Adoption of Electronic Health Record – Health System Example

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"Adoption of Electronic Health Record" is a wonderful example of a paper on the health system. Former President George W. Bush’ s emphasis on the healthcare industry to provide every American with an electronic health record (EHR) elated the information technology enthusiasts (Murphy, 2011).   President Obama worked with Congress to pass the American Recovery and Reinvestment Act (ARRA) in 2009.  The ARRA earmarked $19 billion as a financial incentive for the hospitals that can make meaningful use (MU) of the EHRs (Murphy, 2011).   Since then, non-federal funded hospital adoption of EHRs has increased five times (Charles, Gabriel, and Furukawa, 2014).   The nursing informaticist has become valuable to healthcare institutions that plan to implement EHRs as the federal incentives are at stake (Ericksen, 2009). Implementation The Institute of Medicine (IOM) advises upon the utilization of information technology (IT) to enhance patient safety through its support system (IOM, 2001).   Study analysis of IT implementation in healthcare promotes patient safety through standardization, error reduction, and elimination of hand-written data orders (IOM, 2001).   The use of IT in healthcare can advance nursing evidence-based practice undeviatingly in real-time; this allows prompt accessibility to healthcare literature thereby augmenting the best clinical decision-making (Simpson, 2012).   The Technology Informatics Guiding Education Reform (TIGER) is directed at engaging all healthcare stakeholders in improving nursing education and practice (Walker, 2010).   Its goal is to make nurses competent in developing technologies to ensure the delivery of patient-centered care (Du Long, 2008).   Adoption of EHR, being a change, poses challenges to organizations.   This paper uses Roger’ s diffusion of innovation theory as a tool to convince the resistant members of the multidisciplinary team to adopt the EHR system. Relative advantage The impetus of EHRs continues to grow in the healthcare industry just as its adoption has become preconditioned after the passing of ARRA.   Nurses should understand the advantage of EHR’ s implementation when it is fully integrated.

  According to McGonigle and Mastrian (2012), nursing professionals are information-reliant knowledge workers.   The use of EHR improves the timely extrapolation of patient’ s data augmenting the abilities of nurses and helps them devise useful strategies, mediate, and evaluate the efficiency of the individualized treatment plans (Kilpatrick, 2013).   Understanding the positive impact of EHR on the social and task environment fosters the experiential process of change (Prochaska and DiClemente, 1984). Compatibility of Values and Nursing Practice The evolution of healthcare in conjunction with nursing practice raises ethical concerns when nurses confront issues contrary to their beliefs (LaSala and Bjarnason, 2010).   Transparent communication between EHR’ s project manager and stakeholders is critically important to establish a firm foothold on employees’ behavioral change.   EHRs’ program manager should impart the benefits of EHR to one’ s success and happiness; this is crucial for the experiential process of change (Prochaska and DiClemente, 1984). Simplicity Successful adoption of EHR in any institution requires the usability of the system’ s software (McGonigle and Mastrian, 2012).   A well-design EHR assists the clinicians in providing the best clinical practice; EHR’ s foundation represents the clinical end-user viewpoint (Franzke, Wright, & Hautamaki, 2013).   The aforementioned authors also believe that EHR’ s usability is a common reason behind resistance to its swift utilization in the healthcare industry.   Physicians, nurses, and other team members should be involved in EHR design and modification.   The use of IT to assimilate nursing data leaves nurses more time for patient care (Rung-Chuang and Yu-Ting, 2014).

  Nurses should be included in the early phase of EHR implementation (Gruber, Darragh, Puccia, Kadric, & Bruce, 2010), Trialability The adoption of EHR in any healthcare organization can be challenging for computer-illiterate nurses.   Allowing exposure to innovation can open the door to learning for them.   The experiential process of change includes social liberation as every stakeholder is engaged in the use of EHRs (Prochaska and DiClemente, 1993).   Another way to augment the acceptance of EHR is stimulus control that involves the transformation of the target population’ s environment (Prochaska and DiClemente, 1993).   The aforementioned authors believe that eradication of any environmental condition that promotes the status quo creates a productive milieu for learning innovations that in turn stimulates the change process.

