quality 8 dis

· implementation: involving the installation of new databases and application programs and the use of new procedures

· Maintenance: refers to the degree to which an EHR system is looked after so that it functions properly

· So improvement refers to any subsequent installation or physical change made to an EHR system.

Barriers that delayed the adoption and successful implementation of health information systems and electronic medical records are:

· Beliefs, attitudes, and behaviors of healthcare professionals such as the ability to learn over time,

· Computer knowledge and typing proficiency,

· Motivation and personal initiative to explore and use the systems and user-developed strategies and workarounds to solve minor difficulties

· The resistance of physicians and other healthcare professionals to accept and use EMR.

· Cost of the system.

· Limited in training session and staff support.

So basically the barriers will be:

· Human Barriers (Healthcare Professionals)

· Financial Barriers (Money and Funding)

· Legal and Regulatory Barriers (Laws and Policies)

· Organizational Barriers (Hospital Management)

· Technical Barriers (Computers and IT)

· Professional Barriers (Working at Hospitals)

Suggestion to solve it:

· Improving the awareness of the importance and benefits of using EMRs by focusing on the topic through a multi-phase approach.

· Improving the knowledge of using EMRs through formal training during different levels of medical education and training.

· EMRs should be developed and implemented as a course or a subject of the formal undergraduate as well as postgraduate medical education programs

· implemented by the ministry of health and its formal channels for all healthcare professionals at all types of hospitals and healthcare organizations.

· Develop hospital orientation and training programs on EMRs

· Allocating the proper funding and enough capitals investments

· Designing the annual budgets of the hospitals to capacitate the high operation and maintenance costs of EMRs

· Conducting feasibility studies that show the benefits versus costs of implementing and using EMRs,

· Proper planning of hospital resources in the phases of EMRs implementation

· Hospitals should start developing their policies and procedures that control the use of data, information and EMRs internally, including singing privacy and confidentiality agreements and consents.

· Users should educate, trained and committed to using EMRs with caution not to disclose or abuse the information otherwise they will put themselves into a liability, accountability, and legal problems.

· Sometimes it is essential for hospitals to redesign their medical and administrative workflow to match with EMRs specifications.

· Implementation of EMRs should be controlled by a time frame and project management schedules not to let the EMRs implementation take more than expected time.

· Hospital management should develop their experience choose, implement and evaluate EMRs and their performance over time.

· Hospitals should check for an installed live model of the system in another hospital to evaluate the system while in the production phase.

· System protection and monitoring should be one of the priorities of the hospitals.

· Hospital management should develop a strategic plan for the adoption, implementation and future development of EMRs.

· Hospital management should provide necessary initial and continuous training for hospital staff on how to best use EMRs and HIS.

· To ensure that HIS and EMRs vendors and commercial providers are supplying hospitals with the proper system documentation, user manuals and guidelines for using and troubleshooting EMRs

· We have to make sure that computers and networks are working fine - regarding hardware - and that they have fewer maintenance problems

· It is essential, for the healthcare professionals as users, to make the system’s interface design more friendly and understandable,

· Using data standards is an essential step in validating data on the systems and consequently crucial for the quality, accuracy, and reliability of such source.

· Improving healthcare professionals’ support to EMRs through increasing their participation and involvement in the stages of systems development, systems implementation, and deployment.

· Improving motivation of healthcare professionals to learn and train on using EMRs by providing them with direct and indirect incentives, including overtime payments,

· We should also provide enough time suitable and convenient for healthcare professionals to learn and train on using EMRs.

· Conducting training programs for healthcare professionals to educate them on how to take new EMRs responsibilities and accountabilities, so they would better understand their part of the process.

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Key stakeholder:

· nurses, physicians, therapists, case managers and other clinical staff will be using the EHR system frequently and extensively.

· The front office staff and office manager are essential stakeholders in the EHR selection process because they are responsible for inputting the demographic

· The billing department is essential to your EHR selection process because, without the billing department, your practice will not get paid

· The administration and board members of the practice will be essential stakeholders because they will make critical financial and operational decisions regarding the EHR project.

Disadvantages of electronic records

· High startup costs

· Substantial learning curve

· Confidentiality and security issues

· Lack of standardized terminology, system architecture, and indexing