NUR 514 Benchmark Electronic Health Record Implementation Paper

March 8, 2022
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NUR 514 Benchmark Electronic Health Record Implementation Paper

NUR 514 Benchmark – Electronic Health Record Implementation Paper

Benchmark-Electronic Health Record Implementation Paper

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Health informatics comprise one of the most effective ways to enhance quality care and patient outcomes. Patients receive better medical care if health care providers have access to complete and accurate information. Many studies demonstrate that electronic health records (EHRs) can enhance the ability to diagnose diseases and reduce and prevent medical errors that leads to optimal patient outcomes (Hansen et al., 2019). Implementing an electronic health records system in a health care facility is one of the critical aspects of attaining quality care and increasing patient satisfaction. The benefits of EHRs as a form of health informatics are broad. On this basis, the paper explores the role of nurse practitioners in different situations in implementing an EHR system in their facilities.

Description:

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.

In a paper of 1,500-1,750 words, discuss the following:

1. Consider an opportunity for tracking care improvement. What key information would be needed in the database? Example: Time lapse from medication order documented in the EHR to delivery of medication to the patient for the cardiology service.
2. Describe the role informatics plays in the ability to capture this data.

Role of Informatics in Capturing the Data

Informatics play a critical role in capturing the above data needed in the system being developed. Informatics allow for the systematic collection, organizing and storage of data. Informatics ensure that each data is organized according to its intended clinical use. Effective storage of health data ensure its effective use when needed in the organization. Informatics also analyze the large volume of the collected data from different sources. Providers use the analyzed data to make informed decisions about the care needs for their patients (Kalsy et al., 2018). Informatics also standardize processed utilized in the systems. Standardization ensures that the activities of the organization are run in an efficient manner to minimize delays and wastage of resources. Standardization also eliminates the possibilities of redundancies, hence, streamlining of the processes used in an organization (Chung et al., 2016; Sharma et al., 2020). Consequently, system effectiveness can only be achieved through the optimization of knowledge on nursing informatics.

What type of project management strategies and methodologies can be implemented to support informatics initiatives to help improve quality within the clinical practice?
3. Discuss which systems and staff members would need to be involved in the design and implementation process. What is the role of the advanced registered nurse in promoting evidence-based practice and leading quality and performance improvement initiatives within this setting?

4. Outline strategies for implementing the new EHR proposal. Consider communication changes, transitioning to the new EHR, and managing resources (human, fiscal, and health care resources).
5. Discuss what professional, ethical, and regulatory standards must be incorporated into the design and implementation of the system.
6. Describe the measures and steps you would take to evaluate the success of the EHR implementation from a staff, setting, and patient perspective to measure effectiveness and ensure continuous quality improvement in practice?
7. Explain what leadership skills and theories would be needed to facilitate collaboration with the interprofessional team and provide evidence-based, patient-centered care?

Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.

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.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Course Materials if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing

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.

Topic 8 DQ 1

Description:

Open and clear communication is critical for the effective functioning of the interprofessional team and the delivery of safe patient care. Discuss the way communication technologies can enhance coordination of care by interprofessional teams. Be sure to discuss a specific communication technology in your response.

Topic 8 DQ 2

Description:

Virtual care and telehealth technologies have the capability to greatly expand access to quality health care. Discuss some benefits and drawbacks of virtual care/telehealth, particularly related to the collaboration and coordination of care and the role of the advanced registered nurse.

Topic 8: Interprofessionalism and Interrelationships in Informatics and Information Systems

Description

Objectives:

1. Analyze the role of the advanced registered nurse in promoting evidence-based practice and leading quality and performance improvement initiatives.
2. Analyze quality standards and performance measures related to the use of informatics for continuous quality improvement in practice settings.
3. Discuss project management strategies and methodologies for implementing health care informatics initiatives that improve quality within clinical practice.

Study Materials

Nursing Informatics and the Foundation of Knowledge

Description:

Read Chapters 16 and 20 in Nursing Informatics and the Foundation of Knowledge.

Health IT

Description:

Explore the HealthIT.gov website.

