The rapid growth of information technology (IT), combined with provisions of the American Recovery and Reinvestment Act (ARRA) of 2009, have led to a paradigm shift in healthcare documentation and recordkeeping, resulting in widespread implementation of healthcare information technology (HIT). Successful integration of HIT requires an artful blend of traditional project management techniques with the distinctive theories of change and IT administration (Coplan & Masuda, 2011). As a future leader in the field of nursing informatics, it is inevitable that I will be taking an active role in managing HIT projects. In this paper, I describe my personal insights into the unique process of technological change implementation in the healthcare industry.
Scholarly Resources
Much can be learned from the experience of others; and, for that reason, I elected to review the implementation practices of three healthcare organizations. In 2006, Jefferson University Physicians (JUP) began the adoption of the Physician Quality Reporting System (PQRS), a pay-for-performance (P4P) initiative offered by the Centers for Medicare & Medicaid Services (CMS) (Berman et al., 2013). Since this project was one of the early attempts at integrating HIT, their analysis of the process provides an excellent example of traditional project management techniques. Similarly, the Minnesota Hospital Association (MHA) took part in a pilot project in 2007 to evaluate the benefits of creating a hybrid database of clinical and administrative data (Pine et al., 2012). However, this project involved an in-depth analysis of interoperability and, thereby, describes various IT management approaches. Lastly, the electronic health record (EHR) implementation process of Glide Health Services (GHS), a nurse-managed health center (NMHC), was selected to depict the value of including change management practices (Dennehy et al., 2011).
Considerations for Managing HIT Projects
Although the text of the Project Management Institute (PMI, 2013) purports itself to be a guide, and not “applied uniformly to all projects” (p. 2); I find that the traditional methods described are incompatible with the capriciousness and cultural complexities associated with HIT projects. Coplan and Masuda (2011) suggest the incorporation of change and IT management practices to facilitate projects the unpredictable world of healthcare. In addition, I assert, and will illustrate in the following sections that the careful consideration of what I refer to as the 3Cs (communication, collaboration, and compassion) further enables the fluid completion of HIT projects.
Communication
It is undeniable that effective communication is a prerequisite for the successful completion of any project.
Jha, A. K., Burke, M. F., DesRoches, C., Joshi M. S., Kralovec P. D., Campbell E. G., & Buntin M. B. (2011). Progress Toward Meaningful Use: Hospitals’ Adoption of Electronic Health Records. The American Journal of Managed Care, 17, 117-123
Though the benefits of IT are numerous, successful adoption into healthcare has been difficult. The Medicare Payment Advisory Commission (2004) states, “barriers include the cost and complexity of IT implementation, which necessitates significant work process and cultural changes” (p. 158). These challenges, sadly, have resulted in a series of ineffective systems.
In an effort to improve clinician workflow and enhance patient safety, a healthcare facility has purchased and will soon be introducing a computerized provider order entry (CPOE) system for use within the electronic health record. A pre-deployment evaluation plan will permit the informatics team to appraise the usability of the CPOE and provide administrators with valuable data regarding its successful implementation. This paper describes the formation of this evaluation plan including the goals, methodology, and tools to be used. The final sections cover the ethical implications and dissemination of findings, along with the limitations and opportunities that the study provides.
“An electronic health record (EHR) is a digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users.” (healthit.gov) The EHR mandate was created “to share information with other health care providers and organizations – such as laboratories, specialists, medical imaging facilities, pharmacies, emergency facilities, and school and workplace clinics – so they contain information from all clinicians involved in a patient’s care.” ("Providers & Professionals | HealthIT.gov", n.d., p. 1) The process has proved to be quite challenging for providers. As an incentive, the government began issuing payments to those providers who “meaningfully use certified electronic health record (EHR) technology.” (hhs.gov) There are three stages that providers must progress through in order to receive theses financial incentives. Stage one is the initial stage and is met with the creation and implementation of the HER in the business. Stage two “increases health information exchange between providers.” ("United States Department of Health and Human Services | HHS.gov", n.d., p. 1) Stage three will be the continuation and expansion of the “meaningful use objectives.” ("United States Department of Health and Human Services | HHS.gov", n.d., p. 1) The hospital, where I work, initiated the HER mandate many years ago. In this paper, I will discuss the progression and the challenges that my hospital encountered while implementing the EHR mandate.
Administrative Mandates, including the Health Information Technology for Economic and Clinical Health (HITECH) Act, ICD-10 and HIPAA 5010, are all part of administrative simplification and the need for systems optimiza...
