Implementing Electronic Health Records At Apollo Hospital: Benefits, Challenges, And Strategies For Change

Company Overview

Apollo hospital has been ranked among the top best Asian hospitals and among some of the few hospitals that have embraced and leveraged different technological trends with a view to facilitative effective and seamless healthcare delivery. However, there are a number of technologies that the hospital needs to adopt with a view to increase efficiency, improve patient-staff communication and also to improve patient data recording and privacy within the organization. The organization still relies on paper documentation as their main record-keeping method. However, given the nature of technology today, there are several methods of keeping patient data some of which are digital (Madden et al., 2016).

Therefore, to increase efficiency and privacy of the patient’s data, there is a need for the hospital to change into the electronic and digital method of data keep known as the EHR system.

The technology makes sharing of information easy and safe as it is instant and secured (Ben-Assuli, 2015). Consequently, building on these capabilities of the technology, it is clear that it will be of much importance to Apollo Hospital upon its implementation. The benefits of the implementation of EHR include improved employee efficiency, improved patient outcomes, and financial gain (Palvia et al., 2015).

Over the past few years, most health organizations have been transitioning from manual data recording and keeping systems to electronic health records (EHRs) (Charles et al., 2013). The initiative of EHRs was also established a few years ago and at the moment most of the health institutions have been trying to leverage the use of these computerized records (Fragidis & Chatzoglou, 2018). The transitioning from the manual systems has led to a lot of changes in the documentation and data keeping processes in hospitals (Nguyen et al., 2014). Moreover, it has brought about changes to the staff in the hospitals. This is because it is a real-time patient centred record digital version that allows medical staff to access information instantly when need be (Patterson et al., 2017). It contains treatment and medical history of the patients which makes it possible for healthcare providers to make easy follow-ups on a patient’s condition (Friend et al., 2017).

Transitioning from the conventional data keeping method to this digital version will come along with a number of challenges and losses for the key stakeholders in the change process (Liao et al., 2017). Adapting to change is quite difficult and this applies to almost all industries. Creating a vision and urgency for the proposed change is necessary as this will help stakeholders understand the essence of the change. It is worth to note that if the entire working staff understands the necessity of change, it will be easy to instil the change since they can resonate with the fact that change is beneficial and this makes it easy for the employees to embrace the change and become more motivated to the change hence facilitating the process of change smoothly (Van et al., 2015). Therefore it is essential for stakeholders to understand how change affects the employee efficiency and performance and patient outcomes.

Rationale for the Change

Possible losses associated with EHRs include lack of standardized EHR products, costs and resistance to change by the members of staff (Heisey-Grove et al., 2014). This is brought by the difficulty from the use especially during the initial stages of implementation which leads to the reduction of productivity and finally lack of perceived benefits to the providers since the benefits accrued are those of society and the payers (Gabriel et al., 2014). The transition requires a change in software and also training among the employees with a view to equip them with the necessary skills required in the operation of the technology (Adler-Milstein et al., 2014). Due to the day in day out technological advancements, organizations will be faced by the challenge of the ever-changing electronic health systems due to software implementations (Chan et al., 2016). Consequently, the advantages from the adaption of change clearly outweigh the challenges faced by employees during the change transition (Vahdat et al., 2018).

• Structural, responsibilities, resources, processes, and performance measures

For the technology to be effectively implemented in the institution, there are a number of structures that will require change. For instance, the responsibilities of the staff members, processes, structures of data keeping, timeframes and resources will change. The support structure will change since most of the staff members responsible for data keeping will be replaced with trained personnel who have the know-how of operating the system.

• Need for Particular Support Structures

Selection of a champion will be significant as he will act as the technology’s advocate through encouragement and also through providing the project such as redesigning and assessing workflow, conducting training to the staff members, understanding the financial issues and finally evaluating the process of implementation.

• Staging the Introduction Change Process

On developing a realistic EHR change plan, there are a lot of pieces that need to be coordinated before the execution of an EHR successful implementation. The introduction of the change process needs to be staged since there will be a change in the software systems in the organization.

• Impact on Workloads

 The technology will have an impact on the workloads hence this needs to be managed. The technology will reduce the workload of the staffs since work around the processes will be eliminated. Health care providers such as the nurses, clinicians, and physicians should be informed frequently about the progress of the on-going change so as to less painfully experience the benefits. Keeping in mind that the patient care comes first and the main reasons for implementing change are ultimately for patient safety and care. Therefore it is crucial to keep the staff members continuously at the forefront of their minds throughout the implementation process. Communications to the staffs should begin as early as possible regardless of the scale or the scope of a project so as to prepare the members of staff of what is clearly to come.

The creation of a realistic plan comes down to balancing three simple acts which are time, cost and scope. Balancing of these three acts leads to the effective implementation of EHRs in organizations. The implementing process will follow different stages. The first stage is that of decision which is followed by the selection and followed further by the implementation phases which include the pre and post implementation.

