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I need to make sure my paper alines with these guidelines. The paper will you put into a CDC template please
1. Introduction?Purpose
2. Project and Product Overview
3. Justification
4. Scope
5. Duration
6. Budget Estimate
7. High-Level Alternatives Analysis
8. Assumptions, Constraints, and Risks
9. Project Organization
10. Appendix A: References
Running head: PROPOSAL FOR EVIDENCE BASED PRACTICE Implementation strategy for Electronic Health Record in the healthcare facilities incorporating
human factors engineering principles PROPOSAL FOR EVIDENCE-BASED PRACTIVE 2 Abstract
An electronic health record is a computerized way of storing patient information within a
database. This method of storage allows the medical records of all patients in the database to be
shared through a controlled network of medical institutions. The records are in digital format;
they require to be coded to protect the patient?s information. The EHRs contain a comprehensive
outlook of the patients in the database. The records are aimed at ensuring quality management,
providing evidence when making decisions, and reporting the outcome. Medical institutions that
have integrated this mode of data storage increase safety in the organizations practices. The
report evaluates the case for EHRs as a way to improve healthcare in the country. Section A: Problem Description
AT& T organization is a very busy public hospital whose main business is to offer
orthopedic services. Due to the large number of customers visiting the hospital every day, the
medical records for all the patients continue to pile, considering that the same medical
information is being filed manually. Because of this, the Front Office Receptionist continues to
have a hard time each day trying to manually open the different folders carrying patients? the
files. Being as hard as that, it implies that the delivery of the services in the hospital does not
occur in a satisfactory manner (Selg & Rihel, 2007).
The problem of doing the service delivery manually in the hospital has had far-stretching
effects to both the hospital and the clients. For the hospital, the slow service delivery has
constantly jeopardized the customer relations aspect of the organization. This is because when a PROPOSAL FOR EVIDENCE-BASED PRACTIVE 3 client visits the hospital and takes the whole day waiting for the staff to retrieve his or her files
and go through the records, next time, he or she will opt to a different hospital. For the clients on
the other hand, someone with a critical health condition may not be saved just because his or her
medical records are lost. Therefore, the absence of efficient medical coding can worsen the
conditions of the patient.
The problem resulting from the absence of medical coding system in the hospital mainly
affects the Front Office Receptionist. This is because the front office receptionist is the person
who is responsible for the production of the medical information for the different clients getting
into the hospital.
There are a lot of consequences if the problem is ignored. By ignoring the problem, it is
very likely that the service delivery in the hospital will continue to be slow. The amount of work
for the front office receptionist will continue to increase, and become too much for him or her.
This means that the receptionist will be straining each day, trying to serve all the clients. This is
not healthy for the receptionist. The hospital will generate less than the expected income. This is
because it will not serve the clients in a proper rate (Heerkens, 2002).
Voice of the Customer Analysis or Market Analysis is also evident as far as this problem
is concerned. With the absence of the medical coding equipment in the hospital, the customers
continue to complain that they do not receive the services in a satisfactory manner. Some
complain that their records occasionally get lost. Others say that they have to queue for long
hours before they can be attended to, while other still complain of their medical documents
which have been torn or soiled.
Section B: Literature Support PROPOSAL FOR EVIDENCE-BASED PRACTIVE
From the Journal of Revenue and Pricing Management, it is evident that the
implementation of electronic health management would promote the growth of private medical
institutions. Private physicians would provide better quality healthcare to the patients. Record
keeping would become efficient, and the entity would minimize the losses incurred due to
reimbursement coding (Kumar & Bauer 123). It is also evident that the cost associated with
implementation of EHRs is low compared from the benefits that can be derived from them
(Kumar & Bauer 123).
Daniel et al.?s article reveals that 77% of the participants interviewed have basic
knowledge concerning the use of technology in handling the patient?s information (Gaylin et al.
