A Focus on the Adoption of Electronic Health Record Systems in a Hospital

The evolving concept of electronic health record systems, EHRs refers to the systematic electronic collection of patients’ health information such as demographics, medication, allergies medical history, immunization status, radiology images, laboratory test results, vital signs as well as personal information (Blumenthal et al, 2008).The records are kept in a digital format making it possible to be shared among various healthcare settings through networked information systems capable of handling wide range enterprise information or other means of information exchanges (Chun-Ju & Esther, 2012). Despite their great potential to enhance healthcare services delivery, physicians in the US have been reluctant in adopting EHRs. The top barriers to adoption of EHRs, which have been the subject of undercurrent resistance by nurses in my hospital, include: cost of EHRs, technical support to the system and ability to use the systems (Nancy et al, 2009).

In order to achieve a successful implementation of EHRs in my hospital, I recognize the fact that proper planning is essential. It is a large undertaking to fully implement an EHR for any practice. Its success, therefore, depends on diligent planning from careful identification and appointment of the project manager and team to outlining stages of implementation of the system (Blumenthal et al, 2008). It will also be important to focus on the people as well as change management in order to get the entire process on board and reduce the high failure rate associated with most IT-related projects (Nancy et al, 2009). EHR is likely to change roles/duties of the associated staff hence the anxiety and fear so far experienced due to anticipated culture practice change. The concerns of the nurses must therefore be addressed in an open manner for them to understand that the change will be in their best interest (Chun-Ju & Esther, 2012).

The nurses will be among the key stakeholders in the implementation and use of the EHRs. As a result, it is important to win their approval of the new technology which is the subject of the pre-training meeting. First, individuals are often concerned with the Relative advantage of a new technology in order for them to adopt it. One my key concerns will therefore be to be to show them how EHR will improve record keeping as opposed to the old manual system (Rogers, 2003). In this regard, I will highlight the vast problems associated with manual heath records: manual data entry which subject to human error, cases of misplaced/lost files or customers forgetting their patient numbers making it difficult to retrieve records, cases of multiple entries of patients’ files and the need for a large administrative staff which minimizes health service provision (Blumenthal et al, 2008).

The nurses’ concern about compatibility of the EHR with the existing values/practices will also be addressed in order for them to comprehend how the new technology will align systematically with their current practices (Rogers, 2003). I will therefore demonstrate to them how EHR allows for documentation of interactions with customers, viewing of patients’ medical histories as well as insurance information, making referrals, ordering of laboratory test exercises and subsequent viewing of the test results (Nancy et al, 2009). I should also make them understand that the EHR will allow for sending of prescription requests electronically to pharmacies (minimizing the risk of misreading hand-written prescriptions thereby flagging potentially dangerous drug interactions). It will also provide the doctors with tools for decision support for instance clinical guidelines and drug interactions checks as well as post-visit print-outs for patients (Rogers, 2003).

As it stands, the nurses are also concerned with their ability to use the new system. This will largely depend on the simplicity of the chosen system. This must be addressed through a careful selection of an appropriate system that will ease learning and mastery of the new innovation by the adopters (Rogers, 2003). Research will also be carried out by the project team to assure the adopters that the hospital will purchase high quality hardware which shall efficiently support the EHR and ease use by adopters. A proper system selection procedure will get us close to selecting a system which can be used without further modification. While it’s often tempting to deem you require customization, this will invariably cost much time and resources. Instead, I will focus the nurses more about learning the new system as originally designed, only selecting from its available options (Blumenthal et al, 2008).

Adopters of a new innovation are often also concerned about the observable results of the proposed system in order for them to contemplate adopting it. They need to have reliable proof of success of t the proposed system other situations (Rogers, 2003). It will therefore be my obligation to collect such evidence from successful adopters of a similar system to ascertain how useful the system can be in our setting. It may also be necessary for my office to organize for my selected project team a visit to a practice that has adopted the proposed EHR system. Such a visit, if possible, may be necessary before the pre-training meeting so that I have a larger team who understand the system at the meeting. This visit will give us a much better idea of how the EHR system will really work other than rely on the vendors’ demonstrations (Nancy et al, 2009). The outcome of the visit may also trigger further adjustment, if need be.

Finally, for a successful implementation of the new technology, it is important to train and retrain the users over time (Chun-Ju & Esther, 2012). It will be my obligation to present to the nurses and other stakeholders my hospitals’ plan and modalities to offer them this much needed training. This assurance will likely enhance their confidence and acceptance of the system. As stated earlier, introduction of the new system will completely change their practice environment. As a result, change management will be a significant part and parcel of adopting the new system (Rogers, 2003). Communicating the hospital’s case for such change will assist the staff to understand the essence for the same. This will be best captured through a documented vision statement. It will also be necessary for me to maintain communication with the staff members all through the project cycle in order to continue identifying their perceptions and possible sources of further resistance (Nancy et al, 2009).

In conclusion, an electronic health records system is an evolving technology that involves collection of electronic health records of patients or populations. Such records are then stored in a digital format which enhances their sharing among different users. The EHR systems have a great potential to enhance healthcare services. However, their adoption faces resistance, which in the case of my hospital, will be dealt with by addressing the concerns of my nurses on the relative advantage of the proposed system, its compatibility with our practices, its simplicity, trial ability as well as its observable results. Addressing these in the pre-training meeting and the subsequent proper training is anticipated to win their approval and develop the nurses and other staff into being super users of the EHR system.

References

Blumenthal, D., DesRoches, C. & Donelan, K. (2008). Health information technology in the United States: the information base for progress. Princeton, NJ: Robert Wood Johnson Foundation.

Chun-Ju, H., & Esther, H. (2012). Use and Characteristics of Electronic Health Record Systems Among Office-based Physician Practices: United States, 2001-2012. Publications and Information Products centre for disease control and prevention, 111, 32-36

Nancy, M.L, Angelina K., Don, E.D. & Meryl, B. (2009). How to Successfully Select and Implement Electronic Health Records (EHR) In Small Ambulatory Practice Settings. Medical informatics and decision making, 6, 23-32

Rogers, E.M. (2003). Diffusion of Innovations. New York, NY: Free Press.