization by clinicians. The system should foster ease of interaction between the patient and the health care provider sans impeding the nature of communication between the patient and the health care provider. Essentially, EHR characterizes one such system. As such, the system identified should be both insightful and easy to learn by the users. Making the system simple to use and easy to learn is vital in ensuring the system effectiveness in providing the required functions.

According to Bullard (2016), the implementation of the health informatics system definitely requires significant input of the health care staff to succeed. Therefore, the necessary staff that would be required to design and implement this system consists of nurses, administrative staff, IT experts, physicians, medical assistants, and system user’s leader. The inputs of these staff are vital in the design process because they inform the features of the system that should be incorporated. Besides, the staff are also required at the implementation stage to help in establishing the system’s usability and ease of use. Further, the personnel are required to collaborate during the entire process from the design to evaluation of the system to realize the success of the project.

Professional, Ethical, and Regulatory Standards that must be Incorporated into Design and Implementation of the System

It is necessary to consider aspects of ethical, professional, and regulatory standards while designing and implementing EHRs (Ben-Assuli, 2015). Regarding the professionalism aspect, the American Nurses Association insists that the information technologies used in health care should ensure both safety and positive outcomes in patients. Besides, the data accuracy and proficiency should also be considered by ensuring that it is collected, stored, scrutinized, and reported appropriately. Similarly, the ethical aspects in the EHRs data should also be considered. The ethical principles encompass several areas such as patient privacy, confidentiality, and security of health data. The other core responsibility of health care providers includes designing, execution, and assessment of system utilization within the health care settings.

On the other hand, it is important to integrate regulatory standards in the EHRs design and implementation. For instance, the system’s implementation team should consider the security standards of the Health Information Technology for Economic and Clinical Health Act (HITECH) and HIPAA (Kiel, Ciamacco & Steines, 2016). HIPAA provides that health care organizations have the obligation to safeguard patients’ health data. Besides, the privacy, security, and confidentiality requirements should be taken into account to foster effective and efficient use of electronic health data. The HITECH Act details stern measures that apply to the requirements under the HIPAA standards. Fundamentally, the Act adds the legal responsibility for failing to comply with HIPAA standards in relation to the use and security of electronic health data.

How EHR Team Will Ensure that All Order Sets Are Part of the New Record

To ensure that all order sets are part of the new record, it is recommended that team tasked with implementing the EHRs should apply the four-step process. The four steps include designing a governance system for the structure of the order set. This step is characterized by creating a governance body that ensures effective communication and decision making for the coordination, customization, and integration of the project. The governance body may include any member of the staff and they are tasked with different responsibilities such as oversight provision, maintaining effective communication with other stakeholders, and determining the use of metrics. The second step is planning and assessing the order set’s maintenance and workflow. This stage is characterized by development of the prospects, objectives, and deadlines of the order sets. Besides, the obtainable order sets are perfected and integrated into the new systems.

The third stage encompasses establishing and effectively utilizing a style guide that ensure reliability. The style guide basically entails the formulation of an approach capable of enhancing the reliability of various aspects such as design, order set sequencing, naming, size threshold, and types of evidence. Essentially, reliability here is crucial because it fosters search, use, retrieval of data, and standardization. Finally, the fourth step is advocating for practices that make order sets more efficient for application in the clinical environment. This stage is mostly focused on staff engagement whereby the employees involved in the utilization of order sets are asked to appraise the system. They may employ the use of different approaches such as meetings to create awareness in the organization. Involving health care professionals is vital because it ensures that the system is effectively adopted in the organization.

How to Communicate Changes in the Plan

The organization can communicate the design and adoption of the EHRs using the official communication mechanisms. These mechanisms may include one-on-one dialogue, posters, emails, and organizing meetings with staff to brief about the progress, requirements, and any changes. These official communication approaches are vital in ensuring that clinicians are made aware of EHRs system requirements, thus, helping in reducing the possibility of resistance by the staff to accept EHRs changes (Sinsky, Beasley, Simmons & Baron, 2014). To ensure success, the communication should be updated and provided in good time to enable the staff to be well versed with it. The management should also ensure that the organization environment is conducive for open and free communication. The employees should be free to provide their perspectives on the design and execution of the proposed EHRs system.

