Electronic health records open a way to use information technologies to improve healthcare. Server databases with applications providing access to them may be used to facilitate the doctors’ work by storing and analyzing patients’ data, organizing the work process, and easing the collaboration. Patients, too, may use this system to manage their data, add new ones when necessary, and communicate with their doctor. However, its implementation is connected with financial, ethical, and professional challenges, which should be solved by efficient leadership and communication between various specialists.
Tracking Care Systems and Their Benefits
An electronic health record system is the database where the medical data are safely stored. Medical workers use computer applications to manipulate those data during their work, monitor and analyze patients, create reports, and other functions are often available, too (Adler-Milstein et al., 2017). The system architecture is designed to facilitate collaboration between doctors, make calculations with measurable data and work with statistics, provide simple and straightforward user interfaces for patients and staff members, and organize the work process (Jacobs et al., 2019). Thus, the system combines the database and the application to work with the medical data, organizing, analyzing, and protecting them.
The critical information that needs to be present in the database is the patients’ information relevant for medical purposes: their diagnoses, analyses data, and complaints. As those systems are used primarily for patient condition monitoring and organizational purposes, the patient information should be included as fully as possible (Adler-Milstein et al., 2017). Medical workers may use it in their online meetings and other organizational activities, which may be conducted via the EHR system as well (Jacobs et al., 2019). The most visible and valuable benefit of EHR systems is the quickening of the doctors’ work and reducing the time spent on the work with documents (Lambooij et al., 2017). In addition, they improve access to healthcare information, making it easier for patients to obtain medical help (Gesulga et al., 2017). Therefore, the EHR tracking care system is a valuable tool for the hospital, increasing its performance and easing the work for its staff.
The EHR system implementation and design require professional, ethical, and regulatory standards, ensuring the system’s functionality and safety. Professional standards are connected with the knowledge-intensive specific of the EHR implementation and the necessity of IT specialists and strong healthcare leaders (Gesulga et al., 2017). Ethical and regulatory standards mean that data stored in the EHR databases are personal and highly sensitive; they should be strongly protected, and their access should be regulated (Layman, 2020). Blockchain technology is one of the ways to solve the issue: it increases data safety by ensuring that only its owner, a patient, may have authorized access to them (Roehrs et al., 2019). A blockchain system is much harder to hack as it requires immense computing power and is easy to recover in case of partial data loss. To conclude, tracking care systems have a significant potential to improve the healthcare sector, increasing doctors’ work speed and efficiency. Still, they require new regulatory standards and strategies for their implementation.
Strategies and Leadership for the EHR Implementation
Staff should be trained appropriately to use the benefits provided by the EHR system; in other cases, the system will not improve work processes in a hospital. Doctors and nurses are the primary system users, and they should become familiar with using it daily for work optimization, organization, and patient data monitoring (Lambooij et al., 2017). As implementing such a system is a knowledge-intensive project, people who have specific knowledge in the various fields of information technology, including blockchain, are necessary for EHR implementation (Roehrs et al., 2019). System development and maintenance are the primary tasks of the hospital’s IT department (Jacobs et al., 2019). In addition, IT specialists teach doctors and nurses how to use the system correctly (Lambooij et al., 2017). In that way, the system’s efficiency may be increased by facilitating the communication between medical workers and the IT department.
Therefore, while IT specialists are necessary to design the system and help in its implementation and maintenance, all doctors and nurses should be trained to become familiar with it. It may help them conduct evidence-based medical practice more efficiently, as they are registered in the system containing all patient data. They include analysis results, such as the sugar level or blood pressure, patient complaints, and stories, and doctors may access them quickly to make data-driven decisions (Adler-Milstein et al., 2017). Thus, the core of the EHR implementation strategy is the communication between various specialists, and strong leadership is the key to its development.
Communication changes, transition period, and the necessity to manage human, financial, and healthcare resources are challenges that efficient healthcare leaders should solve. While the implementation requires an interdisciplinary team, healthcare leaders are doctors, and the result of their leadership should be evidence-based patient-centered care. The theory identifies seven leader types relevant to the healthcare sector: a supporter, change manager, project manager, advocate, champion, facilitator, and decision-maker (Laukka et al., 2020). Leadership types that fit best for the EHR system implementation are championship and change managing. The former type describes leaders striving to be the best, adopting the most efficient approaches to medicine, and seeking knowledge for that, including the tracking care system installation. Change managers seek changes beneficial for the industry: their strength is that they initiate communications between various specialists necessary for changes, such as the EHR system implementation.
One should develop a viable management plan to implement a beneficial EHR system in a hospital. It is the algorithm of how things will actually be done, and in the case of EHR, agile project management is the best practice (Kannan et al., 2017). The method is based on the cooperation between separate specialists, who share their own responsibility and add edits to the project. This methodology is widely used in software development due to constant communication and code improvement in this process. A similar approach is necessary during the EHR implementation, as each of its stages requires the attention of various specialists. To summarize, four essential components are necessary for the EHR implementation: staff involvement, a viable strategy, leadership, and management. The first component is the key to the successful implementation, the leadership and management are the implementation process’ organization, and the strategy is the general plan of the process.
