Electronic medical records implementation: organizational change assessment and planning

EMR System Implementation

The healthcare industry is increasingly impacted by advanced in Information Technology (IT). As our abilities to coordinate, interconnect and streamline the transmission of data through IT solutions improve so too do our abilities to provide efficient, safe and effective healthcare decisions for presenting patients. This is the notion that underscores the present discussion regarding Inter-Regional Health Systems, an organization identified specifically for the purposes of this discussion and approaching a proposed IT transformation. Inter-Regional is a multi-site healthcare complex with a wide variety of emergency room, clinic, specialist and outpatient facilities on each site. On the whole, the company has roughly 10,000 employees across its various sites. The private health firm is seeking to improve efficiency as a way of improving its economic performance and considers that it will likely benefit from the implementation of an Electronic Medical Records system. The discussion here evaluates this proposition.

Need for Proposed Change:

First an foremost, we note that the proposed change is made wholly necessary by the outdated and poorly integrated systems that span multiple facilities. It has been more than a decade since inter-regional updates its medical records system. Moreover, as the company has expanded and purchased existing healthcare facilities and complexes, it has taken on an array of mismatched IT systems. At the present juncture, this is producing an impasse where patients moving between different areas of the same healthcare system encounter gaps in records and various resultant bureaucratic errors. According to Draper (2012), "this is not only inefficient for you and for your doctor, but it also increases the risk that you won't get the healthcare that you need because the doctor doesn't have the right information. It can also lead to mistakes and problems with prescription conflicts or allergies." (Draper, p. 1)

This is why the EMR-driven strategy would be ideal for Inter-Regional. With the company's major growth stage now behind it, it is incumbent upon Inter-Regional to improve consistency and workflow through its system. This need is also of particular importance because inconsistency can lead to legal liability and compliance failures. The Microsoft Corporation (2012) finds that an EMR-based "solution can help you create complete records that comply with the Nationwide Health Information Network (NHIN) and regional health information organizations' (RHIOs) requirements, and span multiple organizations." (MC, p. 1)

Influencing Factors:

The key factors influencing the adoption of such a system would be the ease-of-use of this system for its end-users; the capacity of the system for Inter-facility networking; the pricing and costs associated with the adoption of the system; and the technical support offered by the service provider. These features must be considered during implementation with respect to the selected service provider. It is appropriate to consider a number of service providers and to evaluate their respective records of accomplishment where these factors are concerned.

Ease of Use is an important feature because the adaptability of personnel to electronic systems will dictate their effectiveness in making facilities more efficient and better integrated. On this point, a system should be selected which, uses the system processes to which personnel are accustomed and to create an integrated EMR around these existing processes. One such service provider, Medinformatix (2010) describes its approach to this end goal, reporting that "our screens are viewer friendly, the progression in keeping with the natural workflow your staff are accustomed to. The number of click-throughs to key functions are minimized." (Medinformatix, 1)

This underscores a primary influencing factor in how our firm would proceed with implementation. The degree to which personnel are embracive of or resistant to changes will significantly impact the success or failure of implementation. Most particularly, given that nurses working in larger-scaled healthcare service firms such as ours are often already under significant time constraints, distribution of labor pressures and conflicts of morale, it is imperative that any transformation of information systems and processes not impose further or undue burden on said personnel.

Another of the more important features of the adopted system for our organization is its capacity to transmit data between facilities. Because our healthcare firm functions on a partnership between multiple interdependent healthcare facilities, this type of networking capability is a factor of central importance in influencing our decision. On this point, we are inclined to consider the claim made by one of Medinformatix' competitors, OmniMD, which indicates that the integration of its services is "based on HL7 standards integrate these individual systems to communicate with each other and third party external systems. This allows seamless running of applications across processes and departments." (OmniMD, 1) This provides a compelling model for our expansive healthcare system which must choose a system that is not only adaptable and comfortable at the personnel level but which also addresses some of the firm's broader and more complex demands for the streamlining of information.

Naturally, another important factor is price comparison. The selected system must not only be one that conforms with certain cost and resource limitations but must, more importantly, be empirically evaluated relative to the economic opportunities gained by improved efficiency and reduced proclivity for error. In the context of such an equation, our firm must define price points based on the intersection of cost benefits and outlay of initial investment. It is worthy of noting that within the context of EMR implementation, and indeed, in the area of IT implementation altogether, systems are highly tailored to the individual needs of the implementing firm. As such, cost will vary significantly from one firm to the next. It is thus that a bidding process is likely required once the firm has selected a set of service provider candidates most capable of meeting our specialized set of needs. Cost determination will therefore be based upon a wide-ranging and complex set of factors relating both to our firm's needs and the capabilities of the service provider ultimately selected from this process.

Organizational Readiness: