...EHR/CPOE Implementation Executive Summary This thesis follows the implementation of Computerized Patient Order Entry/Electronic Health Record (CPOE/EHR) system implemented by Partners Healthcare System (PHS) during 2002-2003 for all its constituent practitioners. It looks at the problems faced during implementation of the system and identifies new potential problems that the system may encounter. Particularly in consideration is the effort it takes to convince healthcare professionals to switch to CPOE/EHR, the cost of installing the system, the potential of automating redundancies in the system and the potential of healthcare professionals getting skewed data out of the system suggestions. It looks at the management challenges faced by the administration when bringing about CPOE/EHR to PHS and divulges in some techniques that were used for tackling these issues. It defines ways in which the system is being used to improve patient healthcare and save millions of dollars for the government, healthcare facilities and patients alike. This thesis also finds ways to combat the potential problems that may arise later and the system and looks at related government policies and statutes which apply to the implementation. Finally some metrics of success are discussed their effectiveness in driving a result. Problem Definition CPOE/EHR Implementation can face a host of problems that can hinder the process flow and the acceptability of the system by the people involved. The initial...
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...A Case Review of EHR Implementation in a Pediatric Emergency Department Jennifer Juif Southern New Hampshire University A Case Review of EHR Implementation in a Pediatric Emergency Department Organizations face many challenges when implementing an electronic medical record (EHR) system. Quality, safety, and efficiency need to be maintained during implementation. The case study reviewed: Impact of electronic health record implementation on patient flow metrics in a pediatric emergency department (Kennebeck, Timm, Farrell, Sooner, 2012) attempted to quantify the effects of offloading low acuity patients and its impact on length of stay. Length of stay and volume of patients in an emergency department are correlated. The study was conducted in a pediatric emergency department (ER) in Cincinnati, Ohio. Prior to implementation, a plan was utilized to off load patients to a different area in the ER due to a surge from the H1N1 flu virus. This was successful in decreasing patient numbers and length of stay. The organization decided to use the same template for the EHR implementation. Despite its prior success, offloading patients did not improve efficiency or length of stay (LOS) during EHR implementation. The primary issue identified was the failure of offloading patients. The study stated, “During implementation only 5% of patients were diverted. During the H1N1 surge, 10-20% of patients were diverted.” (Kennebeck, Timm, Farrell, Spooner, 2012). The...
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...The key barriers to widespread implementation of EHRs include: 1. Financial Concerns: a. Initial capital costs – The average cost for initial set up in a physician’s office is around $38,000.(1) The cost increases depending upon size of the organization. b. Operating costs – This include software maintenance, data storage, the cost for initial data conversion, the initial low productivity on the EHRs. 1. Downtime during installation and training. 2. There are less availability of knowledgeable trainers. 3. There are less numbers of authenticate EHR vendors. 4. There exists lack of technical standards. 5. The privacy and security are still a matter of concern. 6. Lack of solid business case is one of the most important barriers to implementation of EHRs in the United States. 7. Physician’s reluctance to use EHRs and HIEs. 8. The currently...
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...Generate Clinical Quality Measures Introduction The American Hospital Association (AHA) commissioned iParsimony, LLC, to conduct a study to investigate hospital experiences with implementation of Meaningful Use Stage 1 electronic clinical quality measures (eCQMs). The study describes the experience with and impact of eCQM implementation in four hospitals – large and small, urban and non-metropolitan – each of which had significant experience with electronic health records (EHRs) prior to Meaningful Use and uses a different EHR from a different vendor company. The findings described in the case study are derived from interviews conducted with key leaders and operational staff directly involved in the oversight and management of eCQMs. Based on the experiences of the hospitals in this case study, the current approach to automated quality reporting does not yet deliver on the promise of feasibility, validity and reliability of measures or the reduction in reporting burden placed on hospitals. Specific policy changes are needed, starting with Stage 2 Meaningful Use, to redirect the electronic clinical quality reporting requirements to focus on a small set of well-tested measures supported by a mature policy infrastructure that can guide valid and feasible measure development, testing and implementation. Background In the past 10 years, there has been an unprecedented expansion in the number and type of quality measures hospitals are required to report for federal programs. The...
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...Barriers Hospitals are facing with EHR Implementation o Cost: Only a handful of providers have the upfront cash to implement EHR. It is very costly considering, implementation, maintenance, and training cost. To be able to get the most benefit (ROI) out of your EHR, you have to be able to invest into it o Time: Organizations fear that they would lose business having to invest that much time into EHR implementation. o Preparation or Planning: EHR implementation requires a lot of preparation and active collaboration of stakeholders, clinicians, vendors and other personnel. Adequate planning will lead to fewer surprises in the long run o Roll out strategy: Big bang vs. incremental approach. Big bang requires a lot more revenue and time o Availability of vendors: Most organizations rushed their EHR implementation process due to the incentives offered by the government. Vendors are not able to meet all the demands of organization or provide adequate training that is needed for a smooth implementation. o Technical issues: There is no perfect system, and technical issues are bound to occur from time to time. Some will be easily resolved while others would not. o System interoperability: If the EHR is an addition to other systems already in place, it is oftentimes very difficult to make the system communicate with each other. o Culture: Most people are resistant to change. Some clinicians have worked for so long in a paper world that the transition is very difficult on them...