924). The research also shows that a large percentage (78%) of the patients prefer the use of
EHRs (Gaylin et al. 922). Most of the respondents believed that the implementation of EHRs
would reduce the cost of medical care. American respondents that believe electronic medical
records would lower the cost of medical care constitute 59% of the sample (Gaylin et al. 923).
The research shows that most patients prefer the use of electronic medical records (Gaylin et al.
924).
Implementation of EHRs has its demerits in that the client?s privacy may be breached if
hackers retrieve the user?s information (Jacques 453). The article by Jacques shows the dangers
associated with EHRs and the government?s efforts to reduce the risks. The Jacque?s article
further shows that the benefits derived from information technology outweigh the demerits
(Jacques 454).
The survey conducted in the editorial, Annals of Internal Medicine shows that only 14%
of the U.S' hospitals implement computerized record keeping with the figure dropping to 3% in 4 PROPOSAL FOR EVIDENCE-BASED PRACTIVE 5 all practices (Baron 698). Although the implementation of computerized health records has
numerous benefits, its implementation needs to be enhanced, to realize benefits (Baron 698).
The adoption of EHRs will facilitate sharing of medical information across hospitals.
This will enable the hospital to track the payment and charges associated with the patient. The
mode of treatment used incase of referrals is documented together with the the patient?s medical
history. This documentation enables the physicians to use effective methods to treat the patient
thus eliminating the redundancy in the treatment offered by the previous treatment. The
physicians would benefit from using the EHRs by saving their operational costs.
Medical errors that may jeopardize the physician?s license can be avoided through
computerized maintenance of patient records. Medical errors that are prevented through the
records include documented allergies in the patient?s records. Some patients may have allergies
to some medication thus, the records may save the patient's life. For a private physician, the
implementation of computerized health records will increase the client base (Kumar & Bauer
123).
The physician can improve his record of accomplishment through improved healthcare. It
can be compared to advertising ,whereby the patients recommend the medical institutions to their
friend. Implementing electronic medical records will allow physicians to make informed health
decisions when treating the patient.
The cost benefit approach has been used in the Journal of Revenue and Pricing
Management to justify the implementation of EHRs. The costs associated with using the EHRs
relate to the maintenance costs, the cost of the hardware and software to be implemented in the
institution, and the installation costs. The benefits derived from the system outweigh the costs.
The organization will benefit from reduced transcription cost since in the United States, up to PROPOSAL FOR EVIDENCE-BASED PRACTIVE 6 $12 billion are used annually in transcription of related expenses (Kumar & Bauer 123). The
physician can divert the money saved from transcription expenses to enhance the health facility
(Kumar & Bauer 123). The physician will handle the revenue loss in the business through
reimbursement coding (Kumar & Bauer 123). Reimbursement from government and insurance
firms are accurate when EHRs are used. The entity reduces the cost related to using the
conventional chart system. The physician in a private medical institution saves on filing space
and cost of maintaining the medical records.
The second article by Daniel et al. evaluates the public?s opinion towards the use of
EHRs (Gaylin et al. 920). The increase in technological advances in other sectors, has allowed
the public to benefit from efficient services at a reduced cost. Prior studies pertaining technology
in the health sector show a low reception to the concept (Gaylin et al. 925). The growth in
information technology sector is anticipated to produce better reception due to the increase in
awareness. For a private physician, evaluation of patients? wants and providing quality health
care should be focused on before implementing changes to the entities operations (Gaylin et al.
921).
The public is aware of the merits associated with information technology and its effects
on the quality of healthcare. The physician should implement the technology to increase the
client base (Gaylin et al. 922). The research was conducted through telephone (Gaylin et al. 923).
The research targeted the technologically informed members of the public. The result highlight
that the public opinion favors information technology (Gaylin et al. 924).
The patient?s health record contains the patients personal information accumulated over
time. With the implementation of EHRs, the information is stored in the hospitals network. This
exposes the patient confidential information to hackers; the patient is entitled to confidentiality PROPOSAL FOR EVIDENCE-BASED PRACTIVE 7 according to the law. Lauren Bair evaluates the challenges associated with EHRs in the third
article. The article evaluates the government?s efforts to handle the challenges associated with
information technology to make the process safe (Jacques 445).
