Question

142 Section 3. INFORMATICS, ANALI , CASE 3-25 Failure of an Electronic Health Record System tor decided to pull the Magnolia Hills Hospital implemented an EHR about six months ago. Your administrator decided to plug on the project a week ago because of all the problems that the facility was experiencing. Phye refused to use the system. They made the nurses print out everything so they could review the patients heal records. The physicians would write orders on a piece of paper and ask the nurses to enter them into the order entry system. The few physicians who did try to use the system properly were still having problems. The system was down at least two hours a day and four to five hours for many days. When the HIM department printed out reports to satisfy ROI requests, what they received was more like screen prints than forms. This system was the brainchild of Dr. Anderson. He is a retired transplant surgeon whose name is on the new transplant center building. He and a small group of his cronies were the ones who picked and controlled the implementation of the system. There was no input from anyone else other than the information technology (IT) staff. The screens are cluttered and difficult to use and do not have data quality built in. The system does not meet condition of participation, state licensing, and privacy requirements The HIM director, physicians, nurses, and other staff learned about the system only three weeks before its implementation. The HIM director was so angry at being left out of the loop that the director took early retirement and left with only two days' notice. Physicians' training on the new system consisted of a demonstration of the system at the quarterly medical staff meeting. Nursing and other staff were given only one hour of training. Since the implementation of the system, there has been turnover in the hospital admin istrator position and a new HIM director has been hired. 1. Identify the failures of the EHR implementation 2. Identify what should be done to prepare the staff for the EHR implementation

Answer 1

1)Failures of E H R implementation

• Improper Goals

Improper setting and understanding of goals leads to failure of E H R implementation.

• Lack of training

Lack of training is another important reason for the E H R failure.Hospitals should give proper training in advance even before the system goes live.Identify the one who require more training and make provisions for the same.

• User Dissatisfaction

One of the failures in E H R implementation is user dissatisfaction which can reduce the productivity.A study conducted by Physician's Alliance of America resulted in the feeling of half of all E H R users as less productive.

• Financial Failures.

In the selection and planning phase,if proper accounting for the costs and benefits of an E H R is failed,it can lead to significant financial issues.It can also happen if the costs were more than expected.

• Negative impact on clinical staff

Lower job satisfaction,workflow disruption and negative feeling among the towards E H R can lead to its failure.

• Matters of security

Inadequate security protocols can give rise to large financial losses and decline in consumer trust.

2)PREPARATION OF STAFF FOR E H R IMPLEMENTATION

• Understand training needs

​​​​​​​Some of the staff might have lack of literacy in general computer.So assess their computer skills and provide basic computer training.Then they will be able to work with E H R.Training also must be provided according to the varying levels of functionality with the system depending on the job roles.

• Optimistic outlook

Help the staff to develop a positive attitude towards the change so that they will be more engaged in their work.

• Plan for a Post implementation feedback

​​​​​​​Evaluation should be an ongoing process to keep staff up-to-date,proficient and competent in handling their assigned job.