Artificial Intelligence Research: The Utility and Design of a Relational Database System

Description:

Read “Artificial Intelligence Research: The Utility and Design of a Relational Database System,” by Diling, from
Advances in Radiation Oncology (2020).

Application of Project Management Tools and Techniques to Support Nursing Intervention Research
Description:

Read “Application of Project Management Tools and Techniques to Support Nursing Intervention Research,” by Rew, Cauvin, Cengiz, Pretorius, and Johnson, from Nursing Outlook (2020).

How Data Can Save Lives: Informatics for Health 2017

Description:

Read “How Data Can Save Lives: Informatics for Health 2017,” by Cookson, from BMC Series Blog (2017), located on the BioMed Central website.

Electronic Health Record (EHR) System Testing Plan

Description:

Read “Electronic Health Record (EHR) System Testing Plan,” located on the HealthIT.gov website.

EHR Testing: Specifics and Best Practices

Description:

Read “EHR Testing: Specifics and Best Practices,” by Mikhailau (2019), located on the Health IT Outcomes website.

Health IT Standards

Description:

Read “Health IT Standards,” located on the HealthIT.gov website.

Perspectives of Healthcare Practitioners: An Exploration of Interprofessional Communication Using Electronic Medical Records

Description:

Read “Perspectives of Healthcare Practitioners: An Exploration of Interprofessional Communication Using Electronic Medical Records,” by Bardach, Real, and Bardach, from Journal of Interprofessional Care (2017).

Best Practices for Health Informatician Involvement in Interprofessional Health Care Teams

Description:

Read “Best Practices for Health Informatician Involvement in Interprofessional Health Care Teams,” by Holden, Binkheder, Patel, and Viernes, from Applied Clinical Informatics (2018).

Impact of Information and Communication Technology on Nursing Care: Results of an Overview of Systematic Reviews
Description:

Read “Impact of Information and Communication Technology on Nursing Care: Results of an Overview of Systematic Reviews,” by Rouleau et al., from Journal of Medical Internet Research(2017).

Top 10 Telehealth Benefits and Challenges Concerning Hospitals

Description:

Read “Top 10 Telehealth Benefits and Challenges Concerning Hospitals,” from Delabano (2020), located on the Access website.

Perspectives of Nurses Toward Telehealth Efficacy and Quality of Health Care: Pilot Study

Description:

Read “Perspectives of Nurses Toward Telehealth Efficacy and Quality of Health Care: Pilot Study,” by Bashir and Bastola, from JMIR Medical Informatics (2018).

NUR 514 Benchmark Electronic Health Record Implementation Paper

An electronic health record (EHR) refers to an electronic form of the traditional patient’s medical file kept by the health provider over time. It contains information from administrative and clinical encounters between patients and their health providers during patient care. The EHR also supports other patient care-related activities through interfaces, such as evidence-based decision support, outcomes reporting, and quality management (Schopf et al., 2019). This paper aims to discuss components of designing and implementing the EHR, the professional, ethical, and regulatory standards that should be incorporated, and leadership skills needed for collaboration of the interprofessional teams.

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Key Information Needed in the Database to Track Opportunities for Care Improvement

The EHR support providers make better decisions and improve patient care quality. It achieves this by improving the accuracy and clarity of medical information, which reduces the occurrence of medical errors (Schopf et al., 2019). The EHR also makes health data available and easily accessible, reduces duplication of services, reduces treatment delays, and empowers patients to make better health decisions. Patient information is needed in the EHR database to help identify opportunities for patient

NUR 514 Benchmark Electronic Health Record Implementation Paper Online

improvement. The key patient information includes demographics, current medical problems, past medical and surgical history, medications, vital signs, immunization history, progress notes, laboratory results, and imaging reports (Schopf et al., 2019). The information can predict a patient outcome which helps to provide appropriate interventions to achieve the best possible outcomes (Schopf et al., 2019). It can also identify risk factors for a disease or complications and guide providers to take prior preventive interventions.