Private physicians risk the client?s private information being retrieved by unauthorized
people. This breaches the client?s right to privacy. The US government has implemented many
controls to ensure that eradication of the vice without success. Client?s information and EHRs
depend on one another to ensure quality healthcare. The patients should understand the risk
associated with their privacy and weigh the dangers they may be exposed to in both cases
(Jacques 440). EHRs implementation by the private physician should ensure the client
understands the information and the benefits (Jacques 441).
EHRs are meant to improve healthcare through the evaluation of a patient?s medical
history before administering treatment. The medical information may be lengthy and may cost
the patient time. The time taken by the physician to go through the medical records may be spent
to attend to other patients (Baron 697). The editorial from the Annals of Internal Medicine
evaluates the need to implement other systems to complement EHRs (Baron 697).
The article evaluates the efficiency of information systems in the medical sector and the
organization implementing IT in to its operations. The survey of regional health information
organization shows the need to improve implementation of computerized records (Baron 698).
Section C: Solution Description
EHRs method of storing patient information will assist the medical institutions enhance
their control over the revenue. Revenue enables organizations to run their business efficiently
and effectively. The health sector faces many challenges in its revenue control due to its unique PROPOSAL FOR EVIDENCE-BASED PRACTIVE 8 nature. The medical institutions account for their activities, different from other profit oriented
sectors (Kumar, Sameer, & Ken Bauer 120).
The adoption of EHRs will facilitate sharing of medical information across hospitals.
This will enable the hospital to track the payment and charges associated with the patient. The
mode of treatment used incase of referrals is documented together with the the patient?s medical
history. This enables the physicians to use effective methods to treat the patient other than
redundancy in the treatment offered by the previous treatment. The physicians would benefit
from using the EHRs by saving their operational costs.
Medical errors that may jeopardize the physician?s license can be avoided through
computerized maintenance of patient records. Medical errors that are prevented through the
records involve documented allergies in the patient?s records. Some patients may have allergies
to some medication thus; the records may save the patient's life. For a private physician, the
implementation of computerized health records will increase the client base (Kumar et. al. 123).
The physician can improve his record of accomplishment through improved healthcare. It
can be compared to advertising, whereby the patients recommend the medical institutions to their
friend. Implementing electronic medical records will allow physicians to make informed health
decisions when treating the patient.
The cost benefit approach has been used in the journal of revenue and pricing
management to justify the implementation of EHRs. The costs associated with using the EHRs
relate to the maintenance costs, the cost of the hardware and software to be implemented in the
institution, and the installation costs. The benefits derived from the system outweigh the costs.
The organization will benefit from reduced transcription cost since in the United States, up to
$12billion are used annually in transcription of related expenses. The physician can divert the PROPOSAL FOR EVIDENCE-BASED PRACTIVE 9 money saved from transcription expenses to enhance the health facility. The physician will
handle the revenue loss in the business through reimbursement coding. Reimbursement from
government and insurance firms are accurate when EHRs are used. The entity reduces the cost
related to using the conventional chart system. The physician in a private medical institution
saves on filing space and cost of maintaining the medical records.
The second article by Daniel evaluates the public?s opinion towards the use of EHRs. The
increase in technological advances in other sectors, has allowed the public to benefit from
efficient services at a reduced cost. Prior studies pertaining technology in the health sector show
a low reception to the concept. The growth in information technology sector is anticipated to
produce better reception due to the increase in awareness. For a private physician, evaluation of
patients? wants and providing quality health care should be focused on before implementing
changes to the entities operations (Jennifer, et al. 922).
The public is aware of the merits associated with information technology and its effects
on the quality of healthcare. The physician should implement the technology to increase the
client base. The research was conducted through telephone. The research targeted the
technologically informed members of the public. The result highlight that the public opinion
favors information technology.
