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  1. Using the template in the Appendix to the textbook,Strategic Healthcare Manageme

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  1. Using the template in the Appendix to the textbook,Strategic Healthcare Management: Planning and Execution, ?Project Charter,? develop these sections of your project charter:
    1. Scope
    2. Duration
    3. Budget
    4. all i need is what is asked for this week. please add if we need to. 

Running Head: Electronic Health Record Systems ELECTRONIC HEALTH RECORD SYSTEMS






DATE Running Head: Electronic Health Record Systems




Electronic health records systems (EHR) is the process by which electronic (e.g., digital) health


records are created or received and preserved for legal or business purposes. EHRs requires


decision making throughout the electronic health record's life cycle through the processing,


distribution, maintenance, storage, and retrieval of the health record to its ultimate disposition,


including archiving or destruction. Healthcare industry has made significant progress in the quest for electronic health records


(EHRs), which will improve the quality and safety of patient care and achieve real efficiencies in


the healthcare delivery system. EHRs are information technology systems that are designed to


support decision processes, with the assumption that improving the ability to identify evidence,


or assist with the integration of evidence this improves the quality of care.


Traditional health records concept and processes have been evaluated and applied in this


relatively new world of electronic health record systems; EHRs are there for the provision of


care across the healthcare continuum.


The e-health environment encompasses much more than the storage and retrieval of information.


The objectives of this study are to understand the factors influencing the adoption decision, how


the dynamics of the system affects the adoption patterns and what kind of interventions can


accelerate the adoption.




In the current world, Electronic Health Record systems have been implemented by an ever


increasing number of hospitals around the globe. Many governments such as in the U.S, U.K, Running Head: Electronic Health Record Systems


Denmark, New Zealand and Australia have initiated financial regulations to back on the


implementation of the systems having driven by the promise of enhanced integration and


availability of patients data. EMRs are being provided to improve the efficiency and costeffectiveness in healthcare settings. The rapid change of the environment has also been one of


the major factors for the adoption of the EHR systems.


Electronic health record is now used by majority of the physicians during patient encounter.


Through the use of checklists, alerts, and predictive tools the EHR systems have facilitated safety


and quality improvement. This system has already improved efficiency and quality since it has


reduced the costs of ?chart pulls? and can serve a number of patients at a time unlike the legacy


system that were used before.


Key considerations for a healthcare organization, apart from the primary one of improved patient


care, are cost containment and improving the efficiency of work practices. Health Information


Systems have the potential to support these objectives, at the same time as ensuring patient


safety. It is therefore imperative that we have means at our disposal to effectively evaluate not


only a health information system in a general sense, but more specifically whether the use of


Electronic Health Records is helping or hindering the realization of such goals. The implementation of health information technology involves significant financial investment


from health care providers. Therefore policy decision makers need to have a good understanding


of how information technology systems can be implemented effectively, and how they are


subsequently used by health care staff once they have been embedded within work processes. Running Head: Electronic Health Record Systems


The implementation of information systems in hospitals is more challenging than elsewhere


because of the complexity of medical data, data entry problems, security and confidentiality


concerns and a general lack of awareness and benefits of information technology.


As every health division resolves to implement EHRs is very important for the physicians to


understand the analysis of the patient data as by the systems, which must describe the problems


of the patients, and at the operational level the orders of the physicians are translated into action,


and therapeutic effects on the patients are measured and recorded. It is very vital for the


governments to be able to finance these infrastructure in order to be able to provide health care


for its populations.


The unaided human mind simply cannot process the current volume of clinical data required for


practice by this electronic health recording systems due to their enhanced speed and large


memories for storage of patients? data. The greatest benefit of computerization is quality than


improving efficiency since this aids in keeping track and monitoring abnormal results then giving


it appropriate follow-up. Moreover, electronic records can be linked with public health


surveillance, which may be extremely important in emergencies such as a bioterrorism attack or


an epidemic.


U.S.A have implemented EHRs and large organizations such as Veterans Health Administration


and Kaiser Permanente use robust EHRs (vista and epic) that generate enough data to change the


practice of medicine. In 2009 Kaiser Permanente reported two studies, one pertaining to the


management of bone disease and other chronic kidney disease. and with this they could show


that with this EHRs could focus on patients at risk and use all of the tools available to improve


disease management and generally population health. Running Head: Electronic Health Record Systems SOLUTION DESCRIPTION


This widespread implementation of EHRs would be of positive significance to the healthcare in


many ways such as: Paper records are limited; data in paper is not structured well that it can be computable


and hence shareable with other computer and systems. Paper also has shortcomings such, it is easy to destroy and difficult to analyze and determine who has seen it.