Role Informatics Plays in the Ability to Capture This Data

Informatics deals with computational systems, particularly with systems that involve data storage and retrieval. The role of informatics in facilitating the capturing of the data in EHR databases includes providing tools with clinical and operational applications that help health organizations capture health information in EHRs to advance medical care (Aguirre et al., 2019). Informatics help organize patient data collected from a myriad of devices and systems such as electronic medical records, patient portals, health tracking devices, and diagnostic systems (Aguirre et al., 2019). Informatics captures the data from all these devices, which is usually in different formats, and converts it to a single format stored in the database. For instance, database management systems have programming interface applications that transmit connections between databases and are used to process complex health information across various platforms.

The Systems and Staff Members that Would Need to Be Involved in the Design and Implementation Process and Team

Implementation of the EHR will entail handling a wide range of medical information across various medical settings. Therefore, it will be important to incorporate a range of systems that will convert the information in real-time and upon request. Systems that will be required in the EHR include Documentation system, Billing and reimbursement system, E-prescribing, and Report generation systems. The documentation system will facilitate electronic charting and enable information to be well-structured and easily accessible to practitioners and patients (Aguirre et al., 2019). The billing and reimbursement system will facilitate easy payment of health services and ease reimbursement with insurance companies. The E-prescribing system will help track prescribed medications, evaluate medications for allergies, side effects, and interactions, and enable clinicians to make quick decisions regarding patients’ medication (Aguirre et al., 2019). Furthermore, the report generation system will enable providers to develop reports using specific information like demographics, medication, and procedures.

The EHR team will be sourced from key internal stakeholders and external consultants. The team will be composed of a project manager, application analyst, application developer, QA Test Engineer, physician, nurse, billing advocate, and super-users. The project manager will be the team leader and will be responsible for keeping the team focused on the project and timelines and will address user issues (Aguirre et al., 2019). The application analyst will be responsible for data migration and cleansing, while the application developer will be tasked with system customization. The QA Test Engineer will be responsible for system testing and performance. The physician, nurse, and billing advocates will represent physicians, nurses, and billing departments, respectively, and advise on training, data, and testing (Aguirre et al., 2019). Lastly, the super-users will be the early adopters for the EHR implementation training programs.

Professional, Ethical, and Regulatory Standards That Must Be Incorporated Into the Design and Implementation of the System

Professional standards that must be incorporated in the EHR design and implementation include completing a risk analysis of the system, encrypting electronic health information, and obtaining a HIPAA-compliant business associate agreement. According to Lee (2017), system users must be advised to report when data breaches occur immediately. Ethical standards must be incorporated by ensuring that patient health information is protected, including billing information, claims processing, enrollment status, diagnostic notes, and clinic visit notes (Lee, 2017). Ethical standards that must be incorporated in the implementation include adhering to patient confidentiality laws such as the Directory information rule, Treating physician rule. Social media rule and Business Associate Agreement rule. Regulatory standards must be integrated by complying with the HIPAA and HITECH regulations (Lee, 2017). The design and implementation team will ensure that HIPAA and HITECH regulations are followed during EHR software development, including its design, programming, and distribution.  

How the EHR Team Would Ensure That All Order Sets Are Part of the New Record

Order sets refer to a group of orders that standardize and accelerate the ordering process for a specific clinical case. Order sets that are standardized and up-to-date facilitate the application of clinical decision support (CDS) at the point of care (Yang, Kang & Lee, 2016). The EHR team can ensure that all order sets are part of the new record using small groups of clinicians with multidisciplinary representation to curate order sets based on clinical guidelines, organizational policies, and expert opinion (Yang et al., 2016). The group should be tasked with approving, reviewing, and maintaining Clinical Ordered Sets in the new EHR. The EHR team can also create a clinical content strategy containing the best clinical practices and the organization’s standards with data content sources (Yang et al., 2016). Furthermore, the EHR team can develop a process that identifies and replaces obsolete content in the order sets that have potential adverse effects on patient safety and patient care quality.

Communication of the Changes, Including Any Kind of Transition Plan

Communication to the rest of the staff about the new EHR would be made through super-users and internal memos. The super-users will be provided in-depth training on all aspects of the EHR system to enable them readily understand and answer questions from the staff about the EHR (Aguirre et al., 2019). They will communicate to the staff on a face-to-face basis in organization meetings and CME programs. They will train the staff on the EHR, including its components and benefits in healthcare delivery. Internal memos will communicate to the staff about any changes in the EHR system and outline the implementation process.