Measures and Steps to Evaluate the Success of EHR Implementation from Staff Setting and Patient’s Perspective

Fundamentally, numerous measures can be used to determine the success of implementation of the EHRs (Yen et al., 2017). The common measures may include incidences of medical errors, the process of adoption, changes in the organizational culture, efficiency in the infrastructure and network, and the level of patient contentment with the system. On the other hand, the steps that can be used in the EHRs evaluation process include adequate preparation, determining the return on investment, examining the data quality and input, monitoring the efficiency of the system, and evaluating the quality of care the EHRs adoption. The profitability of the EHRs system to the patients and the organization can be determined by performing a cost-benefit analysis. Consequently, the efficiency of the EHRs can be assessed by relying on the patient data entirely. Similarly, the quality of healthcare can be gauged through surveys on patient satisfaction. On the other hand, the level of health care providers’ satisfaction and adoption process of the EHRs can be equally determined by the survey. Finally, the scope of error should be established to help in examining the quality of data input. In a nutshell, by looking into these techniques, it is likely to appraise the EHRs implementation.

Leadership Skills and Theories

Undeniably, the EHRs implementation process is intricate and marred with enormous challenges. As such, effective leadership skills are necessary for the success of the implementation process (Aldosari, 2017). On that note, the leadership skills needed in this case include excellent communication skills, effective critical thinking and problem-solving techniques, outstanding technical abilities, and project management. Some aspects of skills such as open communication are crucial because they ensure that stakeholders are kept informed on the progress throughout the implementation process. Creating an environment of open communication also ensures that stakeholders voice their concerns and possibly suggest ways in which the outcomes can be improved.

During this process, critical thinking and problem-solving skills are necessary to effectively manage the diverse team members. Notably, successful EHR design and implementation require staff with diverse expertise, experience, and viewpoints. However, this diversity increases the possibility of contradictions, thus, the need for a people with outstanding experience in problem solving. The team members also need project management skills because the EHR design and implementation often require the establishment and appraisal of different deliverables. The technical skills on the other hand are vital to ease the understanding of the technical terms related to the information technology used in EHR implementation.

Regarding the necessary leadership theories, the transformative leadership and anticipatory leadership theories are appropriate for EHRs implementation and design process. The transformative leadership style is majorly concerned with ensuring that people collaborate to achieve a goal in question. In this context, the leaders have the obligation to lead the employees by motivating, stimulating, and moving them to discover the essence of innovation in performing their roles and responsibilities. On the other hand, the participatory leadership style is appropriate in this context because it is characterized by inspiring stakeholders to play their role in the EHRs implementation project to realize success. The style requires that the leader should empower the implementation team to achieve the desired goals.

Conclusion

It has been established that EHRs are vital in enhancing quality of care and also recognizing different opportunities in the health care system. Through the EHR system, it is possible to identify developments that can be used meaningfully to increase the benefits for the organization. Moreover, the input of teamwork is vital for design and implementation of the EHRs. That is, there is need to integrate views from different stakeholders including nurses, IT experts, and doctors. Most importantly, it is imperative to incorporate effective leadership skills and theories to help in the design and implementation of EHRs.

NUR 514 Benchmark Electronic Health Record Implementation Paper References

Aldosari, B. (2017). Causes of EHR projects stalling or failing: A study of EHR projects in Saudi Arabia. Computers in biology and medicine, 91, 372-381.

Ben-Assuli, O. (2015). Electronic health records, adoption, quality of care, legal and privacy issues and their implementation in emergency departments. Health policy, 119(3), 287-297.

