EHR Implementation and Meaningful Use in Community Hospitals
This paper proposes the adoption of a computerized health information management system for a community hospital seeking to achieve meaningful use compliance. It identifies a six-member interdisciplinary project committee, evaluates two real-world systems—PRIMIS and McKesson Hospital Information System—and recommends McKesson's Paragon platform based on its clinical integration, HIPAA compliance, and EHR capabilities. The paper examines how the system meets all three stages of meaningful use, addresses patient privacy and data security, outlines strategies for quality improvement data collection and storage, and discusses cost-reduction benefits through workflow automation. It concludes by emphasizing the essential role of nursing staff in the planning, selection, and implementation of health information technology.
- Introduction: Rationale for integrating IT into hospital care
- Project Committee: Six interdisciplinary roles for EHR implementation
- Real-Life Computerized Management Systems: PRIMIS and McKesson compared for hospital use
- Proposed System and Meaningful Use Benefits: McKesson recommended for integration and HIPAA compliance
- System Features, Patient Care, and Documentation: Paragon platform features and clinical documentation tools
- Data Management, Privacy, and HIPAA Compliance: Data storage, backup, security risk steps, and HIPAA rules
- Nursing Involvement and Cost Reduction: Nurses' role in EHR adoption and cost-saving automation
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What makes this paper effective
- Provides a structured, proposal-style format that moves logically from team formation through system selection to compliance and implementation strategy.
- Grounds recommendations in real-world systems (PRIMIS and McKesson), comparing benefits and drawbacks before justifying the final choice.
- Integrates regulatory context—meaningful use stages, HIPAA Security Rule, and EHR incentive programs—throughout, showing how the chosen system satisfies each requirement.
- Demonstrates interdisciplinary awareness by covering physician, nursing, IT, and administrative perspectives within one unified framework.
Key academic technique demonstrated
The paper uses applied systems analysis: it identifies a problem (lack of compliant electronic management), evaluates existing solutions against measurable criteria (meaningful use stages, HIPAA compliance, cost savings), and produces a justified recommendation. This technique—criterion-based comparative evaluation leading to a reasoned proposal—is central to health informatics and policy writing at the undergraduate level.
Structure breakdown
The paper opens with a brief rationale for health IT adoption, then specifies the project committee and each member's role. Two commercial systems are evaluated, followed by a detailed defense of the recommended system. Subsequent sections address meaningful use stage compliance, clinical documentation features, nursing care quality, data collection and storage strategy, HIPAA compliance steps, cost-reduction mechanisms, and the strategic value of nursing involvement. References follow APA format throughout.
Introduction
In this modern age, the incorporation of information technology (IT) with the health care system is critically important. Given the need for quality care within the industry, there is great significance in many institutions regarding the implementation of electronic health records (EHRs) and information support systems. The use of registries and IT support systems will enable a community hospital to monitor and track patients while improving patient safety and quality of care (Chin & Sakuda, 2012). The advantages of computerized management systems are not limited to reduced bookkeeping and accounts for patients and physicians; they also include continued access to reasonably priced healthcare, enhanced quality of care, prevention of medical errors, reduction in healthcare expenses, improved administrative efficiencies, and greater patient engagement in their own healthcare (Chin & Sakuda, 2012). The following proposal investigates and recommends a new computerized management system that will bring the community hospital into compliance with meaningful use regulation.
Project Committee
The following project committee will be responsible for implementing the new electronic management system and bringing the hospital into compliance with meaningful use legislation. The interdisciplinary team members listed below include their title, position, and role in executing the project, along with the skill sets required for the project to be productive and successful.
1. Electronic System Implementation Manager
The primary role of the implementation manager is ensuring that the project remains dynamic and on track. The project manager is accountable for: (i) monitoring the work strategy to ensure the project stays on schedule; (ii) maintaining a list of vendor and practice issues that need to be resolved; (iii) planning implementation-related events, such as hardware distributions; and (iv) assigning daily tasks to other members of the implementation team. The manager will also be responsible for communicating information and keeping all members informed (Health IT, 2013).
2. Lead Nurse
The lead nurse is a significant member of the team and plays a vital role alongside other nursing staff. Acting as a clinical leader, the lead nurse understands clinical workflows and procedures. In addition, the lead nurse plays a critical role in motivating and encouraging medical staff to embrace the change to electronic equipment, and is responsible for building consensus and consent among nursing personnel (Health IT, 2013).
3. Lead on Information Technology
This team member is responsible for positioning and operating the software and hardware of the management system. The IT lead serves as a bridge between the technology and the individuals using it, understanding the issues and problems they encounter with the functioning and operation of the software and hardware (Health IT, 2013).
4. Physician Leader
It is imperative to note that implementation of the electronic information system may not commence without appointing a physician leader. This member serves as a point of reference between system managers and physicians, clearly articulating the expectations for the electronic information system they will operate. The physician leader is also responsible for ensuring that all other physicians in the healthcare institution are kept up to date on the development and advancement of the system (Health IT, 2013).
5. Electronic System Builder
The electronic system builder is responsible for creating and modifying electronic health record system application areas, including the formation of templates and drop-down menus. This team member will be the most knowledgeable regarding the functioning of the electronic system in all its aspects. In addition, this member will frequently communicate with the electronic and information system management and may participate in training new personnel on how to use the system (Health IT, 2013).
