Christopher A Longhurst, Jonathan P Palma, Lisa M Grisim, Eric Widen, Melanie Chan, Paul J Sharek
{"title":"Using an Evidence-Based Approach to EMR Implementation to Optimize Outcomes and Avoid Unintended Consequences.","authors":"Christopher A Longhurst, Jonathan P Palma, Lisa M Grisim, Eric Widen, Melanie Chan, Paul J Sharek","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Implementation of an electronic medical record (EMR) with computerized physician order entry (CPOE) can provide an important foundation for preventing harm and improving outcomes. Incentivized by the recent economic stimulus initiative, healthcare systems are implementing vendor-based EMR systems at an unprecedented rate. Accumulating evidence suggests that local implementation decisions, rather than the specific EMR product or technology selected, are the primary drivers of the quality improvement performance of these systems. However, limited attention has been paid to effective approaches to EMR implementation. In this case report, we outline the evidence-based approach we used to make EMR implementation decisions in a pragmatic structure intended for replication at other sites.</p>","PeriodicalId":80028,"journal":{"name":"Journal of healthcare information management : JHIM","volume":"27 3","pages":"79-83"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3998198/pdf/nihms526545.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32295334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"So much to do, so little time. To accomplish the mandatory initiatives of ARRA, healthcare organizations will require significant and thoughtful planning, prioritization and execution.","authors":"Kimberly Klein","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The American Recovery and Reinvestment Act of 2009 (ARRA) has set forth legislation for the healthcare community to achieve adoption of electronic health records (EHR), as well as form data standards, health information exchanges (HIE) and compliance with more stringent security and privacy controls under the HITECH Act. While the Office of the National Coordinator for Health Information Technology (ONCHIT) works on the definition of both \"meaningful use\" and \"certification\" of information technology systems, providers in particular must move forward with their IT initiatives to achieve the basic requirements for Medicare and Medicaid incentives starting in 2011, and avoid penalties that will reduce reimbursement beginning in 2015. In addition, providers, payors, government and non-government stakeholders will all have to balance the implementation of EHRs, working with HIEs, at the same time that they must upgrade their systems to be in compliance with ICD-10 and HIPAA 5010 code sets. Compliance deadlines for EHRs and HIEs begin in 2011, while ICD-10 diagnosis and procedure code sets compliance is required by October 2013 and HIPAA 5010 transaction sets, with one exception, is required by January 1, 2012. In order to accomplish these strategic and mandatory initiatives successfully and simultaneously, healthcare organizations will require significant and thoughtful planning, prioritization and execution.</p>","PeriodicalId":80028,"journal":{"name":"Journal of healthcare information management : JHIM","volume":"24 1","pages":"31-5"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28650197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"There's an app for that--mHealth takes center stage.","authors":"Rick Krohn","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80028,"journal":{"name":"Journal of healthcare information management : JHIM","volume":"24 3","pages":"9-10"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29160211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Connecting for care--nursing and health information exchange.","authors":"Judy Murphy","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80028,"journal":{"name":"Journal of healthcare information management : JHIM","volume":"24 3","pages":"11-3"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29160212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Workflow viewpoints: Analysis of nursing workflow documentation in the electronic health record.","authors":"Luann Whittenburg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article amplifies the emphasis on organizational workflow reignited by the Institute of Medicine reports on healthcare quality. The analysis of nursing workflow is central to understanding the power of technology to modify the fundamental constructs of nursing practice. The aim is to understand the evolution of nursing workflow and the concept of workflow from the management and computer science perspectives used in electronic health records and computerized provider order entry. The understanding of the workflow models within health information disciplines may improve the model of nursing workflow underlying the implementation of electronic health record systems. The article follows the Walker and Avant evolutionary method of concept analysis.</p>","PeriodicalId":80028,"journal":{"name":"Journal of healthcare information management : JHIM","volume":"24 3","pages":"71-5"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29162750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anthony Dunnigan, Karen John, Andrea Scott, Lynda Von Bibra, Jeffrey Walling