Bullard, K. L. (2016). Cost-effective staffing for an EHR implementation. Nursing Economics, 34(2), 72.

Kiel, J. M., Ciamacco, F. A., & Steines, B. T. (2016). Privacy and data security: HIPAA and HITECH. In Healthcare information management systems (pp. 437-449). Springer, Cham.

King, J., Patel, V., Jamoom, E. W., & Furukawa, M. F. (2014). Clinical benefits of electronic health record use: national findings. Health services research, 49(1pt2), 392-404.

Sharfstein, J. M. (2015). Using health care data to track and improve public health. Jama, 313(20), 2012-2013.

Sinsky, C. A., Beasley, J. W., Simmons, G. E., & Baron, R. J. (2014). Electronic health records: design, implementation, and policy for higher-value primary care. Annals of internal medicine, 160(10), 727-728.

Yen, P. Y., McAlearney, A. S., Sieck, C. J., Hefner, J. L., & Huerta, T. R. (2017). Health information technology (HIT) adaptation: refocusing on the journey to successful HIT implementation. JMIR medical informatics, 5(3), e28.

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS  NUR 514 Benchmark Electronic Health Record Implementation Paper

One of the most effective approaches to improve quality treatment and patient outcomes is through health informatics. When health care practitioners have access to complete and accurate information, patients obtain better medical care. Many studies show that electronic health records (EHRs) can improve disease diagnosis and reduce and eliminate medical errors, resulting in better patient outcomes (Hansen et al., 2019). One of the most important parts of providing excellent care and enhancing patient happiness is implementing an electronic health records system in a health care facility. The advantages of EHRs as a kind of health informatics are numerous. Based on this, the research investigates the role of nurse practitioners in various situations while installing an EHR system in their facilities.

Description:

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.

Also Read: How the role of advanced registered nurse transformed over time

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

1. 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.
2. Describe the role informatics plays in the ability to capture this data.

Role of Informatics in Capturing the Data

In order for the system to be built, the aforementioned data must be collected using informatics. Informatics allows for the collection, organization, and storage of data. An informatics specialist ensures that all healthcare data is properly organized and accessible. When it comes to health information, accessibility is critical. Informatics also deals with data from a variety of sources. Patient care decisions are made using data analysis (Kalsy et al., 2018). Informatics also aids in the standardization of system procedures. Standardization makes a company’s operations run more smoothly and efficiently, with fewer delays and waste. Standardization improves the efficiency of an organization’s processes (Chung et al., 2016; Sharma et al., 2020). As a result, the only way to achieve system effectiveness is to optimize nursing informatics knowledge.

What type of project management strategies and methodologies can be implemented to support informatics initiatives to help improve quality within the clinical practice?
3. 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?

4. 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).
5. Discuss what professional, ethical, and regulatory standards must be incorporated into the design and implementation of the system.
6. 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?
7. Explain what leadership skills and theories would be needed to facilitate collaboration with the interprofessional team and provide evidence-based, patient-centered care?

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.

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.

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 Course Materials 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 practice in the provision of safe, effective health care.

Attachments

Topic 8 DQ 1

Description:

Open and clear communication is critical for the effective functioning of the interprofessional team and the delivery of safe patient care. Discuss the way communication technologies can enhance coordination of care by interprofessional teams. Be sure to discuss a specific communication technology in your response.

“All the work of interprofessional collaborations involves communication. Success or failure of the team is dependent on the effectiveness of the communication processes. Communication is a complex process of transmitting a message between a sender and receiver” (DeNisco, 2021, p. 159). Relationships of all kinds depend heavily on effective communication. Ineffective communication results in misunderstandings, conflict, failure to meet goals and frustrations amongst the participants in the relationship. The complexity of the health care environment increases the importance of quality communication in order to facilitate collaboration amongst all members of the health care team. Effective communication is essential to avoid mistakes of misunderstanding which could lead to patient harm.

