Recommended Solution and Potential Implementation Issues

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Business Solutions

Shanovia Smith

Pierce at Lackwanna College

HCA 520: Healthcare Informatics and Information Technology

Professor: Dr. DeVida J. Rembert

June 19th, 2026

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Business Solutions

Organizational Analysis of the Emergency Department

The selected community hospital has an Emergency Department (ED) that sees

around 40,000 to 50,000 patients on an annual basis. This is a high-volume, high-pressure

environment where efficiency, communication, and coordination are all critical in-patient

safety and satisfaction. Regardless of the ED's implementation of an Electronic Health

Record (EHR) system, the ED is still plagued by inefficiencies in its workflows, constraints

on real-time view of patient status, and a lack of communication between departments.

Organizationally, the ED is structured according to a functional dispositional system

by departments, with clinical services each organized separately (triage, nursing, laboratory,

radiology, physician care) (Brambilla et al., 2022). This design fosters unit specialization and

accountability, but also facilitates silo-thinking and, by extension, poor coordination between

units throughout the patient journey. Consequently, the flow of patients isn't managed as a

coordinated system, but instead as a variety of isolated duties.

Mini SWOT Analysis

A SWOT analysis was completed to gain greater insight into any internal and external

factors that may impact the ED's performance.

Strengths

The ED has access to a team of experienced, skilled multi-disciplinary staff that can

troubleshoot and handle complex and high acuity cases. They also have an existing patient

information system, which serves as the basis for digital transformation. The community also

has high trust in the hospital and high demand from patients for its services, providing

continuity of the services it provides (AlBishi, et al., 2025).

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Weaknesses

Despite it all, poor integration between systems means that there's limited visibility of

patient flow in real-time in the ED. Verbal updates, phone calls, and manual tracking boards

are highly important for communication and can lead to delays and miscommunication.

Patients are not tracked consistently across departments, and diagnostic testing is not tracked

consistently.

Opportunities

The potential for utilizing more sophisticated healthcare information exchange

technologies, including patient tracking, predictive analytics, and workflow automation

solutions, is great. These systems can help to streamline operations, boost patient satisfaction,

and generate better compliance with quality standards for reimbursement (Snigdha, Hossain,

& Mahabub, 2023).

Threats

The main issues are the threat of increased ED crowding, higher expectations of

patients, stress on staffing, and financial penalties for sub-optimal ED performance, measured

by poor outcomes like long wait times and low satisfaction scores. Also, more sophisticated

healthcare solutions elude and potentially pose a long-term competitive threat.

Organizational Policies, Procedures, and Workflow Structure

An effective clinical policy is in place within the ED that classifies patients and

prioritizes patient safety. Patients are judged on arrival and classified according to their level

of clinical urgency by a standardized system of patient triage, for example, the Emergency

Severity Index (ESI). The policies, however, work well in theory, but their possibilities are

limited by technology support.

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Current Workflow Process

1. Patient Registration

The patients are manually entered into the EHR system with patient info such as

demographics and insurance information. Administrative backlog and high arrival

volumes are often one of the reasons that delay this step (Acharya, 2026).

2. Triage Assessment

The nurses assess patients' situations and determine the priority. This is a process that

may be structured but is not necessarily integrated in real time with downstream

departments.

3. Provider Assignment

Physicians are not distributed on a workflow basis, and manual workflow may result

in uneven distribution of physicians.

4. Diagnostic Testing

Laboratory and imaging orders are all ordered electronically but tracked separately

and may involve manual processing to make sure they are carried out.

5. Treatment and Monitoring

Patient progress is reviewed, not tracked, through periodic updates, which introduce a

delay in identifying bottlenecks.

6. Discharge or Admission

Bed availability and discharge readiness are communicated manually between

departments, slowing patient turnover.

Workflow Inefficiencies

The absence of an integrated tracking system leads to several inefficiencies:

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• Delayed identification of patient bottlenecks.

• Ineffective communication between departments (Huang, Chiou, Chen, & Sub-R-Pa,

2024).

• Limited visibility of room availability.

• Lack of automated escalation for delayed care processes.

These inefficiencies directly contribute to ED overcrowding and increased patient

wait times.

Requirements Analysis for the Proposed System

The proposed Emergency Department Patient Tracking and Flow Management

System (EDPTFMS) should enforce the Input–Process–Output (IPO) model to provide the

effective functioning of the system and should be interoperable with existing systems (Patil,

2024).

Inputs (Data Entered into the System)

The system must capture comprehensive patient and operational data, including:

• Patient demographic information (name, age, insurance details).