One may measure the efficiency of the EHR system in a hospital from three perspectives: staff, patients, and the setting itself. The former is how quickly the staff became familiar with the system and started to use it efficiently. There always is a transitional period, during which the efficiency of the hospital is lower than before the implementation (Jacobs et al., 2019). Thus, the shorter the transitional period, the higher the efficiency from the staff perspective. The patient perspective is the patients’ satisfaction with the system: the usability of the system’s patient-side and the improvement of their experience in the clinic are parts of it. The setting perspective evaluates how efficient the system is itself: are there any security breaches, how quickly it works, and how many functions are available (Jacobs et al., 2019). Thus, the system’s success is measured by three metrics: staff work efficiency, patient satisfaction, and the system’s structure relevance.
To measure the efficiency of the EHR implementation, I would first evaluate patient satisfaction: for that, I would use the system itself to send them quick checklists about their experience. A checklist should contain points about whether the patient has reasonable user control, are error messages recognizable and clear, and whether they understand their data and diagnoses (Khajouei et al., 2018). Answers will be a good efficiency evaluation from the patient side. Then, I would create a questionnaire for the staff members to ask them whether they have any hardships in dealing with the system and how they use it. In addition, I would measure how much time they spend working with documents and computers and compare it with this time before the implementation. Results will show the efficiency of the system from the staff side. The examination by specialists is necessary to evaluate the success of the setting: to check whether data are stored safely and ensure that there are no safety breaches.
Two main challenges for the EHR implementation may be identified: the professional and ethical ones. The former is connected with a lack of money, qualified specialists, leaders, and teachers who may train staff to use the EHR system. A lack of strong leadership in the healthcare sector is especially hard, as no changes and communications may be initiated without strong, flexible, and intelligent leaders (Laukka et al., 2020). The latter is possible problems with privacy, legal and policy support, ethical issues connected with sensitive medical data storage, and the resistance to the implementation caused by it (Gesulga et al., 2017). As patients’ data are saved in the external database, they may be used without the patients’ knowledge, especially if the patient has no direct access to all of those data (Layman, 2020). One of the possible ways to solve this challenge is using blockchain technology, which decreases the chance of security breaches (Roehrs et al., 2019). All those problems should be considered, and their efficient resolution is the key to successful EHR system implementation.
EHR systems have a great potential to change and improve the healthcare sector; for that, they should be wisely implemented. Innovative healthcare leadership is required for that, and champion leaders and change managers are the best ones for the EHR implementation; thus, the leadership preparation would help. Communication between various specialists should be organized, as tracking care system development requires the cooperative work of IT and healthcare specialists. Therefore, agile project management, used for software development and based on shared responsibility, is the best fit for that. The system’s success should be evaluated from the side of the staff, patients, and the system itself; all doctors and nurses need to be taught to use it. Significant challenges are a lack of money, strong healthcare leaders, specialists, and viable ethical and regulation policies; they prevent the EHR implementation and need to be solved.
Adler-Milstein, J., Holmgren, A. J., Kralovec, P., Worzala, C., Searcy, T., & Patel, V. (2017). Electronic health record adoption in US hospitals: The emergence of a digital “advanced use” divide. Journal of the American Medical Informatics Association : JAMIA, 24(6), 1142–1148.
Gesulga, J. M., Berjame, A., Moquiala, K. S., & Galido, A. (2017). Barriers to electronic health record system implementation and information systems resources: A structured review. Procedia Computer Science, 124, 544–551.
Jacobs, M., Boersma, L. J., Swart, R., Mannens, R., Reymen, B., Körver, F., van Merode, F., & Dekker, A. (2019). Electronic Health Record implementation in a large academic radiotherapy department: Temporarily disruptions but long-term benefits. International Journal of Medical Informatics, 129, 342–348.
Kannan, V., Fish, J., Mutz, J., Carrington, A., Lai, K., Davis, L., Youngblood, J., Rauschuber, M., Flores, K., Sara, E., Bhat, D., & Willett, D. (2017). Rapid development of specialty population registries and quality measures from electronic health record data. Methods of Information in Medicine, 56(S01), e74–e83.
Khajouei, R., Hajesmaeel Gohari, S., & Mirzaee, M. (2018). Comparison of two heuristic evaluation methods for evaluating the usability of health information systems. Journal of Biomedical Informatics, 80, 37–42.
Lambooij, M. S., Drewes, H. W., & Koster, F. (2017). Use of electronic medical records and quality of patient data: Different reaction patterns of doctors and nurses to the hospital organization. BMC Medical Informatics and Decision Making, 17(1).
Laukka, E., Huhtakangas, M., Heponiemi, T., & Kanste, O. (2020). Identifying the roles of healthcare leaders in HIT implementation: A scoping review of the quantitative and qualitative evidence. International Journal of Environmental Research and Public Health, 17(8), 1–15.
Layman, E. J. (2020). Ethical Issues and the Electronic Health Record. The Health Care Manager, 39(4), 150–161.
Roehrs, A., da Costa, C. A., da Rosa Righi, R., da Silva, V. F., Goldim, J. R., & Schmidt, D. C. (2019). Analyzing the performance of a blockchain-based personal health record implementation. Journal of Biomedical Informatics, 92, 103140.