Electronic Medical Records Implementation in a Psychiatric Hospital - Research Paper Example

?Electronic Medical Records (EMR) Implementation in a Psychiatric Hospital Introduction For effective performance of psychiatric hospitals, there is need for change in management, ways of doing things to ensure the hospitals adapt to new technologies, and other changes aimed at improving service delivery. The changes should be done at both individual level and organizational level. The individual level changes should focus on changing the behaviors and skills of medical professionals to make them more receptive to changes. Organizational change should focus on changing the organization culture, technology, and leadership styles. The Need for Electronic Medical Records in Psychiatric Hospital Setting The term Electronic Medical Records (EMR) refers to clinical and managerial utilities of technologies, which include electronic prescribing, billing, computerized physician order entry (CPOE), reporting, record keeping as well as documentation. Psychiatric hospitals are characterized by bulk data records and the kind of patients who are likely to complain on the quality of services given by nurses. EMR implementation will enhance proper, essential, and up to date record keeping for amicable resolution of any controversies or ligations and ensure quality services in psychiatric hospitals. Nurses play a major role in psychiatric hospitals and are required to keep records used by other colleagues such as physicians in making decisions regarding mental patients. Implementing Electronic Medical Record keeping procedure to substitute paper-based medical records will give medical care givers including nurses more time to focus on caregiving (Sharfstein, Dickerson, & Oldham, 2009). By implementing EMR, it will be easy for nurses to notice and correct any inefficiency. Additionally, EMR will allow installation of other programs such as automatic communication, which helps in improving the quality of services in psychiatric hospitals where patients require frequent attention from nurses (Sharfstein, Dickerson, & Oldham, 2009). Implementing EMR in psychiatric hospitals will enable cooperation between different departments thus enhance making of decisions regarding patients since electronically saved data will be easily and simultaneously accessed by different departments (Luo, 2006). Proper use of EMR will promote early identification and apposite treatment of potentially violent psychiatric patient behaviors. In the long run EMR will protect individual nurses and other care providers from allegations of bad record-keeping. Additionally, EMR keeping is easy and will ensure that professional and legal welfare of nurses are not undermined by lack or incomplete records (Luo, 2006). Organizational and Individual Barriers to Implementation of EMR There are significant challenges that would affect the implementation of EMR in psychiatric hospitals. One of the major challenges would be finances. Implementation of EMR requires a lot of money to buy the EMR systems and training. Psychiatric hospitals are characterized by financial limitations since the services offered cannot yield sufficient funds to implement and maintain such a program. To resolve this I would advise the hospitals to seek financial assistance from donors in addition to seeking government funding. Another challenge concerns patient’s privacy since EMR would lead to possible access of patient’s information by other parties who may use it for selfish or harmful motives. Most psychiatric hospitals are still lacking technological clarity regarding disclosure of patient health information to secondary sources. This problem will not be too rampant since the HIPPA act clearly explains on disclosure of private health information. Additionally, I will encourage hospital management to offer training regarding prevention of PHI to wrong parties (Luo, 2006). An additional challenge is that psychiatric hospitals possess a lot of bulk paper records thus it would be difficult and burdensome to convert such records to electronic records. To ease the work, the conversion of paper records to EMR will be a continuous process and not abrupt. Factors That Might Influence Implementation of EMR The success or failure in the process of implementation of EMR in psychiatric hospital may be influenced by several factors. One of the factors is the pre-perceived benefits. To ensure that the hospital staff understands the importance of EMR, I will create awareness on the role of EMR in improving the quality of care to the patients, its ability to ease the process of record keeping, the effects it might have on the schedules of individual staff members, financial concerns, and address concerns regarding security and confidentiality of patients private health information (Luo, 2006). Another factor that can determine EMR implementation is concerns on the demands it might pose on the staff members such as the need for more training on the use of technology. Continuous training will be offered on EMR use. To ensure that these factors are perceived positively, I will seek the hospital management support to train the staff on the need for technological advancement in psychiatric hospital (Luo, 2006). Factors Influencing Organizational Readiness for EMR Several factors determine whether a psychiatric hospital is ready for implementation of EMR and thus determine its functioning ability. These include the existing perception on the effectiveness of EMR by the medical professional, the computer literacy and skillfulness among psychiatric hospital staff, EMR accessibility from outside the hospital, and how implementation of EMR would affect hospitals daily activities. Offering training and creating awareness