An Evaluation of System End-User Support during Implementation of an Electronic Health Record Using the Model for Improvement Framework

Kiepek, Wendy; Sengstack, Patricia

doi:10.1055/s-0039-3402450

Cited by 6 publications

(6 citation statements)

References 10 publications

(10 reference statements)

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“…The present study examined and analyzed the factors and indicated the most remarkable effectiveness of the HIS in improving the clinical staff performance occurred by accelerating paraclinical activities, the process of diagnosis and treatment, access to quality information, and medical research. The results of some other studies also confirmed the findings of the present study [11,30,31].…”

Section: Discussionsupporting

confidence: 93%

Use of Hospital Information System to Improve the Quality of Health Care from Clinical Staff Perspective

Mohammadpour

Ghaemi

Darrudi

et al. 2021

GMJ

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Background:The development of hospital information systems (HISs) has a significant effect on care processes. In this regard, the clinical staff's perspective is very important in evaluating the success of these systems. The present study aimed to evaluate the clinical staff's perspective at hospitals affiliated to Neyshabur University of Medical Sciences on the effectiveness of the HIS in improving their performance and strategies for increasing the system effectiveness. Materials and Methods: In the present cross-sectional study, 120 clinical staff who actively worked with the HIS were included. A two-part questionnaire was used for data gathering. Results: From the perspective of the research population, the effective score of HIS was %64.42 in improving their performance, and %81.85 in the case of developed HIS according to the suggested strategies. According to the research scale, the effectiveness of the system could be improved from good to excellent in the case of implementation of strategies, so that there was a statistically significant difference between the pre-and post-effectiveness (P<0.001). Conclusion: Positive population perspective on the effectiveness of HIS in-performance improvement of the clinical staff indicated that there was a good context for the development and utilization of information technology in the hospitals. The clinical staff's opinions and work needs as the primary group of patient care should be taken into consideration in order to increase the effectiveness of the HIS.

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Section: Discussionsupporting

confidence: 93%

Use of Hospital Information System to Improve the Quality of Health Care from Clinical Staff Perspective

Mohammadpour

Ghaemi

Darrudi

et al. 2021

GMJ

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“…Finally, we note the challenges of investigations in the EHR, a topic extensively discussed in the literature, 106,107 which might have influenced our results. The ETL process that converts the clinical data into the OMOP data tables is a dynamic process that improves over time, but is not completely error free.…”

Section: Discussionmentioning

confidence: 97%

Augmenting the Clinical Data Sources for Enigmatic Diseases: A Cross-Sectional Study of Self-Tracking Data and Clinical Documentation in Endometriosis

et al. 2020

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Background Self-tracking through mobile health technology can augment the electronic health record (EHR) as an additional data source by providing direct patient input. This can be particularly useful in the context of enigmatic diseases and further promote patient engagement. Objectives This study aimed to investigate the additional information that can be gained through direct patient input on poorly understood diseases, beyond what is already documented in the EHR. Methods This was an observational study including two samples with a clinically confirmed endometriosis diagnosis. We analyzed data from 6,925 women with endometriosis using a research app for tracking endometriosis to assess prevalence of self-reported pain problems, between- and within-person variability in pain over time, endometriosis-affected tasks of daily function, and self-management strategies. We analyzed data from 4,389 patients identified through a large metropolitan hospital EHR to compare pain problems with the self-tracking app and to identify unique data elements that can be contributed via patient self-tracking. Results Pelvic pain was the most prevalent problem in the self-tracking sample (57.3%), followed by gastrointestinal-related (55.9%) and lower back (49.2%) pain. Unique problems that were captured by self-tracking included pain in ovaries (43.7%) and uterus (37.2%). Pain experience was highly variable both across and within participants over time. Within-person variation accounted for 58% of the total variance in pain scores, and was large in magnitude, based on the ratio of within- to between-person variability (0.92) and the intraclass correlation (0.42). Work was the most affected daily function task (49%), and there was significant within- and between-person variability in self-management effectiveness. Prevalence rates in the EHR were significantly lower, with abdominal pain being the most prevalent (36.5%). Conclusion For enigmatic diseases, patient self-tracking as an additional data source complementary to EHR can enable learning from the patient to more accurately and comprehensively evaluate patient health history and status.

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“…This study emphasizes several other topics described in our interviews, including staff changes and organizational restructuring. Kiepek and Sengstack 27 also acknowledge the importance of on-site support for end-users during the transition but do not discuss the preparatory work to get to the actual implementation. Overall, our findings support claims from these studies but broaden the scope with respect to the variety in healthcare settings and resource availability.…”

Section: Discussionmentioning

confidence: 99%

“…There can also be extreme difficulty for an organization to develop and maintain its own HIT systems, which often leads organizations away from keeping their homegrown systems, despite the benefits that they may bring. Kiepek and Sengstack 27 suggest some potential success indicators.…”

Section: Discussionmentioning

confidence: 99%

“… 8 , 9 , 25 Though this literature provides useful insight, it focuses largely on initial adoption of HIT, rather than modernization. A more comprehensive narrative of successful decision-making and process for modernization has been described 26 , 27 ; however, these descriptions come only from well-resourced settings with little indication of diversity in the healthcare setting.…”

Section: Introductionmentioning

confidence: 99%

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Modernizing health information technology: lessons from healthcare delivery systems

et al. 2020

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Objective To identify recurrent themes, insights, and process recommendations from stakeholders in US organizations during the health information technology (HIT) modernization of an existing electronic health record (EHR) to a commercial-off-the-shelf product in both resource-plentiful settings and in a resource-constrained environment, the US Indian Health Service. Materials and Methods Thirteen qualitative interviews with stakeholders in various organizations were conducted about HIT modernization efforts. Using a Theory of Change framework, recurring themes were identified and analyzed. Results The interviewees emphasized the importance of organizational and process revision during modernization, converting historical data, and clinical and leadership involvement. HIT implementation required technological and infrastructure redesign, additional training, and workflow reconfiguration. Motivations for modernization included EHR usability dissatisfaction, revenue enhancements, and improved clinical operations. Decision-making strategies, primarily during HIT selection, included meetings with stakeholders. Successful modernization resulted in improvements in clinical operations, patient experience, and financial outlay. Discussion Existing implementation frameworks fail to provide experiential feedback, such as implementation challenges, like data conversion, regulatory, functionality, and interoperability requirements. Regardless of the healthcare environment, HIT modernization requires the engagement of leadership and end-users during HIT selection and through all stages of the implementation to prepare people, processes, and technology. Organizations must iteratively define the technological, infrastructure, organizational, and workflow changes required for a successful HIT modernization effort. Conclusions HIT modernization is an opportunity for organizational and technological change. Successful modernization requires a comprehensive, intentional, well-communicated, and multidisciplinary approach. Resource-constrained environments have the additional challenges of financial burdens, limited staffing, and unstable infrastructure.

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An Evaluation of System End-User Support during Implementation of an Electronic Health Record Using the Model for Improvement Framework

Cited by 6 publications

References 10 publications

Use of Hospital Information System to Improve the Quality of Health Care from Clinical Staff Perspective

Use of Hospital Information System to Improve the Quality of Health Care from Clinical Staff Perspective

Augmenting the Clinical Data Sources for Enigmatic Diseases: A Cross-Sectional Study of Self-Tracking Data and Clinical Documentation in Endometriosis

Modernizing health information technology: lessons from healthcare delivery systems

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