When looking at Electronic Medical Records and how do we get our senior physicians to “buy in” for successful implementation of computer charting for the hospital there are several things to consider. First, most senior physicians are used to the paper patient charting system and are reluctant to convert to EMR because they feel it would take away from patient interaction and care. According to Griffith and White (2010) diagnostic excellence requires two kinds of knowledge which are rapid communication of patient’s current needs and an understanding of the clinically indicated responses.
With this in mind EMR makes recording patient information faster and more complete, includes safeguards to improve accuracy, and it speeds up patient related information. In 2004 president George W. Bush, set an ambitious goal that by 2014 all citizens would have access to their electronic medical record. President Barack Obama reinforced that commitment with nearly twenty billion in stimulus money for hospitals who convert to electronic medical records and a rather recent legislation called the American Recovery and Reinvestment Act further underlined the initiative to move towards the electronic medical record.
This legislation is aimed at creating more funding and a network of incentives for healthcare professionals and physicians who are ready to adopt EMR and abide by the concept of “meaningful use” of electronic medical records. The opportunity for improvement is to optimize the documentation of patient encounters, improve communication of information to physicians, improving access to patient medical information, reduction of errors, optimizing billing and improving reimbursement for services, forming a data repository for research and quality improvement, and reduction of paper costs within the HCO.
It is important to resolve this problem of EMR use now because it will considerably increase patient outcomes and patient safety within the hospital. Currently departments within the hospital have difficult time communicating with one another in a timely manner. EMR will enable departments to communicate effectively and cut down on treatment time for patients. This will result in better continuity of care for patients from the outpatient to inpatient and back to outpatient care.
HCOs must keep in mind there is a lot of federal pressure to have all patient’s access to their medical record thru EMR by 2014 and the penalties for not being in compliance are levied in reduced reimbursements of Medicare and Medicaid payments with financial penalties as well. The desired outcome from my MAP implementation is to have EMR fully operational within eighteen months and also have an inter workability with other healthcare systems for patients care.
I also want to accomplish the ability for all interdisciplinary services to have the ability to communicate with one another and the health team to have access to medical records for patient care in order to cut costs of visits and provide overall better patient care within the HCO. There are several realistic constraints to consider in the implementation of EMR which are the costs of implementing which is normally between one and three million dollars, federal and state compliance issues, and infrastructure for servers supporting EMR.
I also have to consider the constraint of time for the implementation process which is usually averages twelve to eighteen months for full system wide usage of EMR. There are several other constraints of EMR which are ensuring financial incentives for physicians, employee training, and sustainment training for updates and maintenance to EMR. The problem exists because senior physicians came thru medical school at a time where computers weren’t being used on a broad basis for patient care and they believe EMR will disrupt their traditional working style and require a greater constraint on them when dealing with EMR.
The physicians also are concerned with the complexity and usability of EMR which will require them to allocate additional time and effort which would take away from patient care. There are several actions that are needed to achieve my MAP goal. First, I must have C suite leadership buy in for the implementation of EMR. Next, I must ensure the financial plan is approved for EMR system. I also must ensure to have the physical space for the system within the clinics and facilities of my HCO.
I have to make sure a training plan is developed for my IT staff, physicians, nurses, and associates. I have to develop a plan for embedding IT staff within each clinic to provide assistance and troubleshoot any glitches within the EMR system. I must ensure my EMR system talks with the networks of other facilities to ensure the patient information flow is adequate for patient processing time and internal consulting. I also have to ensure protection for HIPPA and the safeguarding of patient information when it is sent to outside servers.
Finally, I must ensure my EMR system is in compliance with all federal, state, and local requirements. When looking at the key actions steps and there sequencing the first step I would do is ensure I have C suite buy in for the implementation of EMR. Before I meet with them I would have my total implementation plan completed and ready to present to them and ensure that all key steps are covered. Next, I would ensure with the HCOs building manager that the necessary space is available for the EMR system and all spaces are compliant with fire barriers with in the hospital.
The next key action step would be the implementation of the training plan on EMR for my IT personnel to ensure they are fully ready for the launch. I would also have to ensure the training plan for the physicians, nurses, and staff is fully implemented and resourced. This would lead me to ensure I have my IT staff embedded in each clinic for the first month to make sure the implementation goes smoothly as possible.