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...making the implementation phase go as smoothly as possible. A system analysis is taking a system the business is going to use to better their organization and breaking it down to see how it can better the business and what problems need to be fixed before implementing the system. It also predicts the cost of the system and the money it will save the business that is using it. The system I am going to be using is the implementation of Electronic Health Records (EHR) into small rural health care facilities. This particular one is for D.W. McMillan Memorial Hospital. D.W. McMillan Memorial Hospital is a 49 bed community hospital who are located in Brewton, Alabama. D.W. McMillan Memorial Hospital decided they wanted to take a shot at implementing HER to make their organization more modern and up to date on technology that is being used nationwide. Not only will it benefit their patients, but also the workers, and the organization as a whole. D.W. McMillan Memorial Hospital realized they needed and EHR system when they started using the bar code medication administration system. Up until the point they realized they need an automated system, they always used the traditional paper version of medical records. They used system analysis to take a look at their current paper medical records that were being used and they wanted to implement a software that would be an easy transition, with easy-to-navigate screens that “mirrored paper-based processes” (EHR implementation in a smaller...
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...Creating a Leadership Team for Successful EHR Implementation Provided By: The National Learning Consortium (NLC) Developed By: Health Information Technology Research Center (HITRC) The Doctor's Office Quality Information Technology University (DOQ-IT University) The material in this document was developed by Regional Extension Center staff in the performance of technical support and EHR implementation. The information in this document is not intended to serve as legal advice nor should it substitute for legal counsel. Users are encouraged to seek additional detailed technical guidance to supplement the information contained within. The REC staff developed these materials based on the technology and law that were in place at the time this document was developed. Therefore, advances in technology and/or changes to the law subsequent to that date may not have been incorporated into this material. National Learning Consortium The National Learning Consortium (NLC) is a virtual and evolving body of knowledge and tools designed to support healthcare providers and health IT professionals working towards the implementation, adoption and meaningful use of certified EHR systems. The NLC represents the collective EHR implementation experiences and knowledge gained directly from the field of ONC’s outreach programs (REC, Beacon, State HIE) and through the Health Information Technology Research Center (HITRC) Communities of Practice (CoPs). The following resource is an...
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...record (EHR) system. Currently, the clinic still conducts patient care using paper health records. Mr. Magone and the physicians have discussed the option, and they realize that EHR usage is proven to improve the quality and safety of patient care. In fact, they all believe in implementation of the EHR so much that Mr. Magone has incorporated EHR implementation into Yorkshire Clinic's strategic plan. Recently, the company determined that your organization qualifies for government incentives—under the Health Information Technology for Economic and Clinical (HITECH) Act of 2009—with successful EHR implementation. Mr. Magone and the physicians realize that EHR implementation will be costly and will take time, but they are willing to make the investment. There is widespread support for the endeavor, and everyone has agreed to be part of the steering committee to guide project development. The various stakeholders include physicians, nurses, administrators, and patients. There have been several meetings in which the end-users have been afforded the opportunity to ask questions and provide their feedback about the initiative. There is growing enthusiasm among physicians and clinicians about the possibilities that EHR implementation will bring. Mr. Magone has made it clear that patient needs are driving the project. He wants to ensure that EHR design is driven by patient care and satisfaction. He also wants to make sure that proper work-flow planning occurs and areas where EHR use could...
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...is easiest to manage from a technical standpoint (one that reduces risk of technical error, requires fewer end user staff, or needs less maintenance). Clinical staff may be purely focused on a system that has an interface that is easier to navigate though and is less time consuming compared to the user interfaces of other potential vendors. It is important to identify each department’s agendas and needs prior to beginning the system selection process so that they can be discussed and addressed. It is more difficult to resolve conflicts of interest later in the decision-making process. These are some questions that definitely should be asked during the initial vendor selection; what are the goals of each department for selecting a new PM or EHR system? What is the timeline for selecting and implementing the new system? What is our organization’s budget for a new...
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...information system is a combination of data, processes and information technology that interact to collect, process, store and provide output for an organization (Wager,K 2009). In an health care organization there are two types of information systems: administrative and clinical. In order for an organization to find the best system they must follow the process for selecting and acquiring an information system. * System implementation begins when the organization gains the system and begins to put it in use. There are several stakeholders that are involved in the implementation process. The CFO (chief financial officer) manages the budget and all future expenses. The CEO (chief executive officer) is the leader of the organization and overlooks everything that is done. The implementation team gets everything in order and ready for the implementation of the new system. The vendors job is to find the system that best fits the buyers requirements. The IT department operates and assists with technical support. To start the implementation process an implementation team should be assembled and a system champion must be identified. The system champion will be responsible for leading the team. Then the team will come together and determine the expectations of the project and create a project plan. After the plan is determined, the team must look through vendors to find the appropriate information system for their organization. * Before, the team looks at several vendors, it is...
