Evidence-based management of ambulatory electronic health record system implementation: An assessment of conceptual support and qualitative evidence

McAlearney, Ann Scheck; Hefner, Jennifer L; Sieck, Cynthia J.; Rizer, Milisa; Huerta, Timothy R.

doi:10.1016/j.ijmedinf.2014.04.002

Cited by 20 publications

(15 citation statements)

References 39 publications

(64 reference statements)

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“…Whilst initial emphasis is ensuring safe EPR functionality, this should evolve towards user customisation and secondary use of data to improve outcomes, such as patient safety 46. Successful sites demonstrate common themes, including the use of published evidence, focus on workflows rather than technology and ensuring that management structures facilitate the process 47. Specifically, regarding academic medical centres, early and ongoing executive support, emphasis on training and support, ongoing system optimisation and patient portal functionality were success factors 48…”

Section: Resultsmentioning

confidence: 99%

What to expect from electronic patient record system implementation: lessons learned from published evidence

Priestman

Sridharan

Vigne

et al. 2018

BMJ Health Care Inform

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BackgroundNumerous studies have examined factors related to success, failure and implications of electronic patient record (EPR) system implementations, but usually limited to specific aspects.ObjectiveTo review the published peer-reviewed literature and present findings regarding factors important in relation to successful EPR implementations and likely impact on subsequent clinical activity.MethodLiterature review.ResultsThree hundred and twelve potential articles were identified on initial search, of which 117 were relevant and included in the review. Several factors were related to implementation success, such as good leadership and management, infrastructure support, staff training and focus on workflows and usability. In general, EPR implementation is associated with improvements in documentation and screening performance and reduced prescribing errors, whereas there are minimal available data in other areas such as effects on clinical patient outcomes. The peer-reviewed literature appears to under-represent a range of technical factors important for EPR implementations, such as data migration from existing systems and impact of organisational readiness.ConclusionThe findings presented here represent the synthesis of data from peer-reviewed literature in the field and should be of value to provide the evidence-base for organisations considering how best to implement an EPR system.

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Section: Resultsmentioning

confidence: 99%

What to expect from electronic patient record system implementation: lessons learned from published evidence

Priestman

Sridharan

Vigne

et al. 2018

BMJ Health Care Inform

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“…The fact that methods were being developed to assist with HCT planning (Paine et al, 2014; Reiss et al, 2005; van Staa et al, 2011), and provider input was sought through a continuous needs assessment process (provider surveys and feedback sessions and actual TPT use), furthered their interest and commitment (McAlearney, Hefner, Sieck, Rizer, & Huerta, 2014). This is illustrated by one representative provider comment: “HCT is much more complex than I thought it was, yet I am thinking about using [the TPT] with all my transition-aged patients now.”…”

Section: Discussionmentioning

confidence: 99%

Integrating an EMR-based Transition Planning Tool for CYSHCN at a Children's Hospital: A Quality Improvement Project to Increase Provider Use and Satisfaction

Wiemann

Hergenroeder

Bartley

et al. 2015

Journal of Pediatric Nursing

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An electronic medical record (EMR)-based transition planning tool (TPT) designed to facilitate transition from pediatric to adult-based health care for youth (16–25 years) with special health care needs was introduced at a large children's hospital. Activities to increase provider use were implemented in five plan–do–study–act cycles. Overall, 22 of 25 (88%) consenting providers in four pediatric subspecialty services used the TPT during 303 patient encounters, with nurses and case-managers the top users and physicians the least likely users. Use was highest with intensive technical assistance and following the introduction of an upgraded tool. Provider satisfaction with the TPT and self-reported transition planning activities notably increased across the PDSA cycles.

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“…According to the included studies, the most common role for healthcare leaders in HIT implementation was that of supporter [33][34][35][38][39][40][41][42]47,48]. Leaders at all levels were responsible for supporting HIT implementation [33,35,39,47].…”

Section: Role Of Supportermentioning

confidence: 99%

“…In some studies, support was described as providing sufficient resources to advance HIT implementation [35,42,46]. These resources were either financial [42] or they were to enable HIT training for the healthcare professionals using HIT [38,48,49]. Support was also understood as motivating healthcare professionals to use HIT and working closely with them [48].…”

Section: Role Of Supportermentioning

confidence: 99%

“…Healthcare leaders performed tasks related to change management by informing healthcare professionals about the changes through clear communication [38,42,45] and identifying any resistance [39,41,45]. However, in many cases leading was not simple, for example, physician leaders pointed out that physicians were too autonomous and difficult to lead [48] and resistance to change was common [39,41,45,48].…”

Section: Role Of Change Managermentioning

confidence: 99%

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Identifying the Roles of Healthcare Leaders in HIT Implementation: A Scoping Review of the Quantitative and Qualitative Evidence

Laukka

Huhtakangas

Heponiemi

et al. 2020

IJERPH

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Despite major investment, health information technology (HIT) implementation often tends to fail. One of the reasons for HIT implementation failure is poor leadership in healthcare organisations, and thus, more research is needed on leaders' roles in HIT implementation. The aim of the review was to identify the role of healthcare leaders in HIT implementation. A scoping review with content analysis was conducted using a five-step framework defined by Arksey and O'Malley. Database searches were performed using CINAHL, Business Source Complete, ProQuest, Scopus and Web of Science. The included studies were written either in English or Finnish, published between 2000 and 2019, focused on HIT implementation and contained leadership insight given by various informants. In total, 16 studies were included. The roles of healthcare leaders were identified as supporter, change manager, advocate, project manager, manager, facilitator and champion. Identifying healthcare leaders' roles in HIT implementation may allow us to take a step closer to successful HIT implementation. Yet, it seems that healthcare leaders cannot fully realise these identified roles and their understanding of HIT needs enforcement. Also, healthcare leaders seem to need more support when actively participating in HIT implementation.

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Evidence-based management of ambulatory electronic health record system implementation: An assessment of conceptual support and qualitative evidence

Cited by 20 publications

References 39 publications

What to expect from electronic patient record system implementation: lessons learned from published evidence

What to expect from electronic patient record system implementation: lessons learned from published evidence

Integrating an EMR-based Transition Planning Tool for CYSHCN at a Children's Hospital: A Quality Improvement Project to Increase Provider Use and Satisfaction

Identifying the Roles of Healthcare Leaders in HIT Implementation: A Scoping Review of the Quantitative and Qualitative Evidence

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