{"title":"An implementation case study. Implementation of the Indian Health Service's Resource and Patient Management System Electronic Health Record in the ambulatory care setting at the Phoenix Indian Medical Center.","authors":"Anthony Dunnigan, Karen John, Andrea Scott, Lynda Von Bibra, Jeffrey Walling","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Phoenix Indian Medical Center (PIMC) has successfully implemented the Resource and Patient Management System Electronic Health Record (RPMS-EHR) in its Ambulatory Care departments. One-hundred and twenty-six providers use the system for essentially all elements of documentation, ordering, and coding. Implementation of one function at a time, in one clinical area at a time, allowed for focused training and support. Strong departmental leadership and the development of 'super-users' were key elements. Detailed assessments of each clinic prior to implementation were vital, resulting in optimal workstation utilization and a greater understanding of each clinic's unique flow. Each phase saw an increasing reluctance to revert to old paper processes. The success of this implementation has placed pressure on the remainder of the hospital to implement the RPMS-EHR, and has given the informatics team an increased awareness of what resources are required to achieve this result.</p>","PeriodicalId":80028,"journal":{"name":"Journal of healthcare information management : JHIM","volume":"24 2","pages":"23-7"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28927082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The federal health record gateway.","authors":"Dennis Porter","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The federal government can make federally held health data available to every American through a single, secure, recurring instance based portal on the emerging Nationwide Health Information Network (NHIN). The Federal Health Record Gateway (FHR Gateway) supports the President's initiatives for patient-centered health by enhancing transparency of government-held clinical and health claims data.</p>","PeriodicalId":80028,"journal":{"name":"Journal of healthcare information management : JHIM","volume":"24 2","pages":"60-3"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28927088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Emotion and ambulatory EHR in the ARRA era.","authors":"Amy Berlin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>There is a growing focus in change management literature on the role of emotion in managing change. Barriers to adoption and effective implementation of ambulatory EHR-ranging from technical to financial to logistical-are well-described in the health-care IT literature. In the ARRA era, ambulatory practices are under increasing pressure to overcome these barriers. This article explores the emotional barriers to EHR adoption and implementation in ambulatory settings, synthesizing ideas drawn from business and psychology literature on emotion in organizational change. Key strategies for assessing and addressing these barriers are outlined.</p>","PeriodicalId":80028,"journal":{"name":"Journal of healthcare information management : JHIM","volume":"24 2","pages":"19-22"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28926080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Meaningful use. What does it mean for healthcare organizations?","authors":"Barbara J Hoehn","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80028,"journal":{"name":"Journal of healthcare information management : JHIM","volume":"24 1","pages":"10-2"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28650192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Protection detail. Protecting against breach of electronic protected health information.","authors":"Gerry Blass, Susan A Miller","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Covered entities need to conduct risk assessments that cover the requirements of HIPAA, HITECH and Meaningful use, and create a process for steady and consistent mitigation of known gaps and vulnerabilities based on risk. Reducing risk of vulnerabilities of unauthorized access to your ePHI can be done via safeguards and controls, plus audits and monitoring. When reducing risk is outside of a covered entities control, audits and monitoring are required in order to demonstrate due diligence. Know where your ePHI is stored, where it is at risk, and take steps now to reduce or eliminate the risk. Encrypt vulnerable locations. Encrypt sensitive data. By doing so, you will be protecting your organization by reducing risk of breach of ePHI. Finally, don't forget what is sometimes considered to be the hardest part--documenting your compliance activities in order to demonstrate evidence of due diligence in and avoid major $$$$ penalties for negligence under the HITECH Act of 2009.</p>","PeriodicalId":80028,"journal":{"name":"Journal of healthcare information management : JHIM","volume":"24 3","pages":"7-8"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29160210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}