• Clinical triage scores and acuity levels.

• Vital signs and nursing assessments.

• Provider assignments and care responsibilities.

• Diagnostic orders (lab and imaging requests).

• Room and bed availability status.

• Time stamps for each stage of patient movement.

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These inputs form the foundation of real-time tracking and decision-making.

Processes (System Functions)

The system should include the following automated and semi-automated processes:

• Real-time tracking of patient location and status across departments.

• Automated alerts for prolonged wait times or delayed treatment milestones.

• Workflow routing based on triage priority and resource availability.

• Integration with EHR systems to ensure data consistency.

• Predictive analytics to forecast patient surges and resource demand.

• Escalation protocols for critical delays in care delivery.

These processes are essential for reducing communication delays and improving

operational coordination.

Outputs (Reports and System Results)

The system must generate actionable outputs, including:

• ED wait time and throughput reports.

• Provider workload distribution dashboards.

• Room utilization and turnover analytics.

• Patient flow bottleneck identification reports.

• Quality performance indicators, such as the length of stay.

• Real-time operational dashboards for ED leadership.

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These outputs support data-driven decision-making and continuous performance

improvement.

Vendor Selection Criteria and Weighted Objectives

To ensure the selection of the most appropriate solution, the hospital will use a

weighted decision matrix based on key operational and strategic objectives.

Weighted Criteria Table

Objective Weight

(%)

Rationale

EHR Compatibility 30% Essential for seamless integration and avoiding

workflow disruption

Real-Time Tracking

Capability

20% Core requirement for improving patient flow

efficiency

Cost of Implementation 20% Budget constraints require financially sustainable

solutions

Ease of Use 15% Influences staff adoption and training

requirements

Vendor Support &

Training

15% Ensures long-term system success and

maintenance

Rationale for Weighting

Integrating with the existing hospital systems is a priority because of the need to

integrate with the present hospital systems (Akhtar, 2025). Real-time tracking is also

essential, as it directly responds to the issue of ED overcrowding. Finance plays an important

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role, since there is a limit on cost. Usability and vendor support are deemed to be less

important, but essential for successful adoption and sustainability.

Healthcare Application System Solutions

Three potential healthcare information system solutions were identified for studying

and subsequently recording their ability to enhance patient rotation, communication, and

operational efficiency in the ED.

Solution 1: Epic Systems – ED Patient Flow Module

Epic Systems Corporation

In the United States, Epic Systems is one of the most popular EHR vendor suppliers

which integrated an emergency department module to support patient flow within the EHR

system (Chishtie, et al., 2023).

Advantages

• Seamless integration with existing Epic EHR environments.

• Strong clinical documentation and data interoperability.

• Advanced reporting and analytics capabilities.

• Widely trusted and used in large hospital systems.

Disadvantages

• High implementation and licensing costs.

• Complex system requiring extensive staff training.

• Less flexibility for smaller or mid-sized hospitals.

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Epic performs strongly in system compatibility and analytics but is less cost-effective for

smaller healthcare facilities.

Solution 2: Oracle Cerner Emergency Department Solution

Oracle Cerner

Oracle Cerner is a comprehensive EDMS that centers on workflow management,

patient tracking, and clinical documentation in emergency departments (Annam, 2024).

Advantages

• Strong real-time tracking and clinical decision support.

• Scalable across medium and large hospital systems.

• Effective integration with laboratory and imaging systems.

• Robust enterprise-level infrastructure.

Disadvantages

• Lengthy implementation timelines.

• User interface complexity may reduce ease of adoption.

• Integration challenges with non-Cerner legacy systems.

Cerner is highly effective for large-scale operations but may require significant training

and change management.

Solution 3: TeleTracking Patient Flow System

TeleTracking Technologies

TeleTracking has a forte in hospital operations, and its main emphasis is on improving

the maximum flow of patients, bed management, and maximum use of capacity (Rolo, 2025).

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Advantages

• Best-in-class patient flow and capacity management tools.

• Proven reduction in ED overcrowding in healthcare case studies.

• Strong real-time visibility of patient movement and resource allocation.

• Can integrate with existing EHR systems without replacement.

Disadvantages

• Requires integration with other systems.

• Additional dependency on a third-party vendor.

• Limited clinical documentation capabilities compared to full EHR systems.

TeleTracking is highly specialized and directly aligned with the ED flow problem, but it

depends on integration with existing systems.