Technology has an ever-growing impact on all aspects of health care, including communication. As Rouleau, et al. (2017) point out, communication systems are utilized for a variety of purposes, including management, education, support and counseling, and diagnoses and the sharing of this information between care providers or between providers and their patients. The modalities include email, smart phones, telemedicine, messaging and clinical decision support systems.

One specific example of communication technology new tp my work setting is the use of “secure chat” whereby members of the healthcare team can send text messages to each other through the EHR. This messaging can either be patient-specific, or not. The benefits of this modality include a convenient method of communicating non-urgent information from the bedside nurse to the provider or therapist. For example, the nurse can communicate to the provider that a pediatric patient’s parent has just arrived at the bedside and would like an update when the provider is free.

The ability to communicate via the EHR reduces the need to call the provider and potentially interrupt their current work. This system is also helpful for the provider to communicate to the physical therapist that they would like to be notified when the therapist is working with the patient in order to meet at the bedside and discuss recommendations in person. While this technology has many benefits, it also has some challenges. These include the reality that nurses and providers may not look at the EHR for a period of time and therefore don’t see messages immediately. This reality necessitates the practice that any time-sensitive communication must still be communicated in person of over the phone to assure receipt of the information in the necessary time frame.

Topic 8 DQ 2

Description:

Virtual care and telehealth technologies have the capability to greatly expand access to quality health care. Discuss some benefits and drawbacks of virtual care/telehealth, particularly related to the collaboration and coordination of care and the role of the advanced registered nurse.

Topic 8: Interprofessionalism and Interrelationships in Informatics and Information Systems

Description

Objectives:

1. Analyze the role of the advanced registered nurse in promoting evidence-based practice and leading quality and performance improvement initiatives.
2. Analyze quality standards and performance measures related to the use of informatics for continuous quality improvement in practice settings.
3. Discuss project management strategies and methodologies for implementing health care informatics initiatives that improve quality within clinical practice.

Study Materials

Nursing Informatics and the Foundation of Knowledge

Description:

Read Chapters 16 and 20 in Nursing Informatics and the Foundation of Knowledge.

Health IT

Description:

Explore the HealthIT.gov website.

Artificial Intelligence Research: The Utility and Design of a Relational Database System

Description:

Read “Artificial Intelligence Research: The Utility and Design of a Relational Database System,” by Diling, from
Advances in Radiation Oncology (2020).

Application of Project Management Tools and Techniques to Support Nursing Intervention Research
Description:

Read “Application of Project Management Tools and Techniques to Support Nursing Intervention Research,” by Rew, Cauvin, Cengiz, Pretorius, and Johnson, from Nursing Outlook (2020).

How Data Can Save Lives: Informatics for Health 2017

Description:

Read “How Data Can Save Lives: Informatics for Health 2017,” by Cookson, from BMC Series Blog (2017), located on the BioMed Central website.

Electronic Health Record (EHR) System Testing Plan

Description:

Read “Electronic Health Record (EHR) System Testing Plan,” located on the HealthIT.gov website.

EHR Testing: Specifics and Best Practices

Description:

Read “EHR Testing: Specifics and Best Practices,” by Mikhailau (2019), located on the Health IT Outcomes website.

Health IT Standards

Description:

Read “Health IT Standards,” located on the HealthIT.gov website.

Perspectives of Healthcare Practitioners: An Exploration of Interprofessional Communication Using Electronic Medical Records

Description:

Read “Perspectives of Healthcare Practitioners: An Exploration of Interprofessional Communication Using Electronic Medical Records,” by Bardach, Real, and Bardach, from Journal of Interprofessional Care (2017).

Best Practices for Health Informatician Involvement in Interprofessional Health Care Teams

Description:

Read “Best Practices for Health Informatician Involvement in Interprofessional Health Care Teams,” by Holden, Binkheder, Patel, and Viernes, from Applied Clinical Informatics (2018).

