Numerous organizations according to Mack et al. (2000), have faced many problems in their provision of paperless EMR. Some of these organizations have accepted and attempted to solve the challenges encountered, and the Mayo Clinic Scottsdale abbreviated as MCS is one of them. It integrated various teams representing IT, care, and business efforts to back the design and implementation of a paperless EMR system. MCS had a vision which encompassed the conversion of the present financial, laboratory findings, and demographic data architecture into paperless data. This data served specialized practices, clinical research, clinics and primary care providers, and inpatient acute care. The implementation of MCS paperless EMR, as well as its incorporation to the Rochester system, ended with activation of seventy interfaces, one WAN, two new LANs, and thirty-five new systems with over three thousand converted patients inventories. In the entire process of design and implementation of the system, MCS adopted an approach where the executive leadership team was highly incorporated in all procedures of making decisions, managing clinical, monetary, and business features of the entire process. Additionally, the physician sponsorship of system and clinical works procedures offered valuable input and guidance in EMR implementation. Therefore, through careful assessment of the approach adopted by MCS in designing and implementation of paperless EMR, it is easier to comprehend the strength and weaknesses of the methodology adopted by MCS and primary components significant for the overall success of the project.
Strengths and Weaknesses of the MCS Approach
One of the main strength of the MCS approach in implementing the paperless EMR is the constant incorporation of the hospital mission in most of the project decisions. Its mission is to offer the greatest quality and sympathetic care to patients at reasonable expenditure via a physician-centered team of different individuals performing jointly in research, education, and clinical practice in a united multi-campus facility (Mack et al., 2000). For instance, the Information Service Steering Committee abbreviated as ISSC was established to introduce physician and an executive representative from all sections of Mayo Clinical Arizona to which ensured the MCS mission was incorporated on development and implementation of EMR. This cluster offered service quality control in the implementation phase via workflow, clinical guideline, and risks management. Service quality is one the component of the MCS mission which gives the approach undertaken to implement paperless EMR strength by ensuring the system implementation was supported by the project sponsors of MCS initiative.
Constant communication, innovation, and having support centers were also some of strengthens of the approach undertaken by MCS. Using and developing significant and constant communication with healthy discussions and decisions ensured that the implementation of the paperless EMR continued as planned. For example, by creating a collaborative environment and team building through communication, a refined comprehension of anticipations of EMR systems was established and collectively communicated to every stakeholder in its implementation. Consequently, because of limited time is given to bring facility construction and implementation of the information system, the approach involved teams which performed creatively to compress multi-thread initiative undertakings, accommodate change, and testing. Additionally, there was a support center which constantly monitored the status of paperless EMR. For instance, integration to the tracking system challenges and graphic indicators could offer emergency status and pager notification to the need-to-recognize individuals. Therefore, all these aspects gave the approach adopted by MCS a significant strength in the paperless EMR implementation which is some of the things MCS did right.
A significant weakness in the approach embraced by MCS in paperless EMR implementation was a failure to recognize and understand the community within which the information system was being implemented. Approximately half the users of paperless EMR were learning in a diversity of novel job competencies and technology simultaneously. However, the implementation team failed to comprehend that different people and cluster have different learning skills. Even though they did right by offering different training techniques and events which permitted conducive learning setting, all the training provided could not circumvent challenges and release stress triggered by the new work surrounding which had paperless EMR as a new information system. Therefore, MCS could have done better by offering regular communication in different forms, practicing sophisticated activities to handle questions which arose, and offering one number accessibility to ensure that each community member supported the project and achieved the required knowledge.
Electronic Health Record System in Orthopedic Specialty Practice
Electronic Health Record system abbreviated as EHR is a healthcare information system that permits various personnel in hospitals to check different information about patients such as tests results, X-rays, allergies, medications, treatments, diagnoses, and their history among other data (Adler-Milstein et al., 2014). A major project involving EHR was implemented in an Orthopedic specialty practice which had chosen to merge two distinct physician practices with an aim to adopt an EHR system to achieve two main objectives which included going paperless and reducing the transcription expenses (EMRconsultant, 2013). Therefore, describing the implementation success of EHR in the Orthopedic specialty practice can be done in various manners depending upon the vested interest of those describing it. Nonetheless, there are various parameters which individuals can agree upon which require to be incorporated into the implementation of EHR to define it as successful or not. For instance, improved patient care is one of the parameters to describe EHR success which can be seen in the Orthopedic specialty practice through better health maintenance and alter systems, more timely information availability, and evidence-based medicine (EMRconsultant, 2013). Additionally, the success of EHR in can also be described in terms of improved office efficiency by having the enabling Orthopedic specialty practice attend to many patients in fewer hours, decreased expenses, and increased revenue.