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... These phases includes the “disbursement of abundant resources to strategy-essential activities, creating strategy-encouraging policies, employing best policies and programs for constant improvement, linking reward structure to accomplishment of results, and making use of strategic leadership” (Managementstudyguide.com, 2008-2012). This means that the process of implementing change within an organization does take a management team who is willing to follow the correct protocol to ensure implementation was successful. There are checkpoints which are designed for checking to make sure the process of change was implemented correctly. So, making sure that mild stones are meet within the implementation process does evaluate the process and ensure that the organization is on the right track so the change can be sustained over an extensive period of time (Cliff Notes, 2012). Methods Used to Monitor Implementation of the Proposed Change Furthermore, the methods used to monitor implementation of change in the health industry are vast. Specifically, for Chartres-Pontchartrain Mental Health Clinic in New Orleans’s metropolitan area, that is currently in the process of implementing an Electronic Medical Records system (EMRs) for the first time in its clinic. The clinic wants to change from a paper chart system to more of an...
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...Deloitte & Touches’ revolutionary implementation of Women’s Initiative, serves as one of the most transformational changes any company has ever seen. Deloitte thought women were leaving their company in order to fulfill their wifely and motherly duties. The truth of the matter is they left due to not being considered for partnership roles. When CEO Mike Cook at the time realized the significant impact it was having on the business, he implemented a two day intensive workshop for “the Retention and Advancement of Women”. Implementing Women’s Initiative led to a solid foundation surrounded by an environment full of support and development of not just women but men as well. In reading the Women’s Initiative Annual report I felt that women as buyers (WAB) serve as an advancement towards this movement. Currently women account for 85% of all consumer purchases. Deloitte recognized that women executives within the marketplace were increasing. Currently Deloitte is offering a WAB workshop to its professionals in order to better understand the way women process there purchasing decisions. Such examples of how women provided a trusting relationship amongst their clients by providing personal life stories and their way of paying close attention to detail. The WAB has provided other lessons as well for both men and women: 1. Women have a tendency to sit “ face to face” where are men seat beside themselves and consider their mail client “ Right-hand man” 2. Women...
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...INTRODUCTION Real Estate Management System is website which is helpful for Builders as well as a individual as Buyers or Seller. In the currently all the activities are done manually. It is very tough for person to contact a appropriate Buyer or Seller. Our Real Estate Management System deals with the various activities related to the students. There are mainly 3 modules in this software * Search * Post * List On this Website we can register as a Individual, Agent or Builder. Administrator has the power to activate and deactivate the user account Administrator can also add new user and can edit and delete a user. A Builder can register as user and can buy and sell Properties. An Agent can suggest for buying and selling Properties. An Individual can register as a user and can list, buy and sell properties. SYSTEM ANALYSIS EXISTING SYSTEM: System Analysis is a detailed study of the various operations performed by a system and their relationships within and outside of the system. Here the key question is- what all problems exist in the present system? What must be done to solve the problem? Analysis begins when a user begins its registration & starts to search, list & post property. During analysis, data collected on the various files, decision points and transactions handled by the present system. The commonly used tools in the system are Data Flow Diagram, activity diagram, sequence diagram, collaboration diagram, etc. Training, experience and common...
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...policies were made, there was a process to developing a policy for a particular business. All companies, corporation, or business will have policies set in place. This holds true for the foundation for AIDS/HIV. While putting together certain regulation for research groups, this foundation also has to follow each step in the policy process. Coming up with that policy was a process and throughout this paper we will discuss the policy process and what it takes to ensure the write policy has been made to protect the company, consumers and all of its employees. The policy process has certain steps that have to be taken before having a successful outcome. These important steps are as follows: The formulation stage, the legislative stage and the implementation stage. Throughout this paper we will discuss in detail what each step of the policy process consists of, as well as give examples for each step. Also, while discussing how the AIDS/HIV foundation has to follow the same steps while searching for cures. Although, the policy process is made up of many steps, there are only a few main steps to receiving a successful policy. Each step in the policy process can prove to take a lengthy amount...
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...Consulting to help analyze whether to upgrade current software or to acquire new software and then to implement the chosen application. The analysis should include all aspects and considerations of what the resort needs from their word processing capabilities now and in the future. The analysis should also include what the changes the resort and the users of the word processing software will face before, during and after implementation. Utilizing Smith Systems Consulting Boardman Management Group has hired Smith Systems Consulting to help analysis and implement Baderman Island Resort’s processing software problem. Boardman Management Group will utilize the expertise of Smith Systems Consulting in many ways to ensure the resort successful implementation of upgraded or new word processing software. Smith Systems Consulting will analyze every aspect of the project including the problem with the current word processing software, the requirement for the new or upgraded software, the software implementation itself and the changes after the software implementation. To be more specific Smith Systems Consulting will follow a systems development life cycle (SDLC). For now Smith Systems Consulting will be focusing on the analysis...
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