Impact of Information and Communication Technology on Nursing Care: Results of an Overview of Systematic Reviews
Description:

Read “Impact of Information and Communication Technology on Nursing Care: Results of an Overview of Systematic Reviews,” by Rouleau et al., from Journal of Medical Internet Research(2017).

Top 10 Telehealth Benefits and Challenges Concerning Hospitals

Description:

Read “Top 10 Telehealth Benefits and Challenges Concerning Hospitals,” from Delabano (2020), located on the Access website.

Perspectives of Nurses Toward Telehealth Efficacy and Quality of Health Care: Pilot Study

Description:

Read “Perspectives of Nurses Toward Telehealth Efficacy and Quality of Health Care: Pilot Study,” by Bashir and Bastola, from JMIR Medical Informatics (2018).

NUR 514 Benchmark Electronic Health Record Implementation Paper

An electronic health record (EHR) refers to an electronic form of the traditional patient’s medical file kept by the health provider over time. It contains information from administrative and clinical encounters between patients and their health providers during patient care. The EHR also supports other patient care-related activities through interfaces, such as evidence-based decision support, outcomes reporting, and quality management (Schopf et al., 2019). This paper aims to discuss components of designing and implementing the EHR, the professional, ethical, and regulatory standards that should be incorporated, and leadership skills needed for collaboration of the interprofessional teams.

Key Information Needed in the Database to Track Opportunities for Care Improvement

The EHR support providers make better decisions and improve patient care quality. It achieves this by improving the accuracy and clarity of medical information, which reduces the occurrence of medical errors (Schopf et al., 2019). The EHR also makes health data available and easily accessible, reduces duplication of services, reduces treatment delays, and empowers patients to make better health decisions. Patient information is needed in the EHR database to help identify opportunities for patient

improvement. The key patient information includes demographics, current medical problems, past medical and surgical history, medications, vital signs, immunization history, progress notes, laboratory results, and imaging reports (Schopf et al., 2019). The information can predict a patient outcome which helps to provide appropriate interventions to achieve the best possible outcomes (Schopf et al., 2019). It can also identify risk factors for a disease or complications and guide providers to take prior preventive interventions.

Role Informatics Plays in the Ability to Capture This Data

Informatics is concerned with computational systems, particularly those involving data storage and retrieval. Informatics’ role in facilitating data capture in EHR databases includes developing tools with clinical and operational applications that assist health organizations in capturing health information in EHRs to advance medical care (Aguirre et al., 2019). Informatics assists in the organization of patient data collected from a variety of devices and systems, including electronic medical records, patient portals, health tracking devices, and diagnostic systems (Aguirre et al., 2019). Informatics collects data from all of these devices, which is typically in multiple formats, and converts it to a single format that is stored in the database. Database management systems, for example, have programming interface applications that transmit connections between databases and are used to process complex health data across multiple platforms.

The implementation of the EHR will necessitate the handling of a wide range of medical information in a variety of medical settings. As a result, it will be critical to include a variety of systems that will convert information in real-time and on demand. Documentation, billing, and reimbursement systems, as well as E-prescribing and report generation systems, will be required in the EHR. The documentation system will make electronic charting easier and information more organized and accessible to practitioners and patients (Aguirre et al., 2019). The billing and reimbursement system will make it easier to pay for health services and receive reimbursement from insurance companies. The E-prescribing system will aid in the tracking of prescribed medications, the evaluation of medications for allergies, side effects, and interactions, and the ability of clinicians to make quick medication decisions for patients (Aguirre et al., 2019). Furthermore, the report generation system will allow providers to create reports based on specific data such as demographics, medication, and procedures.

The EHR team will be made up of key internal stakeholders as well as external consultants. A project manager, application analyst, application developer, QA Test Engineer, physician, nurse, billing advocate, and super-users will make up the team. The team leader will be the project manager, who will be responsible for keeping the team focused on the project and timelines, as well as dealing with user issues (Aguirre et al., 2019). Data migration and cleansing will be the responsibility of the application analyst, while system customization will be the responsibility of the application developer. The QA Test Engineer is in charge of system testing and performance. Physician, nurse, and billing advocates will represent physicians, nurses, and billing departments, respectively, and will provide training, data, and testing advice (Aguirre et al., 2019). Lastly, the super-users will be the early adopters for the EHR implementation training programs.

