Discussion: The Impact of Electronic Health Records in Health Care
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MHM514STUDENTRESPONSES2.docxZettle - Discussion 2, Post 1
Maggie Zettle
Boostra, Versluis, and Vos researched electronic health records (EHR) through a meta-analysis of articles detailing the results of EHR implementation in hospitals (2014). The researchers conducted a search of online-available, English-written, hospital-wide EHR implementation. They discovered and reviewed 21 articles which met the specific criteria and resulted in three classifications of interventions surrounding EHR context, content, and implementation process. The team concluded that implementation of electronic health records in hospital systems is varied based on 19 interventions. The similarities surrounding the context of EHR implementation in the articles include larger hospital systems, mature EHR vendors, experienced staff, collaborative culture, and flexible organizations tend to have more successful experiences with implementation. It is also difficult to implement EHR while maintaining the functionality of cure and care within the system. Implementation also worked best, according to the article, when the system adapted to the current practices, was reliable and user friendly, safeguards privacy, and run by a vendor with adaptability. Processes which were identified as positives included the active involvement of management, clinical staff, and interdisciplinary staff; training and guidance which addresses clinician fears; and identifying champions and support staff.
Unfortunately, this article focused on the processes surrounding the development and identification of their search strategy. It did not focus on the outcomes in the articles the researchers reviewed. The article could have provided a sound overview of implementation strategies, weaknesses and successes. This information could assist other hospital systems in modernization with electronic health records. Meta-analysis articles also have an implicit bias in that the biases of the cumulative authors cannot be addressed easily. Additional bias was introduced in the selection criteria for these articles by utilizing abstracts only to determine inclusion. This eliminated a significant amount of articles which could provide additional information for the article.
Boonstra, A; Versluis, A; and Vos, JF. (2014). Implementing electronic health records in hospitals: a systematic literature review. BMC Health Services Research. http://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-14-370
Discussion: The Impact of Electronic Health Records in Health Care
Nicole Henry
The article titled, “Implementing electronic health records in hospitals: a systematic literature review” provides an overview of existing literature on the implementation of electronic health records within the hospital setting. The study conducted by Boonstra, Versluis, and Vos provided their detailed methodology on inclusion and exclusion criteria of articles. The focus on findings were placed into implementation categories. They include context, content, and process. Context in general, represents what type of healthcare organization. There are numerous variables included within the research criteria that include external and internal factors. For instance, if the organization was for-profit or non-profit and an organizations capability. Content refers to the sociotechnical approach. This study analyzed how the technology implementation would fit into the workflow of the organization. It not only looks at the fit of the technology but the human aspect of using the technology. One study suggested that understanding this aspect organizations are able implement and use the technology with positive effects (Aarts, Doorewaard, and Berg, 2004) The third category of the study identifies the process of the implementation. This aspect of implementation can lead to anxiety, uncertainty and possible negative impacts (Boonstra, Versluis, and Vos, 2014) Process is how the user friendly the programs are and how long-term maintenance and utilization of the system. This study found that the implementation of the electronic health records may provide benefit but also addresses important issues.
The article provided detailed methodology on how the study was conducted. However, it would have been beneficial to review how and why the government regulations affected this drive to use electronic health records (EHR). Another suggestion is that the study separated findings by the software/hardware vendor. This could impact implementation of EHR. This study was also unable to provide evidence of there being a comprehensive approach to implementing EHR systems.
References
Aarts, J., Doorewaard, H., and Berg, M. (2004). Understanding Implementation: The Case of a Computerized Physician Order Entry System in a Large Dutch University Medical Center. Retrieved from: https://academic.oup.com/jamia/article/11/3/207/794539
Boonstra, A., Versluis, A., and Vos, J. (2014). Implementing Electronic Health Records in Hospitals: A Systematic Literature Review. Retrieved from: https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-14-370
