Electronic Health Record Implementation Paper.

Electronic Health Record Implementation Paper.


One way informatics can be especially valuable is in capturing data to inspire improvements and quality change in practice. The Agency for Healthcare Research and Quality (AHRQ) collects data related to adverse events and safety concerns. If you are working within a practice setting to implement a new electronic health record (EHR) system, this is just one of the many considerations your team would need to plan for during the rollout process. Electronic Health Record Implementation Paper.


In a paper of 1,250-1,500 words, address the following questions related to the advanced registered nurse\’s role during this type of scenario:

What key information would be needed in the database that would allow you to track opportunities for care improvement?
What role does informatics play in the ability to capture this data?
Which systems and staff members would need to be involved in the design and implementation process and team?
What professional, ethical, and regulatory standards must be incorporated into the design and implementation of the system?
How would the EHR team ensure that all order sets are part of the new record? Electronic Health Record Implementation Paper.
How would you communicate the changes, including any kind of transition plan?
What measures and steps would you take to evaluate the success of the EHR implementation from a staff, setting, and patient perspective?
What leadership skills and theories would facilitate collaboration with the interprofessional team and provide evidence-based, patient-centered care?
You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content. Electronic Health Record Implementation Paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Electronic Health Record Implementation Paper.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

This benchmark assignment assesses the following programmatic competencies:

2.3: Develop leadership skills to collaborate on interprofessional teams in the provision of evidence-based, patient-centered care.

5.2: Apply professional, ethical, and regulatory standards of practice in the provision of safe, effective health care.

Role of the Advanced Practice Registered Nurse (APRN) in Electronic Health Record (EHR) Implementation 

The implementation of electronic health record (EHR) systems in all healthcare organizations is now a regulatory and policy issue. All healthcare organizations are under regulatory obligation to have a health information management (HIM) system that electronically records and stores patient information through input by healthcare workers. Electronic Health Record Implementation Paper. This information should be easy to retrieve and this functionality is supposed to make the delivery of healthcare services better, faster, and more efficient. At the same time it is expected that whatever EHR system a healthcare organization installs from whichever vendor, it should be interoperable with the systems of other organizations (Reisman, 2017). Challenges with interoperability or electronic health information exchange (HIE) are central to the problem of care fragmentation that increases healthcare costs and contributes to patient complications. The obligation to have EHR systems by all providers and to make them interoperable is contained in the 2009 law called the American Recovery and Reinvestment Act or ARRA. Tied together with this law is the Health Information and Technology for Economic Clinical Health Act or HITECH that prescribes Meaningful Use (MU). Under the Centers for Medicare and Medicaid Services (CMS), the MU program penalizes or rewards providers who implement the requirement for EHR or otherwise (Sweeney, 2017). The rationale for having EHR systems is to improve the quality of healthcare services, to lower healthcare costs, and to make access to patient data easier (Ozair et al., 2015). This paper examines the role of the advanced practice registered nurse (APRN) in the implementation of a new EHR system for HIM in a healthcare organization. Electronic Health Record Implementation Paper.

Key Information Needed in the EHR Database and the Role Played by Informatics in Capturing the Data

Like any software application, the EHR system is supposed to be engineered to meet the organization’s specific requirements. In other words, all EHR systems are conceptually the same but differ in the details depending on each organization’s specific needs. Part of this is the key information required to be present in the EHR database. This information is what will enable the nurse informaticist in the organization to track opportunities for improvement in patient care. Electronic Health Record Implementation Paper. For the APRN, this information will include benchmarks such as quality, performance, patient safety, and staff engagement (McGonigle & Mastrian, 2017). These would need to be monitored in the organization’s dashboard as easily accessible metrics. To monitor them so that improvements in the quality of care can be done at the appropriate time, corresponding outcome measures must be quantitatively visible on the dashboard to the nurse informaticist at all times (Wang et al., 2018). These outcome measures include but are not limited to readmission rates, patient fall rates, incidence rate of pressure ulcers, staff turnover rates, and rates of catheter-acquired urinary tract infection (CAUTI) and central line-associated bloodstream infection (CLABSI). Electronic Health Record Implementation Paper.

The role played by informatics in capturing this data is immense. To begin with, informatics knowledge ensures that the design of the EHR system is such that it will be possible to monitor important metrics such as quality, performance, and patient safety. After that, the functionality of the organization’s dashboard in terms of displaying the set metrics ensures that quality improvement is done as and when it is due. Electronic Health Record Implementation Paper.

