Clinician Provider Order Entry Implementation
Health Care Information Systems
September 02, 2013
Clinician Provider Order Entry Implementation
Health care organizations look forward when starting the implementation process for information system implementation. Adding or upgrading health care systems is met with excitement and opposition from the employees who must use the system and adapt their current practice processes. Constructing a rollout period for the employees to train and get specific training for their job requirements is imperative to the success of the health system implementation. Employees knowledge of how to use the system is equally important to the implementation process as choosing and designing the program that is best for the organization. Roles and responsibilities
The project or system champion is someone in the organization who is vested in the completion of the project. The champion’s role is to help obtain the buy-in of other physicians into the use of the new system and makes sure the physicians who will be using the system have adequate input in the selection process of how the new system will be used. The board of directors is the governing entity for the health care organization that approves the acquisition and implementation of a new system. The board of director’s role is to have a voice for the organization. Going forward the board needs to be involved in how the new system will affect the processes of the primary users and help curtail the expenses that develop as the project evolves.
The Project manager is the person accountable for the successful implementation of the new information system. “He or she is the person who provides the day-to-day direction setting, conflict resolution, and communication needed by the project team”(Wager, Lee, Glaser, & Burns, 2009, Chapter 7). The project manager is responsible for the team of engineers installing and testing the information system. The project manager is responsible for relaying the progress of the project back to the board of directors.
This includes the good, and the bad as outlined in the case study of Memorial Health System in which Dr. Melvin Sparks yelled at Sally Martin over substantial increases in work force, cost, and time increases. Sally Martin resolved not to share any bad news or setbacks with Dr. Sparks again creating a false sense of understanding of where the project was in the stages of completion. The original action of Dr. Sparks started a domino effect toward the failure of the project. Fundamental Activities
Information Technology (IT) is responsible for the long and tedious process of installing, changing, removing, testing, and correcting the chosen information system for the health care organization. IT must have a strong plan in place for the scope of the projected project. Organizing, identifying the project champion, determining the project’s size and expectations, and establishing and implementing the project plan are the steps in the IT implementation process. Creating detailed project guidelines for cost, number of employees needed to complete the implementation and project completion dates of the different phases to help complete the goals set forth by the health care organization. Fundamental activities that led to the project failure were lack of organization, system analysis, and employee workflow. The project was set to a rushed timeline that did not permit for proper organization for the intricate details of implementing a new information system.
Doing the system analysis in six months and making a choice without direct input from the employees who would be using the system on a daily basis was part of the project failure. Employee workflow is a vital portion of the selection process of a new system in a health care organization. “One of the first activities necessary in implementing any new system is to review and evaluate the existing workflow or business processes”(Wager, Lee, Glaser, & Burns, 2009, Chapter 7). If the process is too complicated or cumbersome, the workforce will fight back and reject the new system. In the case study of Memorial Health System although intentions were good for the implementation of a clinician provider order entry (CPOE) system by Fred Dryer and Joe Roberts the process was rushed and not properly laid out with realistic goals in place. IT was not given adequate time to organize, plan, or determine the scope for the steps they would need to make to implement the new CPOE. Communication
Dr. Melvin Sparks was a fundamental player in the project failure at Memorial Health System. Probably without direct knowledge of his actions, Dr. Sparks started a domino effect that ultimately led to many of the project failures with implementing the CPOE system. The initial communication between Dr. Sparks and his appointed project manager, Sally Martin, set the communication barrier of relaying time delays, lack of workforce, and budget increases that snowballed into the failure of the CPOE implementation. Project Failure
Project failure in the Memorial Health System case study was evident from the beginning of the project. The idea was solid, but the planning was not thorough. Five indicators that the project would fail are lack of clarity of purpose that happens when the objectives of the project are unclear. Lack of belief in the project happens when the key users are not convinced the system will ease their workload.
Insufficient leadership support happens when the lack of commitment shows through the lack of involvement by the leaders spearheading the implementation process. Organizational inertia happens when project work is added on top of the daily workload adding stress to the employees. Project complexity is multifold and is a direct effect of when the people working on the project do not have an understanding of the scope of the project. Minimize Project Failure
Memorial Health Systems could have taken different steps to eliminate or minimize the effects of the project failure on the new CPOE system. This Student would have acted differently to minimize the effects for a different outcome on the implementation process for the new CPOE system. Lack of clarity of purpose
This student would have communicated that the implementation of the new system will make the daily process of patient care is necessary so the providers and supporting staff understand that it will prepare for a better patient health record and reduce errors in orders. Lack of belief in the
This student would have communicated an understanding that the new CPOE system will create an efficient and useful electronic medical record. Therefore, easing the workload and minimizing errors in patient orders. This student would have made continual updates and newsletters updating the providers and staff about improvements that they would be making in his or her patient’s care. Insufficient leadership support
This student would have created a more visible and involved leadership team. This student would have created meetings and training involving both the leadership team and the providers to create a better understanding of how the implementation of the CPOE will help the quality of care given by the providers at Memorial Health System. Organizational inertia
This student would have organized the workforce to help drastically reduce the amount of daily workloads to free up dedicated time for the CPOE implementation project. Working in stressful environments can create lack of forward motion on a project because of the added work. Increasing the workforce to distribute the workload will help in the project continuing to move forward. Project complexity
This student would have had a frank conversation with the contributing departments and stakeholders about the complexity and scope of the CPOE project. Communication would have included that additions to the project would increase the timeframe and cost of the project. When all entities understand the complexity of the project and that, there will be delays or setbacks in the implementation process this will help ease doubt during transitional times. Conclusion
Having a strong implementation plan and goals are imperative when beginning the process of adding or changing an information system. Health care is changing rapidly and implementing system changes takes time, extensive planning, and support. Ensuring that a strong foundation and understanding of the project is in place before implementing a systems change will help in
the success of the project.
Wager, K. A., Lee, F. W., Glaser, J. P., & Burns, L. R. (2009). Health Care Information Systems. A Practical Approach for Health Care Management, Second Edition. [University Of Phoenix]. http://dx.doi.org/ 9780470387801
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