Professional, Ethical, and Regulatory Standards That Must Be Incorporated Into the Design and Implementation of the System

Professional standards that must be incorporated in the EHR design and implementation include completing a risk analysis of the system, encrypting electronic health information, and obtaining a HIPAA-compliant business associate agreement. According to Lee (2017), system users must be advised to report when data breaches occur immediately. Ethical standards must be incorporated by ensuring that patient health information is protected, including billing information, claims processing, enrollment status, diagnostic notes, and clinic visit notes (Lee, 2017). Ethical standards that must be incorporated in the implementation include adhering to patient confidentiality laws such as the Directory information rule, Treating physician rule. Social media rule and Business Associate Agreement rule. Regulatory standards must be integrated by complying with the HIPAA and HITECH regulations (Lee, 2017). The design and implementation team will ensure that HIPAA and HITECH regulations are followed during EHR software development, including its design, programming, and distribution.  

Measures and Steps to Evaluate the Success of the EHR Implementation

The success of the EHR implementation will be measured from the staff, setting, and patient perspective, which will help identify improvement areas. To evaluate EHR implementation success from the staff perspective, I will conduct a survey to measure health providers’ satisfaction with the EHR (Aguirre et al., 2019). In the survey, I will ask them to rate how the EHR implementation has eased healthcare delivery, such as access to patient information, evidence-based decisions, and documentation. The EHR’s success in the healthcare setting will be measured by analyzing data error rates to evaluate how the EHR has improved data input and quality (Aguirre et al., 2019). I will also conduct return on investment (ROI) calculations to measure the EHR’s profitability. Furthermore, the EHR’s success will be measured by surveying patients’ satisfaction with the quality of care. I will also measure patients’ wait times to assess if providers can process patients promptly.

Quality improvement in patient care is one of the ways in which healthcare organizations achieve their desired goals and objectives. The improvement in quality of care is achievable using methods such as the utilization of electronic health records (EHR) to optimize on care outcomes. Electronic health records enable health organizations to achieve their desired efficiency, quality and safety in the use of health technologies in patient care. They use it in data collection, organization, analysis, and retrieval for easy decision making on the care needs by the patients. Therefore, the purpose of this paper is to explore the opportunities that exist for tracking care information with the adoption of a new electronic health records system. It also focuses on the roles of informatics in the new system as well as those of the advanced registered nurse in the use of health information systems and the leadership styles and approaches needed to facilitate the success of the process.

Key Information in the Database

            The newly adopted system should enable opportunities for tracking improvements in the organization. The database should therefore contain a number of information that would be used for tracking improvements. One of the information relates to those for tracking patient response to treatment. The database should be able to capture the problems of patients at the time of contact with the provider, the adopted interventions, and assessment of their effectiveness in facilitating health, wellbeing and recovery. The other information is the demographics of the patient. The database should be able to capture the key demographic data that relates to health. The information will be used for tracking trends of health problems in the population. An additional information is progress notes, diagnostic, and laboratory information. The information will be used for evaluating the need for specific interventions and their effectiveness in facilitating the effective management of the health problem. The other type of information relates to indicators of safety and quality in the organization (Hussey & Kennedy, 2021). The database should capture information such as rates of adverse events in the organization to enable the determination of safety and quality of care given to patients in the institution.