Systems and Staff Members to be Involved in the EHR Design and Implementation

The systems that will be needed in the implementation of the EHR system include the EHR package itself purchased from a particular vendor, a remotely-located server managed by the vendor, and computers hardware. The EHR package is essentially a software package designed to meet the specific organizational requirements. It is installed in the computer system of the organization and accessed through a graphical user interface or GUI. As for the staff that will form the implementation team, these will be (Vant, 2017): Electronic Health Record Implementation Paper.

  1. The nurse informaticist as the project manager: She has medical/ nursing knowledge and is trained in informatics. This suits her as being the best person to oversee the successful implementation of the project within time and resources.
  2. The application analyst who will incorporate all views, suggestions, and opinions into the technical masterpiece before installation.
  • The application developer who is the software engineer that designs the system to suit the organizational needs.
  1. The quality assurance test engineer who will see to it that the system is functional and running as expected for the organization once installation is complete. He or she needs to have a medical background just like the project manager. Electronic Health Record Implementation Paper.

Professional, Ethical, and Regulatory Standards to be Incorporated into the EHR System

The professional standards that must be incorporated into the EHR system include the ability to capture all patient information (personal, demographic, medical and so on) in a fast and efficient way. This must not appear intrusive into the patient’s privacy and must, above all, be culturally sensitive. Ethically, the system must not allow patient data to get into the wrong hands such that the patient suffers harm of whatever nature (physical, psychological, or emotional). This would be against the bioethical principle of primum non nocere or nonmaleficence (Haswell, 2019; Santhirapala & Moonesinghe, 2016). Then, the most important regulatory standard is that the EHR system must conform to the requirements of the Health Insurance Portability and Accountability Act or HIPAA (CMS, 2018). These relate to the privacy and security of the patient information that will be captured and stored in the EHR system. Additionally, the American Recovery and Reinvestment Act (ARRA) also requires the system to be interoperable (accessible by other EHR systems outside the organization). Electronic Health Record Implementation Paper.

Ensuring All Order Sets Are Incorporated and Communicating the Changes

EHR order sets are bundled orderables that ease the process of offering care using a HIM system. They represent sets of instructions that would be given by a clinician in the management of a particular condition or injury. Order sets are a clinical decision support instrument that is included into the computerized provider order entry (CPOE) matrix to standardize care and ensure quality. The team will therefore ensure that all order sets are included in the system by involving the clinicians in the design phase. Alternatively, the team can buy ready-made order sets as a package to be included in the CPOE.

Communication of the changes regarding the system change/ implementation will be through departmental mail and memos. Further staff engagement will be through training by the vendor and the nurse informaticist on how to effectively and productively use the new system. In effect, use of the EHR system will count as one of the organizational policies that all staff will have to adhere to. Staff buy-in will have been obtained through the chosen change model. Electronic Health Record Implementation Paper.

Measures to Evaluate the Success of the EHR Implementation from a Staff, Setting, and Patient Perspective

Evaluation from a staff perspective will entail appraisal of performance by the staff. Any semblance of incompetence in the use of the system will be a pointer to lack of success in the implementation. From a setting perspective, steps will include analyzing metrics such as the number of patients seen by each clinician in a day and comparing the figures with historical data before system implementation. If there is a drop in the figures, that would mean there is failure. This is because the system is supposed to improve performance and not to hinder it. Lastly, from a patient perspective the steps taken will involve analyzing patient ratings and the results of patient satisfaction surveys. These surveys can be done using a short Likert-style questionnaire. Higher satisfaction levels mean success and lower values mean failure in implementation. Electronic Health Record Implementation Paper.

Leadership Skills and Theories to Facilitate Interprofessional Collaboration and Provision of Patient-Centered Evidence-Based Care

Studies have shown that the best leadership strategy to use in facilitating interprofessional collaboration in healthcare is the adoption of transformational leadership. A transformational leader will create strong relationships with staff and motivate them to perform. They will provide a welcoming working environment, empower subordinates, and prioritize staff engagement (Northouse, 2019). It is this way that the motivated and empowered staff will be able to provide care that is evidence-based, safe, timely, and patient-centered. The transformational leadership theory (Turnnidge & Côté, 2016) underpins this philosophy of employing transformational leadership style for implementation success.    Electronic Health Record Implementation Paper.