Need for improved efficiency and productivity; stored data by EHRs can be available to


everyone whenever they need it while they reduce redundancy unlike in the case of paperwork when information is lost.


Improved quality care and patient safety; due to safe keeping of records clinicians are


able to trace if they ever attended a patient this helping them in prescribing drugs. Quality


reports are far easier to generate with a EHRs compared to chart that requires a chart review.


Technological advances; the internet and World Wide Web make the application service


provider (ASP) concept for an electronic health record possible. Patients makes it possible for them to be able to access via the internet from office, home or hospital.


The need for aggregated data; in order to make evidence based decisions, clinicians need


high quality data that should derive from multiple sources: inpatient and outpatient care, acute and chronic care settings, urban and rural care and populations at risk.


The need for integrated data; paper health records are standalone. Lacking the ability to


integrate with other paper forms or information. Digital, unlike paper-based healthcare


information can be integrated with multiple internal and external applications. Running Head: Electronic Health Record Systems




System Dynamics (SD) is a methodology that involves simulation modeling used in the analysis


of complex systems. It focuses on the underlying reasons for changes over time. The cause and


effect relationships and the feedback loops are the two fundamental concepts used to explain a


change in a state of a variable.


The main objective of this study is to develop an understanding of the EHR adoption process and


to evaluate various policy options. A simulation model will provide grounds to attain this


objective. With this tool, policy options can be tested to assess the response of the system.


First, you built a stock-simulation model, then cause and effect relationships among needed


factors influencing the adoption process that need to be revealed. The flow adoption indicates the


number of providers adopting per year. Interactions of these loops determine the system


behavior. The model focuses on the factors that influence the adoption decision of the nonadopted population in the provider sector.


EHR implementation cost is another factor that effects the non-adopted population in their


decision to acquire EHR systems, implementation costs increase as the market matures. While


one would expect these costs to decline in a mature market, considering how fast the digital


technology advances, and thus new and improved structures are needed to support the


advancements, implementation costs increase as more enhanced products are released. With


increased costs, attractiveness of EHR systems declines and fewer providers adopt.




An electronic health record (EHR) implementation plan is a comprehensive set of strategies and


steps used by a health care organization when preparing for and executing the adoption of an Running Head: Electronic Health Record Systems


electronic-based health care system. Selecting and implementing a EHRs can place additional


strain to staff and resources. If practices don?t plan for this change, they will likely create more


work and defeat the intended purpose of increasing efficiency.


The best way to prepare for change is by following this fine steps: Performing a need assessment


Performing a readiness assessment


Performing a workflow analysis


Creating your road map for implementing system EVALUATION


It is important to evaluate whether EHRs could reduce medical errors and/or overcome barriers.


Since EHR Systems are an integral part of HealthCare systems generally, the risk of incidents


due to medical errors can be mitigated by correct identification of initial system requirements.


Through evaluation the EHRs we have to review on the perspectives such us, quality, impacts


and applications. Using goal-based evaluation and Update DE lone and Mclean: goals of an evaluation methods of evaluation (what to evaluate/ IT-system as such)


Research Topics


Research purpose


EHRs success


To find the success (how to evaluate/called IT-systems in use)


Evaluation models


Aims of evaluation


Updated DE Lone and


Based on safety and McLean IS attributes to evaluate weakness factors, and success model the success of EHRs workflow processes of (Updated D & M with those six EHRs in real medical model) dimensions, to Environment. enhance the functions


of the current EHRs.. Running Head: Electronic Health Record Systems


EHRs acceptance Task Fit of EHRs To recognize, forecast, Technology Acceptance Based on safety describe, and Model attributes to predict, recognize the (TAM) explain, and realize factors of computer the factors of the practice behavior that cause behavior that cause users accept or reject users accept or reject current EHRs. current EHRs.


It attempts to measure Task Technology Fit Based on safety and (TTF attributes to measure predict the fit of the performance of an acceptance current EHRs and use of technology between technology in and task based; to user evaluation of check whether this EHRs. EHRs could reduce


medical error or not CONCLUSION


The study focuses on Electronic Health Record how they improve quality medical services by


evaluating factors that may influence health information directors in hospitals to adopt EHR




The establishment and implementation of EHRs will also reduce the cases of medical errors Running Head: Electronic Health Record Systems REFERENCE Swartz, N. 2004, ?A Prescription for Electronic Health Records?, Information


Management Journal, V38, n4, p.20-26. A. K. Jha, C. M. Desroches, E. G. Campbell et al., ?Use of Electronic Health Records in U.S. Hospitals,? New England Journal of Medicine, April 16, 2009 360(16):1628?38.


J. A. Blaya, H. S. Fraser, and B. Holt, ?E-health technologies show promise in developing


countries,? Health Aff., vol. 29(2), pp. 244-251, 2010.


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