From the journal of revenue and pricing management, it is evident that the
implementation of electronic health management would favor the growth of private medical
institutions. Private physicians would provide quality healthcare to the patients. Record keeping
would become efficient, and the entity would minimize the losses incurred due to reimbursement
coding. It is also evident that the cost associated with implementation of EHRs is low compared
from the benefits that can be derived from them (Kumar, et. al. 123). PROPOSAL FOR EVIDENCE-BASED PRACTIVE 10 Daniel?s article revels that 77% of the participants interviewed has basic knowledge
concerning the use of technology in handling the patient?s information. The research also shows
that a large percentage (78%) of the patients prefer the use of EHRs. Most of the respondents
believed that the implementation of EHRs would reduce the cost of medical care. American
respondents that believe electronic medical records would lower the cost of medical care
constitute 59% of the sample. The research shows that most patients prefer the use of electronic
medical records (Jennifer, et al. 933).
Implementation of EHRs has its demerits in that the client?s privacy is bleached in case
hackers retrieve the user?s information. The articles show the dangers associated with EHRs and
the government?s efforts to reduce the risks. The article further shows that the benefits derived
from information technology outweigh the demerits (Jacques 453).
The survey conducted in the editorial, annals of internal medicine shows that only 14% of
the U.S' hospitals implement computerized record keeping with the figure dropping to 3% in all
practices. Although the implementation of computerized health records has numerous benefits,
its implementation needs to be enhanced, to realize benefits (Baron 698). Section E: Implementation Plan
How patient database is created:
Life cycle of electronic health record is made up of three stages; they include the
following initiation, acquisition, and consolidation stage.
Initiation stage PROPOSAL FOR EVIDENCE-BASED PRACTIVE 11 Small, industrial ventures, reacting to predictable pain in a diligence, focus on a specific
position, for example, patient records and provide it with proprietary software. They try to act in
response to distinctive language, makeup, and processes connected to an industry (Petch, 2008).
As the responsiveness of their products along with their integrity grows, they influence the
understanding they have added serving their established base of clients and apply growing
revenues to advance the progress of their product also attempt to extend into the other field of the
industry.
Acquisition stage:
As their sales start to legalize the existence of actual need, entrepreneurs draw attentionlarge firms that seek to take advantage of materializing market and construct in the lead of their
own potentials and product like compatible software, data gathering devices, for example,
barcode readers. Acquirers? complexity draw closer when they attempt to integrate different
software that was produced using a distinct language, operating systems, as well as hardware
platforms (Danabedian & Gilmore, 2003).
Consolidation
Is the ultimate stage in which successful firms make conclusions on the residuals in the
market or leaving it, and in which only some surviving firms develop into standards for the
manufacturing. The reason for dividing database creation into three stages is to enhance
efficiency, traceability should complications arise, and for security purposes.
Section D: Change Model PROPOSAL FOR EVIDENCE-BASED PRACTIVE 12 An electronic health record is a computerized way of storing patient information within a
database. This method of storage allows the medical records of all patients in the database to be
shared through a controlled network of medical institutions. The records are in digital format;
require to be embedded to protect the patient?s information. It is thus inferred that, technology
has facilitated many changes in the globe. The changes have affected many industries, including
the health sector. Technology facilitates the quality of healthcare and enables reduction in errors
affecting the institutions revenue.
One of the changes in this case is that the development of electronic health records to do
code the medical records of the patients in the hospital will ease the work of front office
receptionist in busy hospitals by being able to effectively use the application to achieve accurate
and convenient keeping of records. The adoption of this technology by the office receptionist
may be slow if the receptionist is not given the necessary training on how to handle the
technological innovation. Therefore, for the hospital staff to adjust to this model easily, they have
to be trained on how to code the all the manually recorded data into electronic forms, how to
interpret the coded data and how to apply the coded medical records in the practical settings
Section F: Evaluation
The proposed evaluation strategy must comply with the set standards. One of these
standards is Comité Européen de Normalization: This standardization is in Europe and it is set by
the European Committee for Standardization, which is the officially competent organization of
the European. In the healthcare position, Comité Européen de Normalization standards are
recognized for medical strategies, (Harrison & Coussens, 2007). Healthcare service provider also
uses European standards, such as the EN ISO 9000 administration standards to confirm their PROPOSAL FOR EVIDENCE-BASED PRACTIVE 13 organization. Some healthcare professions are now crucial in European standards the
professional necessities for service to patients (Harrison & Coussens Ch, 2007).