There is also a need to assess options and approaches periodically when contrasting ideas emerge such as IT personnel’ s preferential design, organizational view of the system, and clinicians on the ground (Cresswell and Sheikh, 2009).   Implementation of the EHR is an iterative process and requires teamwork; negotiations with all stakeholders and prudent considerations on system refinements are inherent (Cresswell & Sheikh, 2009).   Observable Results Team members’ acceptability toward EHR uses increases after witnessing discernable positive results.

The project manager should educate all clinical end-users on the benefits offered by EHR to prevent potential impedance (Cresswell & Sheikh, 2009). Change happens to individuals; it is personal and influenced by one’ s awareness of autonomy, capacity, sense of loss, entitlement, and self-gain (Fickenscher and Bakerman, 2011).   All end-users should acknowledge EHR’ s values to advance proficiency, clinical competence, and personal growth. Summary Implementation of EHR in any organization is challenging for nurse leaders and project managers.   Change comes at a price, and the obstacle one faces requires in-depth knowledge and skills to influence people to accept it.

  Developing the five qualities identified by Everett Rogers help nursing leaders in ameliorating the burden of change.   Utilization of EHR would materialize when stakeholders view the amalgamation of healthcare and IT as a tool to improve healthcare practice (McGonigle and Mastrian, 2012).

References

Charles, D., Gabriel, M., Furukawa, M., (2014). Adoption of electronic health record system among U.S. non-federal acute care hospitals: 2008-2013. The Office of the National Coordinator for Health Information Technology. Retrieved from http://www.healthit.gov/sites/default/files/oncdatabrief16.pdf

Cresswell, K., & Sheikh, A. (2009). The NHS Care Record Service (NHS CRS): recommendations from the literature on successful implementation and adoption. Informatics in Primary Care, 17(3), 153-160.

Du Long, D. (2008). Informatics: The Tiger project. The Journal of Issues in Nursing, 13(2). doi: 10.3912/OJIN.Vol13No02InfoCol01

Ericksen, A. B. (2009). Informatics: the future of nursing. RN, 72(7), 34-37.

Fickenscher, K., & Bakerman, M. (2011). Change Management in Health Care IT. Physician Executive, 37(2), 64-67.

Franzke, M., Wright, S., & Hautamaki, B. (2013). The intersection of IT and human factors: summative testing in safety-enhanced EHR design. Biomedical Instrumentation & Technology, 54-58. doi: 10.2345/0899-8205-47.s2.54

Gruber, N., Darragh, J., Puccia, P. H., Kadric, D. S., & Bruce, S. (2010). Embracing change to improve performance. Long-Term Living: For the Continuing Care Professional, 59(1), 28-31.

Kilpatrick, K. (2013). How do nurse practitioners in acute care affect perceptions of team effectiveness? Journal of Clinical Nursing, 22(17/18), 2636-2647. doi: 10.1111/jocn.12198

LaSala, C. A., & Bjarnason, D. (2010). Creating workplace environments that support moral courage. The Online Journal of Issues in Nursing, 15(3). doi: 10.3912/OJIN.Vol15No03Man04

Murphy, J. (2011). Leading from the Future: Leadership Makes a Difference During Electronic Health Record Implementation. Frontiers of Health Services Management, 28(1), 25-30.

Rung-Chuang, F., & Yu-Ting, Y. (2014). A New Vision of Nursing: The Evolution and Development of Nursing Informatics [Chinese]. Journal of Nursing, 61, 78-84. doi: 10.6224/JN.61.4S.78

Walker, P. H. (2010). The TIGER Initiative: A Call to Accept and Pass the Baton. Nursing Economic$, 28(5), 352-355.

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