Project Approach and Processes Used in Orthopedic Specialty Practice and MCS
The approach used in Orthopedic specialty practice to implement EHR and that adapted in MCS to execute EMR differ greatly. For instance, while selecting the EHR system, the Orthopedic specialty examined two vendors from which they chose the one who offered the less expensive product. Additionally, during the process of selecting there was minimum deliberation among four doctors in practice. It was also assumed that the transition to a paperless office could be easy and could not interrupt their productivity and workflow (EMRconsultant, 2013). On the other hand, in MCS case in EMR implementation, an ISSC was established. It was intended to draw all the physician and executive representatives from every MCS aspect to contribute to the development of the system. The ISSC was responsible for contracting individuals such as consultancy which saw its implementation (Mack et al., 2000). Additionally, during the selection of the EMR system in MCS, there were long and detailed discussions with all stakeholders involved in the overall implementation of MCS project. Also, in the MCS case, it was assumed that the EMR system would disrupt the normal performance in the hospital which was the primary force that stirred provision of different training on using the system (Mack et al., 2000). Conversely, the implementation approach used for the two systems in both MCS and Orthopedic have some similarities in that they all experienced various challenges since their initiation stages. For instance, both EMR and EHR systems required numerous template to be established by the implementing team as well as additional training to comprehend their imposed functionality and workflow in both organizations. Although this training was provided, it was expensive and did not meet the full required aim for the system to operate efficiently.
Processes and Key Elements Critical for Overall Project Success
In efforts to make sure that every project achieves the intended level of prosperity, there are some significant processes and key elements which should be included in its implementation. One of the elements is strategic planning which facilitates comprehension of the required importance of the project and its goals (Chapman, 2012). This element ensure SMART objectives are set together with key milestones and success measures through which the project progress is evaluated. Product development is also an important element which encompasses new services, procedures, and products that are closely related to achieving the achieving the described business goals and adding organizational value (Ernst, Hoyer & Rubsaamen, 2010). Thus, product development ensures that projects' benefits are well stated at its initiation phase to enhance clear relation of the project success and effect on general business aims. Additionally, communication is also a vital component for overall project success. This is because it is important to sell project deliverables to individuals affected during its implementation and completion. Therefore, to ensure a successful project, it is essential to ensure that the end users of the project deliverable comprehend the primary reason why the initiative is beneficial which is possible only through communication (Chapman, 2012). Additionally, communicating the benefits of the project aids counter the normal human unwillingness to change which may otherwise hinder the success of the entire project.
Information system implementation has been discovered to be a complex process which requires significant and detailed procedures such as strategic planning and communications. EMR system implementation in MCS adhered to various procedures such as training and constant communication established by ISSC which ensured its success in the hospital. Additionally, EHR implemented Orthopedic specialty practice also followed some laid procedures to bring it to existence. Although the approaches used by MCS and Orthopedic specialty practice differ, there are some similarities which are evident in the challenges they both faced in the implementation process such as a high number of templates and training needs. Nonetheless, in both cases, strategic planning, communication, and product development are some of the essential key elements which could or have to ensure the success of both EMR and EHR implementation.
Adler-Milstein, J., DesRoches, C. M., Furukawa, M. F., Worzala, C., Charles, D., Kralovec, P., & 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), 1664-1671.
Chapman, D. (2012). 5 Essential Elements of a Successful Project. [Online] Projecttimes. Available at: https://www.projecttimes.com/articles/5-essential-elements-of-a-successful-project.html [Accessed 23 Aug. 2018].
EMRconsultant. (2013). EHR Success and Failure in the HITECH Age. [Online] Available at: http://www.emrconsultant.com/emr-education-center/meaningful-use/ehr-success-and-failure-in-the-hitech-age/ [Accessed 23 Aug. 2018].
Ernst, H., Hoyer, W. D., & Rubsaamen, C. (2010). Sales, marketing, and research-and-development cooperation across new...
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