Implementing EMR/EHR

Implementing Electronic Medical/Health Records in Physician-Based Facilities

The integration of electronic health records has been a mainstreaming breakthrough for the health care industry over the past 10 years. Although this new era of health information technology has swept the nation, there are still a considerable amount of complications that many organizations face daily. The challenges of learning how to integrate basic electronic health records has hindered many facilities with the amount of changes from using patient paper charts to revamping their entire systems to an electronic format. The intended purpose of this study is to show insight on the challenges of technical knowledge that have had to overcome in order to successfully implement electronic health records within their organizations.

History of Electronic Health Records Implementation

In 2009, the United States started the establishment of the Health Information Technology for Economic and Clinical Health Act (HITECH) which provided substantial incentives for major hospitals and certain professional to acquire and use health information technology by demonstrating “meaningful use” of electronic health records to Medicare and Medicaid professional participants, along with funding for professionals who serviced Medicaid patients to implement electronic health records within their organization (Thorpe, J. A., Gray, E. A., Cartwright-Smith, L. 2016).

Today, more than 70% of the population has some sort of basic electronic health record system which enables them to have patient demographics, physician’s notes, problems list, and comprehensive patient charts to with very minimal use of paper. They are also able to freely share this information from one provider to another in a different facility, making the continuity of care between specialties a smooth transition for the patient. The goal of providing quality patient care among providers have exceeded the theory of what was initially implemented in 2009, yet the challenges of this integration has still hindered facilities to maximize their knowledge to successfully adapt to the change, leaving barriers within the organization (McAlearney et al., 2015).

Physician’s Technical Knowledge Barriers

One root cause for the slow implementation of electronic health records into physician-based facilities has been noted at the physician-level because of the lack of technical knowledge. With the change from paper charts to an electronic system, many older physicians were faced with the challenge of learning how to navigate through computers and tablets and learning new software, as many of them had never touched a computer before and did not even know how to type (McAlearney et al., 2015). In 2017, McAlearney Hefner, Sieck, & Huerta (2015) conducted a study of grounded theory through 35 interviewees using inductive and deductive methods that concluded that the physician perspective of the change could be conceptualized by using Elisabeth Kubler-Ross’s model which categorized the five stages of grief: denial, anger, bargaining, depression and acceptance.

These five stages identified as followed: Denial – physicians felt overwhelmed and shocked by the amount of information they must retain through the use of computers; Anger – the amount of expenses that organizations had to face while training other clinical staff who didn’t truly show an interest the implementation and provided minimal work ethic; Bargaining – physicians who were unwilling to adapt simply retired, and others provided verbal orders to their clinical staff to avoid actually using their systems on their own; Depression – physicians felt hopeless and inadequate to other clinical staff as they could not conform to the change, creating a loss of power and shift in responsibilities for other staff members; Acceptance – physicians and other clinical staff were provided a better work flow and can easily obtain patient information without the use of paper. These five stages of grief provide insight on how detrimental it was for physicians to adjust and adapt to the integration of technology within their organization in order to adequately provide “meaningful use” to their systems.

A Solution to Successfully Implement Electronic Health Records

TMLT offers a six step video to assist in your in office presence when integrating your EMR/EHR process: https://www.youtube.com/watch?time_continue=30&v=x0LiiSbKKEg&feature=emb_logo .

As technical advancements continue to become useful in modernized medicine, physician-based facilities must find a resolution to ensure that their organization sustains “meaningful use” of their new systems. There are many options that physician-based facilities can take in order to successfully implement electronic health records into their organization. Green et al. (2015) suggests that implementation specialists can be useful to as they will be able to devote most of their work to educating practitioners, clinical staff and vendors about meaningful use. Another way for organizations to maximize their organizations capabilities through electronic health records can be identified as conceptualization of adopting this new feature as a personal change through a metaphor of loss and grief.

Conclusion

Understanding and identifying the effects of the emotional challenges that physician-based facilities have endured or the past ten years while trying to successfully implement electronic health records is key to changing the perspectives of those involved to improve their organization. Many facilities have fallen to the hands of loss because their unwillingness to accept the changes, however, realizing that the change is for the greater good of their organization will bring new perspectives and better opportunities to collaborate with other health entities.

References

Green, L. A., Potworowski, G., Day, A., May-Gentile, R., Vibbert, D., Maki, B., & Kiesel, L.       (2015). Sustaining “meaningful use” of health information technology in low-resource          practices. Annals of Family Medicine, 131(, 17-22. doi:10.1370/afm.1740.

McAlearney, A. S., Hefner, J. L., Sieck, C.J., & Huerta, T.R. (2015). The Journey through           grief: Insights from a qualitative study of electronic health record implementation.         Health Services Research, 50(2), 462-468. doi:10.1111/1475-6773.12227.

Thorpe, J. H., Gray, E. A., & Cartwright-Smith, L. (2016). Show us the data: The critical role health information plays in health system transformation. Journal of Law, Medicine, & Ethics, 44(4), 592-597. doi:10.1177/1073110516684800.