on the significance of EMR use in psychiatric hospital will reduce possible resistance from hospital staff (Luo, 2006). Another factor determining readiness of psychiatric hospitals for EMR implementation is the financial status. Unavailability of funds to purchase the EMR systems, train the staff of it use, and employ technical staff to maintain the system is one of the major obstacle in EMR implementation. I said earlier, I would seek the hospital management assistance to find donor and government funding (Luo, 2006). Hospital policies dictates readiness and ease of EMR implementation in psychiatric hospitals, which characterized by strict privacy policies enacted to enhance accountability, boost privacy of patients private information, and regulate the exchange of patients health information between different parties. To ensure that this does not affect the EMR implementation, I will encourage the hospital management to review the policies to ensure they are in line with the changes brought about by EMR implementation (Luo, 2006). Other factors determining organizational readiness to EMR implementation include perceptions and beliefs, which are essential in modeling future attitudes and behaviors inclusive of negative rumors, privation of involvement, and opposition to change from hospital staff. To ensure that the EMR implementation is successful, I would carry out a review on the organizational context, organizational history of change, organizational interactions and conflicts, and organizational flexibility to ensure that the plan addresses the factors appropriately to create a proper environment for EMR implementation (Sharfstein, Dickerson, & Oldham, 2009) Kotter’s Theory of Organizational Change Kotter’s change and management model posits that organization change can be implemented and managed by an eight step approach. The eight steps include increasing urgency to ensure that the hospital staffs appreciate the need for the EMR implementation. Building managing team that will oversee the EMR implementation process. Getting a clear vision will ensure that all hospital staff understand the need for the change. Encouraging proper and timely communication will ensure cooperation between all stakeholders and fasten the implementation process. Another important step is empowering hospital staff through training on EMR usage. Acknowledging short-term successes will ensure that the hospital staff sees the need for the change. The change should be continuous without letting up, which will be made possible by ensuring that the process sticks to the vision or the change at hand. The above steps will enable creation of apposite climate for change, engage and enable cooperation from the entire hospital and other stakeholders enabling successful implementation and sustenance of the EMR (Spector, 2010). Internal and External Resources Available To Support EMR Initiative Internal factors in psychiatric hospital that would support EMR implementation include existence of successful appreciation of change, suitable social interactions between hospital staff, presence of a project champion, top-management support for the project, computer literacy among the staff, and a clear vision that instills a sense that the change is appropriate. Other resources include GLHI EMR interphase team, EMR vendor, Axoltotl, and personels such as project manager, implementation coordinator, and interface engineer (Sharfstein, Dickerson, & Oldham, 2009). External factor include external funding from donors as well as federal government. Another external resource that will be required is training personnel from the software providers (Luo, 2006). Current Peer-Reviewed Literature on EMR Application Considerable study has been done on implementation of EMR, and the factors that influence the success of the implementation process in hospitals. However, little literature focuses on the EMR implementation and application in psychiatric hospitals. An example of a study that focused on implementation of EMR in psychiatric hospital was done by Boyer, Samuelian, Fieschi, and Lancon (2010). The study focused on the opinions of health professions regarding EMR implementation and was done in a French hospital. The study findings suggested that the strategy of implementation is important and the process should be continuous to reduce chances of refutation from inflexible professionals. Boyer, Baumstarck-Barrau, Belzeaux, Azorin, Chabannes, Dassa, & Auquier (2011) did another study to assess health care professionals’ satisfaction concerning EMR in a psychiatric hospital. The research was based only on the professional opinion, dictated by the psychometric standards. The study concluded that views of health care professionals can help in predicting their acceptance and use of EMR thus guide in EMR implementation. References Boyer, L. L., Baumstarck-Barrau, K. K., Belzeaux, R. R., Azorin, J. M., Chabannes, J. M., Dassa, D. D., & Auquier, P. P. (2011). Validation of a Professionals’ Satisfaction Questionnaire with Electronic Medical Records (PSQ-EMR) in Psychiatry. European Psychiatry, Vol. 26 (2), 78-84. doi:10.1016/j.eurpsy.2009.10.007 Boyer, L., Samuelian, J., Fieschi, M., & Lancon, C. (2010). Implementing Electronic Medical Records in a Psychiatric Hospital: A Qualitative Study. International Journal of Psychiatry in Clinical Practice, 14(3), 223-227. Doi: 10.3109/13651501003717243 Luo, J. (2006). Electronic Medical Records. Primary Psychiatry AVol 13 (2). P.20-23. Sharfstein, S., Dickerson, F., & Oldham, J. (2009). Textbook of Hospital Psychiatry. New York: America Psychiatric Pub. P. 470-472. Spector, B. (2010). Implementing Organizational Change: Theory into Practice. 2nd ed. Upper Saddle River, NJ: Pearson/Prentice Hall. Chap 17. Read More