Role of Informatics

            Informatics plays a critical role in the ability to capture the above information. Firstly, informatics comprises clinical tools as well as applications that facilitates the capturing of health-related data in the electronic databases. The capture data is important for use in advancing the medical care that patients receive. The informatics applications and tools also organize the data obtained from different sources of care in the organization (Sipes, 2019). It organizes the data into forms such as the electronic medical records and devices for tracking health. The organization of data seeks to ensure efficiency in use in making clinical decisions. Informatics also enables easy retrieval of information by the healthcare providers. Accordingly, healthcare providers have enhanced opportunities to access stored data whenever needed to facilitate decision-making. Besides capturing, storing, and retrieval, informatics has security systems embedded in them to ensure data integrity (Barrett, 2018). The systems have advanced levels of security that eliminates any potential access of the private and confidential data by unauthorized parties.

Systems and Staff Members

            The successful implementation of the new EHR system will require the use of a number of systems as well as the involvement of different staff members. There is a need for systems such as billing, documentation, and reimbursement systems. There is also the need for systems to facilitate e-prescribing, telehealth, and report generation. The reimbursement and billing system will enhance the efficiency of paying for healthcare services and making insurance claims. The e-prescribing will be used to order electronic prescriptions for patients. The documentation system will be used for keeping the health records of the patients. The report generation system will be used in developing summaries of healthcare services given and their effectiveness in delivering the expected institutional outcomes (Hussey & Kennedy, 2021).

            The staff that will be involved in the project will be varied. They will include nurses, physicians, IT officer, system developer, and project manager. Nurses and physicians will be the direct adopters of the new electronic health records system. Their involvement in the implementation entails ensuring that the system is user-friendly and facilitates their needs in the provision of patient care. The IT officer will provide the technical support needed for the efficient use of the new system. The system developer will train the staffs on the use of the new system. The developer will also address any technical issues that may be experienced with the use of the system in patient care. The project manager will oversee the whole process of implementation (Hussey & Kennedy, 2021). The manager will ensure efficient use of resources to achieve optimum outcomes with the newly adopted system.

            The advanced registered nurse will play a number of roles in promoting-evidence based practice and leading quality and performance improvement initiatives within the setting. Firstly, the nurse will ensure the use of evidence-based interventions in the use implementation of the new system. The nurse will use their knowledge and skills gained in nursing informatics to influence the utilization of best interventions in the implementation process. The advanced registered nurse will also act as coach and mentor in the use of the new system (Cowie et al., 2017). They will promote competency development in the users of the new system for the realization of the desired goals in its use in the organization.

Strategies for Implementing the New EHR Proposal

            The successful implementation of the new EHR proposal will require the consideration of a number of strategies. One of them will be communication. The users of the new system will be informed about the intended changes in EHR system. Communication will be achieved through internal memos in the organization. The second strategy will be training. The users will be trained to ensure they are competent in using the new system. Training will also minimize the risk of resistance to change from the users (Hussey & Kennedy, 2021). The implementation process will also be systematic. Accordingly, new order sets related to the system will be introduced gradually for use in the organization, as the old system is replaced. A plan for human resource management during the implementation will also be developed. The plan will guide the use of the allocated resources as well as the evaluation of whether the set goals and objectives of the new system are being achieved (Barrett, 2018). Regular assessments will be done to ensure that continuous quality improvement is achieved in system implementation process.

Professional, Ethical and Regulatory Standards

            Professional, ethical, and regulatory standards should be incorporated into the implementation of the new electronic health records system. The professional regulatory standards that must be considered include undertaking risk analysis of the system as well as acquiring HIPAA compliance certificate. A risk analysis will enable the identification of institutional weaknesses that should be addressed for the efficient use of the new system (Rathert et al., 2019). The organization also has to obtain HIPAA certificate to ensure that its practices align with those of the regulation as well as promoting the safe use of information technologies in healthcare. The institution should abide with the regulatory provisions of HIPAA and HITECH regulations by performing regular assessment of the systems and undertaking the necessary improvements. The institution should also train its providers on a regular basis to ensure the staffs have the needed competencies in ensuring safe use of the new system. Ethical standards must also be adhered to in the adoption of the new system. The institution and its staffs must ensure the protection of data privacy and confidentiality. They ensure the safe use of health information system by eliminating unintended access and use of the patient data. The healthcare providers must also demonstrate their compliance with HITECH and HIPAA regulations in all the processes of the new system use such as assessment, planning, implementation, monitoring, and evaluation (Hussey & Kennedy, 2021).