Measures and Steps to Evaluate the Success of the EHR Implementation

The success of the EHR implementation will be measured from the staff, setting, and patient perspective, which will help identify improvement areas. To evaluate EHR implementation success from the staff perspective, I will conduct a survey to measure health providers’ satisfaction with the EHR (Aguirre et al., 2019). In the survey, I will ask them to rate how the EHR implementation has eased healthcare delivery, such as access to patient information, evidence-based decisions, and documentation. The EHR’s success in the healthcare setting will be measured by analyzing data error rates to evaluate how the EHR has improved data input and quality (Aguirre et al., 2019). I will also conduct return on investment (ROI) calculations to measure the EHR’s profitability. Furthermore, the EHR’s success will be measured by surveying patients’ satisfaction with the quality of care. I will also measure patients’ wait times to assess if providers can process patients promptly.

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.

NUR 514 Benchmark – Electronic Health Record Implementation Paper INSTRUCTIONS

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?
  • 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.

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.

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.

Course Code
Class Code
Assignment Title
Total Points
NUR-514
NUR-514-O502
Benchmark – Electronic Health Record Implementation Paper
210.0
Criteria
Percentage
Unsatisfactory (0.00%)
Less than Satisfactory (80.00%)
Satisfactory (88.00%)
Good (92.00%)
Excellent (100.00%)
Content
70.0%

Key Information Needed in the Database to Track Opportunities for Care Improvement
10.0%
A discussion of key information needed in the database to track opportunities for care improvement is not included.
A discussion of key information needed in the database to track opportunities for care improvement is present, but it lacks detail or is incomplete.
A discussion of key information needed in the database to track opportunities for care improvement is present.
A discussion of key information needed in the database to track opportunities for care improvement is clearly provided and well developed.
A comprehensive discussion of key information needed in the database to track opportunities for care improvement is thoroughly developed with supporting details.

Role Informatics Plays in the Ability to Capture This Data
10.0%
A discussion of the role informatics plays in the ability to capture this data is not included.
A discussion of the role informatics plays in the ability to capture this data is present, but it lacks detail or is incomplete.
A discussion of the role informatics plays in the ability to capture this data is present.
A discussion of the role informatics plays in the ability to capture this data is clearly provided and well developed.
A comprehensive discussion of the role informatics plays in the ability to capture this data is thoroughly developed with supporting details.

The Systems and Staff Members that Would Need to Be Involved in the Design and Implementation Process and Team
10.0%
A discussion of the systems and staff members that would need to be involved in the design and implementation process and team is not included.
A discussion of the systems and staff members that would need to be involved in the design and implementation process and team is present, but it lacks detail or is incomplete.
A discussion of the systems and staff members that would need to be involved in the design and implementation process and team is present.
A discussion of the systems and staff members that would need to be involved in the design and implementation process and team is clearly provided and well developed.
A comprehensive discussion of the systems and staff members that would need to be involved in the design and implementation process and team is thoroughly developed with supporting details.

Professional, Ethical, and Regulatory Standards That Must Be Incorporated Into the Design and Implementation of the System (5.2)
10.0%
A discussion of professional, ethical, and regulatory standards that must be incorporated into the design and implementation of the system is not included.
A discussion of professional, ethical, and regulatory standards that must be incorporated into the design and implementation of the system is present, but it lacks detail or is incomplete.
A discussion of professional, ethical, and regulatory standards that must be incorporated into the design and implementation of the system is present.
A discussion of professional, ethical, and regulatory standards that must be incorporated into the design and implementation of the system is clearly provided and well developed.
A comprehensive discussion of professional, ethical, and regulatory standards that must be incorporated into the design and implementation of the system is thoroughly developed with supporting details.

How the EHR Team Would Ensure That All Order Sets Are Part of the New Record
5.0%
A discussion of how the EHR team would ensure that all order sets are part of the new record is not included.
A discussion of how the EHR team would ensure that all order sets are part of the new record is present, but it lacks detail or is incomplete.
A discussion of how the EHR team would ensure that all order sets are part of the new r

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