Issues with the implementation of the EHR system at the Warrior Hospital

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Warrior Hospital implemented an EHR about 6 months ago. Today you received notice from the administrator that they are calling an emergency meeting to discuss next steps, as they are going to pull the plug on the EHR due of the facet of problems that are being experienced. The majority of physicians are refusing to use the system. They are having the nurses print everything out from the system for them to review. Physicians are documenting on paper and writing orders on sticky notes, then having the nurses or unit clerks document into the system. The few physicians who are attempting to use the systems as intended are running into problems. They system is going down several times a day, for a total of four to five hours a day. Providers are not able to correctly complete order entry in the system, as the current workflow build routes the documents to an unaccessible review queue before sending off the orders. Even the HIM department was having issues with the system. Upon receiving a request for ROI, the department received screen prints upon queuing, and not forms.

The system was a home-grown system that was originally developed by Dr. Doe, a neurosurgeon at Warrior hospital who retired several months ago. Dr. Doe and several of his colleagues and residents at the time were the ones in charge of implementing the system. The implementation consisted of Dr. Doe and his team working closely with IT and conducting demonstrations that were used to satisfy one hour of training that each ancillary department received. Nursing received two hours of training. Question and answer times at these demonstrations were limited and the different hospital departments were never met with individually to asses their needs and gain their input prior to implementing the system. Administration supported Doctor Doe at the time and was not receptive to the feedback from others.

The HIM Director, physicians, nurses, and other ancillary staff learned about the system only a couple short months before go-live. The HIM director contacted administration several times wanting to be involved in the process and expressing her concerns, but was told that Dr. Doe has a great systems that is going to bring great things to the hospital. He had used this systems in Neurology and it was very successful. The HIM Director ended up resigning from the role a few weeks before go-live with just a two week notice. Since the implementation of the system, there has been high turnover in nursing as well as a couple key roles in administration. A new HIM Director has been hired and retained by Hospital Administration, along with the Chief Information Officer, to address the many concerns that have been raised since the system went live. These issues include, but are not limited to, lapses in functionality, poor screen design, workflow gaps, and security gasps. Furthermore, it was determined that the system does not meet Conditions of Participation, state licensing or Joint Commission requirements.

For this assignment, you will compose a 1-2 page paper that accomplishes the following:

  • Identify what contributed to the failure of the system. Think in terms of the System Development Life Cycle and identify which steps in each phase were missing. Further discuss the importance of each missing step and how it could have attributed to the success of the implementation.
  • Discuss the importance of the Needs Assessment and Workflow Analysis in the
  • Provide a recommendation to the Hospital Administrator as to whether the plug should be pulled on the EHR, or whether they should keep going and work to improve the system.
  • Defend your recommendation to the Administrator

Grading Rubric Criteria

Paper identifies items that contributed to the failure of the implementation and discusses their impact

10

Paper discusses the importance of the Needs Assessment and Workflow Analysis in planning for implementation

5

Paper includes a detailed defense of the recommendation to the Administrator

10

Paper is 1-2 pages in length (3-4 including cover page and reference page)

2

Paper is properly formatted and free of any spelling or grammar errors

3

Total

30

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