Nirel, N., Rosen, B., Sharon, A., Blondhiem, O., Sherf, M., Smuel, H., et al. (2010). The impact of an integrated hospital-community medical informaiton system on quality and service utilization in hospital departments. International Journal of Medical Informatics , 79, pp. 649-657.
... that do not communicate with each other will need to be addressed. The implications of the American Recovery and Reinvestment Act (ARRA) and Health Information Technology for Economic and Clinical Health (HITECH) Act will lead to an investment in the transformation of healthcare systems. Ultimately, healthcare systems will become transformed to exchange health information between systems in order to deliver equitable high quality care to everyone. According to Kadry, Sanderson, and Macario (2010) clinicians need to understand workflow and recognize barriers to meaningful use. Poor user interface can lead to negative clinical outcomes (Kadry et al., 2010). Without a clear vision, “institutions will convert paper-based systems into expensive digital chaos” (Kadry et al., 2010, p. 185). Without proper workflow analysis, potentially the same outcome could occur.
The development of information network systems ties healthcare care organizations allowing them to disseminate patient information. However, there have been several key challenges in development, implementation and adoption. Some of the challenges organizations encounter is the lack of standardization between health care entities, patient restrictions in health information and access (Tan & Payton, 2010). Another challenge organizations would face is the initial costs and justifying expenditures on a health management information system (HMIS) (Tan & Payton, 2010). The final challenge organizations would be facing is the involvement from federal legislation advocating for the consolidation of electronic health care records (EHR). A focal point for federal legislation is the promotion of broad based...
The future of healthcare is ever changing, and with that comes change management, which brings individuals on board with that change. According to Vora (2013), the change management model includes first, determine the need for change. Second, prepare and plan for the change. Third, implement the change. Finally, sustain the change (Carroll, 2015). As a leader, I feel that it is my obligation to not only continue with my education, but to aid others in furthering their education and
In 2009 President Obama, through the American Reinvestment and Recovery Act, pledged to provide incentives to the nation’s physicians and hospitals to convert to an electronic healthcare system in attempt to improve the quality of care and reduce cost (Freudenheim, 2010). By converting to an electronic system, we have the opportunity for improved communication between all healthcare providers and decreased cost to our healthcare system. The goal is to improve communication across all aspects of the service chain (Horan, Botts & Burkhard, 2010). Almost two years later, the conversion progress continues to be slow. Only one in four physician’s offices, mostly large groups, have implemented the electronic record system (Freudenheim, 2010).
The present environments for healthcare organizations contain many forces demanding unprecedented levels of change. These forces include changing demographics, increased customer outlook, increased competition, and strengthen governmental pressure. Meeting these challenges will require healthcare organizations to go through fundamental changes and to continuously inquire about new behavior to produce future value. Healthcare is an information-intensive process. Pressures for management in information technology are increasing as healthcare organizations feature to lower costs, improve quality, and increase access to care. Healthcare organizations have developed better and more complex. Information technology must keep up with the dual effects of organizational complication and continuous progress in medical technology. The literature review will discuss how health care organizations can provide effective care by the intellectual use of information.
The process of implementing an EHR occurs over a number of years. An electronic record of health-related information on individuals conforming to interoperability standards can be created, managed and consulted with the authorized health professionals (Wager et al., 2009). This information technology system electronically gathers and stores patient data, and supplies that information as needed to the healthcare professionals, as well as a caregiver can also access, edit or input new information; this system functions as a decision support tool to the health professionals. Every healthcare organization is increasingly aware of the importance of adopting EHR to improve the patient satisfaction, safety, and lower the medical costs. Studies have implied that, healthcare professionals who practice clinical features through EHR were far more likely to provide better preventive care than were healthcare professionals who did not.
Information Systems/Technology and patient care technology for the improvement and transformation of health care is an important part of the DNP. Technology has transformed every aspect of human life in positive ways. Technology brought efficiency and improved healthcare deliverance system. Healthcare technologies enabled practitioners to better understand disease process and how to implement best treatment plan. DNP programs across the country embrace information systems and technology in their nursing curriculum because, it prepares nursing students to be innovative and deliver best care (AACN, 2006). DNP graduates must have the ability to use technology to analyze and disseminate critical information to find solutions that
Communication is essential in education, training and everyday life. It's a means by which a thought is transferred from one person to another. Effective communication occurs when the intended meaning of the source and the perceived meaning of the receiver are virtually the same, Schemerhorn (2005).
I agree with the statement above on the basis that communication is the most important thing when it comes to working in unison.