6. Meaningful Use Leader
This member holds sole responsibility for training personnel within the project team and the healthcare institution on how to use the system successfully in order to attain meaningful use (Health IT, 2013).
Real-Life Computerized Management Systems
The following section analyzes two real-life computerized management systems, examining the benefits and drawbacks of each as well as the manner in which they would impact patient care and documentation.
PRIMIS (Patient Relevant Interactive Management Information System)
PRIMIS is an online menu-driven software management information system designed to support different central registry and management functions of hospitals. The system was created by the Hospital Systems Study Group and has been deployed in numerous hospitals in Saskatchewan, Canada (Wig, 1982). Its main advantage is that it facilitates central registry for obtaining and accessing the demographic information of both inpatients and outpatients, and enables proper patient documentation in terms of history and medication. However, a perceived disadvantage of this system is its synchronization issues with other systems, such as the pharmacy system (Wig, 1982).
McKesson Hospital Information System
The McKesson Hospital Information System provides healthcare institutions with a database that supports the electronic operation of health records and increases patient safety. This management information system is beneficial because it integrates the financial, clinical, and physician applications of the hospital and provides solutions to inefficiencies and complexities in hospital operational systems. On the other hand, a downside to this system is that it is quite costly to implement and execute (McKesson Corporation, 2015).
Proposed System and Meaningful Use Benefits
The recommended system between the two is the McKesson Hospital Information System. This system will improve patient care and documentation by facilitating the management and integration of clinical, financial, and operational information across different departments of the community hospital. The hospital will be able to record and maintain patient data electronically, minimizing manual errors and avoiding data loss. Electronic storage also enables data backup, reducing inefficiency within clinical practice. The software vendor has invested substantially in research and development focused on future-centered initiatives to help healthcare institutions use IT more strategically—not only for enhanced business operations but also for improved care and connectivity (McKesson Corporation, 2015).
The recommended system will also ensure the protection of patient privacy. The electronic system introduces security controls so that patient information cannot be accessed without authorization. In addition, the recommended system meets Health Insurance Portability and Accountability Act (HIPAA) requirements (Nass et al., 2009). Because the system incorporates the HIPAA Privacy Rule, its acceptability is high. The restriction of access to authorized personnel only means that patient data is safeguarded from unauthorized parties. It is also imperative to have forms granting authorization from both the patient and authorized personnel, decreasing variability while enhancing informed consent (Nass et al., 2009).
In relation to HIPAA security standards, the system ensures satisfactory data storage integrity, backup, and recovery. McKesson provides hospital information technology and certified EHRs that account for the fluctuating requirements of healthcare organizations (McKesson, 2015). With changes to the healthcare act, the management information system ensures that appropriate security measures are applied to sensitive patient data, including granting patients the right to access their medical and billing records (Nass et al., 2009).
How the McKesson System Will Meet Meaningful Use
Meaningful Use mandates how healthcare providers and clinics should employ certified EHR software to fulfill government-mandated goals that took effect in 2010. These objectives are aimed at improving patient safety, general public health, authorized health information sharing, and patients' access to health information (HMS, 2015).
According to Jeffrey Kao, CIO of McKesson Specialty Health, the company's certified Meaningful Use products help healthcare providers deliver superior care through increased patient involvement, clinical decision support, and care coordination. Kao states that by including the most recent interoperability standards in their next-generation healthcare technology offerings, the company can improve information interchange with other EHR systems that hold or require patient care details—including systems at affiliated hospitals and practices. To support users with first and second stage requirements for digital patient engagement, McKesson leverages the patient portal My Care Plus, which currently provides over 75,000 registered patients with secure online access to their medical records. My Care Plus enables patients to share information with healthcare providers, family members, and caregivers, as well as view lab results, send secure messages to physicians, and access condition- and medication-specific educational resources (McKesson, 2014).
Features of the System and the Three Stages of Meaningful Use
Meaningful use has three stages. Stage 1 criteria emphasize the electronic recording of patient information; providers must fulfill fifteen core objectives and five of ten menu goals. Stage 2 builds on fundamental EHR functionality developed in Stage 1 by promoting objectives for increasingly complex EHR utilization, including electronic patient-provider information exchange and the ability to establish secure messaging services for patients and make health records available online. Stage 3 requires providers to present information with regard to clinical quality measures.
Integration of McKesson's Quippe technology enables ready access to patient management features and clinical decision support. End-to-end Medicomp MEDCIN Engine integration is also available. The system enables care documentation through handwriting, gestures, and various annotation options (McKesson, 2015). These features cover Stage 1 and part of Stage 2 of meaningful use criteria. Built using the most up-to-date interoperability standards, iKnowMed Generation 2 facilitates information sharing across the continuum of patient care—between professionals, ambulatory services, clinics, and other healthcare technology systems—covering Stage 2 interoperability requirements. McKesson's solutions for independent practitioners ensure that healthcare providers spend less time charting and more time on patient care. Bright Note Technology's dynamic processing allows healthcare providers to use their preferred input style for recording patient information in a single note, synchronized immediately across the entire patient chart (McKesson, 2010).
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