Actions	Who	When	Performance Measures
Overall direction	Project manager	Before implementation	Ensure everyone is clear with their respective responsibilities.
Implementation	Project team	Throughout the implementation period.	Ensure that the project is implemented as planned.
Evaluation surveys	IT supervisors	Throughout the implementation period.	Evaluating the success of the change.

Change Objectives and Principals

Clearly, there is a need to adopt a flexible strategy in the change management while implementing the use of EHRs in the Apollo organization. The strategy should clearly insist on the importance on the role of individual staff members and relationship management so as to help the entire staff to manage change. The practice staff must have set goals and visions for the implementation of EHRs and the staff members must buy into the project.

The evaluation of the implementation process will begin in the infrastructure initial stage. At this stage, the coordinator will ensure that the technology is implemented as required. The constant survey will also be made throughout the implementation process to ensure that everything is done as scheduled and planned. Upon completion, the final survey will be conducted to ensure that every step has been done as planned. The effectiveness of the change plan will be evaluated based on the outcomes of the technology.

References:

Adler-Milstein, J., DesRoches, C.M., Furukawa, M.F., Worzala, C., Charles, D., Kralovec, P., Stalley, S. and Jha, A.K., 2014. More than half of US hospitals have at least a basic EHR, but stage 2 criteria remain challenging for most. Health Affairs, 33(9), pp.1664-1671.

Bajwa, N.K., Singh, H. and De, K.K., 2017. Critical Success Factors in Electronic Health Records (EHR) Implementation: An Exploratory Study in North India. International Journal of Healthcare Information Systems and Informatics (IJHISI), 12(2), pp.1-17.

Ben-Assuli, O., 2015. Electronic health records, adoption, quality of care, legal and privacy issues and their implementation in emergency departments. Health Policy, 119(3), pp.287-297.

Chan, K.S., Kharrazi, H., Parikh, M.A. and Ford, E.W., 2016. Assessing electronic health record implementation challenges using item response theory. Am J Manag Care, 22(12), pp.e409-e415.

Charles, D., Gabriel, M. and Furukawa, M.F., 2013. Adoption of electronic health record systems among US non-federal acute care hospitals: 2008-2012. ONC data brief, 9, pp.1-9.

Fragidis, L.L. and Chatzoglou, P.D., 2018. Implementation of a nationwide electronic health record (EHR) The international experience in 13 countries. International journal of health care quality assurance, 31(2), pp.116-130.

Friend, T.H., Jennings, S.J. and Levine, W.C., 2017. Communication patterns in the perioperative environment during epic electronic health record system implementation. Journal of medical systems, 41(2), p.22.

Gabriel, M.H., Jones, E.B., Samy, L. and King, J., 2014. Progress and challenges: implementation and use of health information technology among critical-access hospitals. Health Affairs, 33(7), pp.1262-1270.

Heisey-Grove, D., Danehy, L.N., Consolazio, M., Lynch, K. and Mostashari, F., 2014. A national study of challenges to electronic health record adoption and meaningful use. Medical care, 52(2), pp.144-148.

Liao, T.V., Rabinovich, M., Abraham, P., Perez, S., DiPlotti, C., Han, J.E., Martin, G.S. and Honig, E., 2017. Evaluation of medication errors with implementation of electronic health record technology in the medical intensive care unit. Open Access Journal of Clinical Trials, 9, pp.31-40.

Madden, J.M., Lakoma, M.D., Rusinak, D., Lu, C.Y. and Soumerai, S.B., 2016. Missing clinical and behavioral health data in a large electronic health record (EHR) system. Journal of the American Medical Informatics Association, 23(6), pp.1143-1149.

Nguyen, L., Bellucci, E. and Nguyen, L.T., 2014. Electronic health records implementation: an evaluation of information system impact and contingency factors. International journal of medical informatics, 83(11), pp.779-796.

Palvia, P., Jacks, T. and Brown, W.S., 2015. Critical Issues in EHR Implementation: Provider and Vendor Perspectives. CAIS, 36, p.36.

Patterson, E.S., Anders, S. and Moffatt-Bruce, S., 2017, June. Clustering and Prioritizing Patient Safety Issues during EHR Implementation and Upgrades in Hospital Settings. In Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care (Vol. 6, No. 1, pp. 125-131). Sage India: New Delhi, India: SAGE Publications.

Vahdat, V., Griffin, J.A., Stahl, J.E. and Yang, F.C., 2018. Analysis of the effects of EHR implementation on timeliness of care in a dermatology clinic: a simulation study. Journal of the American Medical Informatics Association.

Van den Heuvel, S., Schalk, R. and van Assen, M.A., 2015. Does a well-informed employee have a more positive attitude toward change? The mediating role of psychological contract fulfillment, trust, and perceived need for change. The Journal of Applied Behavioral Science, 51(3), pp.401-422.