Comparative Evaluation and Recommendation

Each solution has its own point(s) of strength when judged on the weighted criteria.

Epic Systems specializes in complete EHR integration and enterprise analytics, but it can be a

high-cost option. While Oracle Cerner has good scalability and clinical support, usability and

implementation issues exist. The most direct enhancement in patient flow efficiency and

reduction in overcrowding is made by TeleTracking Technologies.

After considering the weighted objectives, TeleTracking Technologies seems to be

the best fit, as it solves the hospital's main issue: emergency department congestion, without

needing to replace the current EHR platform (Browne-Farrell, 2025).

Conclusion

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Emergency Department staff are challenged by poor real-time visibility of patient

flow, manual workflows, and fragmented communication. All of these inefficiencies can help

to cause overcrowding, longer waiting times, and lower patient satisfaction.

This proposed Emergency Department Patient Tracking and Flow Management

System (EDPTFMS) offers a technological, structured solution that creates a more

transparent, communicative, and resource-efficient environment. It allows for data-driven

decision-making and ongoing improvements through its structured inputs, automation, and

actionable outputs.

Based on a comparative analysis of three top healthcare IT vendors, Epic Systems and

Oracle Cerner are known for offering more comprehensive solutions focused on EHRs,

whereas TeleTracking Technologies is the most targeted and effective solution available to

streamline patient flow in its emergency departments. It offers a point of focus on real-time

operational efficiency, which is most aligned with the strategic goals of the hospital.

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References

Acharya, K. (2026). Electronic health record (EHR) management report.

https://www.authorea.com/doi/pdf/10.22541/au.177067346.64502373

Akhtar, Z. B. (2025). AI and EHR Innovation: A Smart Approach to Medical Prioritization

and Patient Care. Real-World AI Systems, 37-56.

https://journals.cypedia.net/rwas/article/download/55/84

AlBishi, S. S., Aboeda, R. F., ALShahrani, F. M., Alaklabi, I. S., Albishi, G. S., Al Shahrane,

S. M., & Alabsi, K. A. (2025). Nursing Practice In Emergency And High-Risk

Environments: A Review Of Clinical Effectiveness And Workforce Challenges. The

Review of Diabetic Studies, 544-555. https://doi.org/10.70082/5wdw2545

Annam, S. N. (2024). Comparative Analysis of IT Management Tools in Healthcare. Stallion

Journal for Multidisciplinary Associated Research Studies, 72-86.

https://www.researchgate.net/profile/Srinikhil-

Annam/publication/387494517_Comparative_Analysis_of_IT_Management_Tools_i

n_Healthcare/links/690044c39708d52f2da200c8/Comparative-Analysis-of-IT-

Management-Tools-in-Healthcare.pdf

Brambilla, A., Mangili, S., Das, M., Lal, S., & Capolongo, S. (2022). Analysis of functional

layout in emergency departments (ED). Shedding light on the free standing

emergency department (FSED) model. Applied Sciences, 5099.

https://doi.org/10.3390/app12105099

Browne-Farrell, G. D. (2025). Strategies to Reduce Waiting Times in a Hospital Emergency

Department. Doctoral dissertation.

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https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=19820&context=dissert

ations

Chishtie, J., Sapiro, N., Wiebe, N., Rabatach, L., Lorenzetti, D., Leung, A. A., & Eastwood,

C. A. (2023). Use of epic electronic health record system for health care research:

scoping review. Journal of medical Internet research, 51003.

https://doi.org/10.2196/51003

Huang, S. W., Chiou, S. Y., Chen, R. C., & Sub-R-Pa, C. (2024). Enhancing hospital

efficiency and patient care: real-time tracking and data-driven dispatch in patient

transport. Sensors, 4020. https://doi.org/10.3390/s24124020

Patil, S. (2024). A new service model for identifying and improving the quality of emergency

department operations in tertiary settings. Doctoral dissertation.

https://doi.org/10.26686/wgtn.26802976

Rolo, M. D. (2025). Network Planning of a Home Hospitalization Service Integrating

Telemonitoring Solutions. Doctoral dissertation.

https://thesis.dial.uclouvain.be/server/api/core/bitstreams/8bcde83f-b13b-4fc8-b154-

d833f43e2a40/content

Snigdha, E. Z., Hossain, M. R., & Mahabub, S. (2023). AI-powered healthcare tracker

development: advancing real-time patient monitoring and predictive analytics through

data-driven intelligence. Journal of Computer Science and Technology Studies, 229-

239. https://doi.org/10.32996/jcsts.2023.5.4.24