Question

Failure of an Electronic Health Record (EHR) System

Quinbery General Hospital implemented an EHR about a year ago. The administrator decided to pull the plug on the project a week ago because of all the problems that they were experiencing. Dr. Monday and Dr. Morgan have refused to use the system. They made Nurse Thompson print out everything so they could review patient s medical records. They would write orders on a piece of paper and ask the nurse to enter it into the order entry system. The system was down at least 2 hours every day. Many days the system was down for 4-5 hours. When the HIM Department printed out reports to satisfy release of information requests, what she received was more like screen prints than forms.

This EHR system was the brain child of Dr. Wilkins. 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, are difficult to use, and do not have data quality built in. The system does not meet the Condition of Participation, state licensing, or HIPAA requirements.

The HIM Director, the physicians, nursing, and other staff learned about the system 3 weeks before implementation. The HIM Director was so angry at being left out of the loop that she took early retirement and left with only 2 days notice. Physician s training was a demonstration at the quarterly medical staff meeting. Nursing and other staff were given 1 hour of training, which they learned only 3 weeks prior to implementation when the new system was announced at a department meeting. Since the implementation of the system, there has been a turnover in the hospital s administrator position and a new HIM Director has been hired.

Critical Thinking Questions:

1. Communications: Define the problem in your own words.

2. Analysis: Compare and contrast the available solutions within this case study.

3. Problem Solving: Select one of the available solutions and defend it as your chosen solution.

4. Evaluation: Identify the weaknesses of your chosen solution.

5. Synthesis: Suggest ways to improve/strengthen your chosen solution.

6. Reflection: Reflect on your own thought process after completing the assignment.

Answer 1

1.The problem here is the lack of proper implementation,training and usage of the most advanced technology of healthcare system "Electronic Health Record" Apart from this the lack of interest of physician to use it,extremely slow system,no training or a mock program has lead to the failure of the EHR system.

2.Some of the solution available are

• Resolving the problem with the system (rectifying and improving the speed of the system)
• Training the staff regularly and clarifying all their doubts.
• Encouraging the physician to use ot by telling its benefits and guide others
• Periodic evaluations and rectifying the faults
• Having a mock program

3.One of the best solution is to train the staffs in regards to its usage and importance because this can dramatically improve the quality of care by reducing medical error,prompt and non delayed treatment, etc.,

4.The main weakness of this solution is "time ".It can be time consuming to teach the staff during their working hours or working days,it can even make the job more stressful to learn new things and take responsibility to implement it in a limited time ,extra effort has to be done to train the staff,an expert is needed to train the staff.

5.Some of the nest way to improve or strengthen the solution are

• Encouraging the physician cam bring the over all change ,so that they can be a role model in the clinical set up
• A pn expert who can be appointed to train the staff during their working hours along with them to reduce the stress and errors
• Weekly once or twice training as continuing nursing or medical education program in the hospital

6.This assignment can make one know the real necessity of the electronic health records in the healthcare system to provide a quality care.