Health level seven standards: This standard is based in the United States of America.
Unlike Comité, Européen de Normalization, Health level seven have different versions. It is
dominantly used in North America and Europe. Health level seven specifies several flexible
standards, guiding principle, and styles by which different healthcare structures can correspond
to each other. Such guiding principles or data standards are a set of regulations that permit
information to be forwarded and processed in a systematic and consistent way. These
information standards are meant to permit healthcare institutes to share easily clinical
information. Hypothetically, this aptitude to exchange information should help to reduce the
trend of medical care to be geographically separated and highly variable, (Danabedian &
Gilmore, 2003). Health level seven also creates document, conceptual and application standards.
Lastly is the American society for testing and materials, which originated from the
America Chapter of the International Association for Testing and Materials of 1898. The
organization is not profiting based, it offer voluntary services. The American society for testing
and materials has six principles, which include standard test method, standard specification,
practice, terminology, guide, and standard classification. It is dealing majorly with surgical
implant specifications.
The role of accreditation bodies is to help in setting national standards: Accreditation is
the procedure through which a free and legalized organization certifies the quality system and
capability of the health institutions on the line of predefined standards. It is carried out on a
regular basis to enhance keeping of standards and dependability of outcomes created to sustain PROPOSAL FOR EVIDENCE-BASED PRACTIVE 14 clinician reports. These bodies also assist in development of accreditation programs; they clarify
areas to be covered by accreditation standards, and identification of customers.
7. Project Plan Rationale Electronics Health Records are sets of software applications planned to improve the cost
of safety and patient protection. It offers a graphical user interface, which allows improved
entering to essential clinical information, direct entry of data by clinicians and additional users,
and clinical decision support tools at the tip of care. Electronic health record is generated within
the set up of a hospital or any health institution. It helps in data entry, maintenance, and
efficiency in data retrieval. It entails the following information, patient demographics,
improvement notes, precedent medical information, tribulations, important signs, immunization,
laboratory information, plus radiology information (Petch, 2008). Electronic health record
computerizes and rationalizes the doctor?s workflow. Electronics health records have the
capacity to create a whole record of a clinical patient encounter and sustaining other care related
operations either directly or circuitously through the interface concurrently. The operations can
be evidence based pronouncement support, quality administration, as well as outcomes reporting.
Appendix
Timeline
Activity Duration Draft Proposal 1 month Identification of the sponsors 3 months Sponsors interview 2 weeks Collection of funds 1 month PROPOSAL FOR EVIDENCE-BASED PRACTIVE Initiation stage 2 weeks Consolidation stage 2 weeks Recording of data 2 weeks Data Analysis 2 weeks Final Reporting 2 weeks 15 PROPOSAL FOR EVIDENCE-BASED PRACTIVE 16 References Bidgoli, H.,2004, The Internet encyclopedia, Volume 1. New Jersey, N J: John Wiley and Sons
Danabedian, M., & Gilmore, G., 2003, Spacecraft Thermal Control Handbook: Cryogenics
Volume 2 of Spacecraft Thermal Control Handbook, David G. Gilmore. New York, NY:
Aerospace Press. AIAA
Griffin, D. and Snook, D., 2006, Hospitals: what they are and how they work, Volume 10. New York, NY: Jones & Bartlett Learning.
Harrison, M. & Coussens, Ch., 2007, Global environmental health in the 21st century: from
governmental regulation to corporate social responsibility: a workshop
summary....
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