Introduction
The electronic health records (EHR) system is considered the future of healthcare. It implies a digital version of patients’ records used to create databases containing interconnected information (Kruse et al., 2018). EHR enhances communication, decreases workload, increases efficiency, and promotes data accuracy (Tsai et al., 2020). However, regardless of the numerous advantages associated with the tool, there are many barriers to its adoption. They might impact the outcomes and units’ readiness to employ a new approach. For instance, the case “ComprehensiveCare and the Failed Implementation of an Electronic Health Records System” revolves around the failure to make EHR part of the organization and poses the question of how better results can be attained.
Problem
The case outlines Jenifer Stanton’s attempts to adopt the EHR system in ComprehensiveCare (CC), a multispecialty healthcare organization involving twelve physicians owning the practice and three physicians who work for the practice. It means that the planned transition to EHR should consider the interests of all parties and be supported by the CC’s IT staff, who do not understand the demands of clinicians well (Gomillion, 2017). Using the EHR system is the government’s current requirement, and it can ensure numerous benefits to the unit, meaning it is vital to start using it (Gomillion, 2017).
However, in the course of the change, numerous complications emerge. The unit does not have the infrastructure necessary for using DocCharts, the chosen EHR software; the spending is too high, and medical and clinical staff refuse to use a new system because of its complexity (Gomillion, 2017). In such a way, the central problem of the case is integrating the new EHR system into the work of CC in ways that consider the organization’s peculiarities and current demands.
Pilot Project
Integration of EHR requires a radical change of the existing approach to working with patients and their data. At the same time, it implies a change in the unit’s work and the operation that had been used previously. However, in many situations, this process is complicated by numerous factors, such as the lack of awareness, insufficient resources, or poor EHR usability (Tsai et al., 2020). It contributes to clinician burnout, lack of desire to continue using EHR, and increased patient dissatisfaction (Pruitt et al., 2022).
Furthermore, IT staff might also feel burnt out and be demotivated if EHR usability is poor and much effort is required to educate clinicians and ensure they know how to use a new system (Pruitt et al., 2022). Under these conditions, the pilot project focused on evaluating the EHR usability and applicability to the organization can be one of the possible solutions.
The case shows that the simultaneous transition of all the organization’s departments and members from an old to a new system might be highly complex and confusing. Additionally, extra costs are required to adapt the existing infrastructure, and much effort must be put into addressing all possible issues. At the same time, EHR systems from a particular vendor are configured and customized at every healthcare facility (Pruitt et al., 2022). It means there is a risk that a standard EHR usability solution will not help to manage unique usability challenges in a particular organization (Pruitt et al., 2022). This situation can be observed in the case as the specific customization required by Dr. Harris was unnecessary and too complicated for others (Pruitt et al., 2022). For this reason, a smaller-scale pilot project can be one of the potential solutions to the problem.
The intervention implies creating a particular group of medics and IT staff to test DocCharts and its usability and applicability to the unit. A self-administered EHR usability and safety assessment tool with the computerized provider order entry (CPOE) can be part of the pilot project (Pruitt et al., 2022). The proposed solution’s effectiveness and practical use arise from its ability to identify potential problems with the selected EHR system, determine its usability, and discover barriers to its adoption before the more significant change requires more effort to correct possible issues (Pruitt et al., 2022). Results of the proposed pilot project supported by the data from the self-assessment tool can be used to create the basis for successful technology use.
Considering Other EHR Vendors and Software
The second solution to the problem identified in the case is considering other EHR options and vendors to ensure the software meets the CC’s demands. Initially, DocCharts was selected as a solution because of the straightforward licensing and discussion with other administrators (Gomillion, 2017). However, there was no preliminary research about the software’s demands for the infrastructure, budget, and opportunities for its customization.
Thus, in most cases, resource constraints, poor training and technical support from the IT staff or vendors, and lack of technology skills are the central barriers impacting successful EHR integration (Tsai et al., 2020). Moreover, the absence of standards, sophistication of technology, and productivity loss impact the attitude to the EHR (Kruse et al., 2018). These obstacles affected the situation as clinicians lacked the necessary technology skills, and the IT staff did not have a medical background. As a result, the complex DocCharts software failed to work in the CC organization.
For this reason, one possible solution is to discuss EHR options and align them with the existing infrastructure. The most spending in the case was associated with upgrading the CC’s network, buying additional computers and SQL servers, and adding a specific interface to the equipment (Gomillion, 2017). It means that DocCharts was not the best option regarding the unit’s readiness for its use. Preliminary discussions in teams with representatives of vendors and the creation of the list of required spending and upgrades would help avoid selecting an extraordinarily complex and demanding approach.
Final Choice
Both options might be considered practical solutions to the CC organization’s problem. However, the pilot project with an additional self-assessment tool might be viewed as a more potent approach. First, the company’s IT staff lacks experience in launching and managing big projects, implying using technologies and structural change. Second, the medical staff faces numerous problems simultaneously, meaning their management requires more effort and reduces satisfaction. Thus, the pilot project could help to create information about all possible complications and evaluate EHR usability before the decision to use it in all departments. At the same time, it would help to determine customization levels and create templates that would simplify working with patients.
Conclusion
Altogether, EHR is one of the tools that might help improve health facilities’ work and data management. However, integration of EHR might require much effort and preliminary investigation to ensure no problems will emerge. For the analyzed case, the pilot project implying using EHR in smaller groups is the preferred option. It would help to evaluate the usability of the selected approach, calculate costs that might be required to use it for all organizations, determine required customization levels, and conclude whether problems might be resolved. The data collected during the pilot will help to introduce changes necessary for the successful integration of EHR.
References
Gomillion, D. (2017). Teaching case: ComprehensiveCare unit and the failed implementation of an electronic health record system. Journal of Information Systems Education, 28(2), 71-82.
Kruse, C. S., Stein, A., Thomas, H., & Kaur, H. (2018). The use of electronic health records to support population health: A systematic review of the literature. Journal of Medical Systems, 42(11), 214. Web.
Pruitt, Z., Howe, J., Krevat, S., Khairat, S., & Ratwani, R. (2022). Development and pilot evaluation of an electronic health record usability and safety self-assessment tool, JAMIA Open, 5(3). Web.
Tsai, C. H., Eghdam, A., Davoody, N., Wright, G., Flowerday, S., & Koch, S. (2020). Effects of electronic health record implementation and barriers to adoption and use: A scoping review and qualitative analysis of the content. Life, 10(12), 327. Web.