Evaluating Success

            The success of the new EHR system will be evaluated from staff, setting, and patient perspectives to determine the effectiveness of the system as well as ensure continuous quality improvement. Surveys will be administered to the staffs to obtain information about their experiences with the new system. The surveys will provide information about the success of the new system and the things that should be improved to facilitate its optimum functioning. Questionnaires and surveys will also be administered to the patients. Patients will provide crucial information about their subjective experiences with the care given in the organization. They will provide information related to their perceived safety, quality, and efficiency of care they receive in the organization. The evaluation of the new system from the perspective of the setting will focus on safety and quality metrics of care (Sipes, 2019). It will focus on aspects such as timeliness of care, changes in safety and adverse events, and cost-efficiency and effectiveness of its operations.

Leadership Skills and Theories

            One of the leadership skills that would be needed to facilitate collaboration with the interprofessional team and provide evidence-based, patient-centered care is team building. Team building is needed for effective inter-professional and evidence-based patient-centered care. The healthcare providers should be able to work in teams in assessing, planning, implementing, monitoring, and evaluating the plans of care utilized to address patient needs. The other skill is open communication. Open communication is important to eliminate errors in care, as well as strengthen the effectiveness of the inter-professional interventions utilized to achieve optimum outcomes in patient care (Hassmiller & Pulcini, 2020). The last skill is creativity. The leader should motivate the followers to utilize creative and innovative solutions that are unique to the needs of their patients. Creativity advances the safety, quality, and efficiency of patient care. The leadership theories that may be utilized include transformational, servant, and democratic leadership theories, as they aim at empowering team members take responsibility for the care given to patients (AL-Dossary, 2017).

Conclusion

            The newly adopted EHR system should be able to facilitate the tracking of care improvements in the organization. It should also facilitate the efficient management of care across the different levels in the organization. Professional, ethics, and regulatory standards will influence the adoption of the new system. Healthcare providers and institutions should therefore strive to ensure that ethics and regulations that guide the use of health information systems are considered in the implementation process.

NUR 514 Benchmark Electronic Health Record Implementation Paper References

AL-Dossary, R. N. (2017). Leadership in Nursing. IntechOpen.

Barrett, A. K. (2018). Technological appropriations as workarounds: Integrating electronic health records and adaptive structuration theory research. Information Technology & People, 31(2), 368–387. https://doi.org/10.1108/ITP-01-2016-0023

Cowie, M. R., Blomster, J. I., Curtis, L. H., Duclaux, S., Ford, I., Fritz, F., Goldman, S., Janmohamed, S., Kreuzer, J., Leenay, M., Michel, A., Ong, S., Pell, J. P., Southworth, M. R., Stough, W. G., Thoenes, M., Zannad, F., & Zalewski, A. (2017). Electronic health records to facilitate clinical research. Clinical Research in Cardiology, 106(1), 1–9. https://doi.org/10.1007/s00392-016-1025-6

Hassmiller, S. B., & Pulcini, J. (2020). Advanced Practice Nursing Leadership: A Global Perspective. Springer Nature.

Hussey, P., & Kennedy, M. A. (2021). Introduction to Nursing Informatics. Springer International Publishing.

Rathert, C., Porter, T. H., Mittler, J. N., & Fleig-Palmer, M. (2019). Seven years after Meaningful Use: Physicians’ and nurses’ experiences with electronic health records. Health Care Management Review, 44(1), 30–40. https://doi.org/10.1097/HMR.0000000000000168

Sipes, C. (2019). Application of Nursing Informatics: Competencies, Skills, and Decision-Making. Springer Publishing Company.