Health Care Informatics

LESSON 17 / FINAL Final Project: Putting It All Together – Converting to Electronic LECTURE NOTES ______________________________________________________________________________________

This course has been designed as an introduction to the elements of the health care record, both

in paper-based systems and in the electronic format. Many of the key requirements, such as

security, storage, access, content, retention, etc., are similar to both forms of the records.

Certainly, each system for record keeping has its advantages and disadvantages. This course has

attempted to balance the content so that the lessons allow you to understand both systems.

It is this instructor’s opinion that the paper-based record will be phased out from the majority of

health care providers in the next few years, perhaps as few as three or four years. This does not

assume that paper-based records will be eliminated since there are requirements for storage,

retention, and future access of the archived records. The actual historical paper-based record will

be headed for storage rooms or other forms of archive storage, such as being scanned into a read-

only electronic format. While some providers will resist the move to this new technology,

ultimately the organizations that pay for the cost of health care will mandate the change (i.e.,

insurance carriers, HMOs, and governmental payers).

As students, many of you have seen or used the electronic version of the health record. Some

organizations were early converts to the technology and have benefited from the conversion, or

at least learned lessons on how a conversion project occurs effectively. Many students who are

employed by health care organizations will be exposed to massive conversion and change

processes in the coming years. While a change in systems may seem to be a monumental

process, it can be done with adequate focus, planning, conviction to the goal, access to resources,

and implementation strategies that engage the major stakeholders in the project.

The conversion process for health records is similar to any process of change that an

organization wants to make in their operations. It requires a leader who can take the desired

outcome for the project and lead a group of employees into a process that achieves the stated

outcome to be accomplished. While that seems to be a simple means of identifying the process,

the challenge is getting the stakeholders or employees to a point of wanting to make the change

and to make the change a successful process.

Some people believe that change will only occur when the “pain” is sufficiently high enough that

the reluctance to change is overridden by the need to stop the “pain.” In this context, “pain” can

be identified as frustration with the duties or other emotional factors that cause the individual to

want to change. While the tactic of using a “threat” of some sanction or action by a supervisor

may appear to be a means of inflicting the “pain,” it rarely works on a long-term basis. The

stakeholders need to come to the conclusion that the change will be beneficial.

There are essentially two issues that seem to be the reaction by some when a change project is

pursued:

 Fear of the unknown

 Questioning how this change impacts them

The key tactics for addressing these reactions are as follows:

 Communication – The project must have a communication strategy that provides answers to issues or questions that are raised by the stakeholders. Providing information on how a

plan impacts each stakeholder addresses the fear of the unknown and how it will impact

them. In this instance, more communication is better.

 Planning – Successful projects will have spent a considerable amount of time planning out the project. Planning also allows for input during the process, and adjustments can be

made during the process.

 Transparency – Nothing will harm a change project as much as secrecy and the lack of transparency. If stakeholders feel that something is being kept from them, it will enhance

their “fear of the unknown.”

 Creation of Milestones and Goals – This provides the stakeholders and leadership with an understanding of how success will be measured by goals and how the timeline will

proceed.

 Celebration of Successes – This will reinforce the value of the project and recognize contributions.

 Leaders and Champions – The project must have a respected leader for the project who has the ability and skills to be successful. Additionally, there are critical influencers who

can and will support and champion the project. They can influence others in the process.

 Flexibility – When a tactic, milestone, or goal is not achieved, adjustments are to be made as necessary. This demonstrates to stakeholders that a successful outcome is the goal.

What follows is a broad outline of a conversion plan for this assignment. You may use any or all

of the elements for your work. Feel free to add items that you feel are essential to your

conversion project. Limit your plan for this assignment to ten (10) pages.

Suggested plan elements for the conversion project:

 Mission Statement for the Project – What do you intend to do?

 Vision Statement for the Project – What is the expected outcome of the project?

 Goals and Objectives – How will you know if you are successful with the project? What will you use to measure success? Does it include a calculation for return on investment?

 Leadership – Who will lead the team? Do they have the skills? Do they have the respect of the stakeholders?

 Stakeholders – How will the process engage and secure feedback from stakeholders?

 Team Membership – Who needs to be on the team? Is it diverse?

 Timeline – What will be the timeline to complete the conversion?

 Communications – How will the process be communicated to stakeholders and others?

 Vendor Selection – If the conversion is being done with a vendor, what will the Request for Proposal process be, including the timelines?

 In-House Process – If the conversion is being down with in-house staff, what are the elements needed to make it a success?

 Finances – What is the proposed budget? Is it ongoing capital, staffing, licensing, etc.

 Decision Making – Who will make the final decision for the project plan?

 Implementation Process – Once the vendor is selected, how will the conversion be phased or rolled out?