NURS 5051/6051: Week 5: Electronic Health Records

To improve the quality of our health care while lowering its cost, we will make the immediate investments necessary to ensure that within 5 years all of America’s medical records are computerized. This will cut waste, eliminate red tape, and reduce the need to repeat expensive medical tests.

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—Barack Obama (2009)

President Obama’s quote epitomizes the urgency surrounding electronic health records (EHRs). In February 2009, the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act designated nearly $26 billion dollars’ worth of funding to promote the rapid adoption and meaningful use of EHRs (U.S. Department of Health & Human Services, 2012). Despite this surge of support for the adoption of electronic health records, many challenges to their implementation have persisted in the subsequent years.

This week, you explore the implementation of electronic health records. You consider the benefits and challenges of the implementation process and how nurses can fulfill the role of change agents.

Learning Objectives

Students will:

  • Appraise strategies for overcoming barriers to the implementation of electronic health records
  • Apply Rogers’ Diffusion of Innovation to the implementation of an electronic health record
  • Analyze the role of nurses as change agents

Required Readings

McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones and Bartlett Learning.

  • Chapter 14, “The Electronic Health Record and Clinical Informatics”This chapter describes the crucial parts of an electronic health record system and explores the benefits of implementing one.

Bates, D. W. (2010). Getting in step: Electronic health records and their role in care coordination. Journal of General Internal Medicine, 25(3), 174–176.

The author of this editorial critically analyzes current applications of electronic health records (EHRs) and their impact on cost, quality, and safety of health care delivery. The author describes a study on the use of vendor-developed EHRs in clinical practice settings, the results of which pinpointed the benefits and drawbacks of EHRs.

Cresswell, K., & Sheikh, A. (2009). The NHS Care Record Service: Recommendations from the literature on successful implementation and adoption. Informatics in Primary Care, 17(3), 153–160.

This article defines the United Kingdom’s National Health Service’s Care Record Service (NHS CRS) as a standard electronic health record system. The article describes the challenges associated with implementing this new information technology and provides recommendations for overcoming those challenges.

Fickenscher, K., & Bakerman, M. (2011). Change management in health care IT. Physician Executive, 37(2), 64–67.

This article offers strategies for health care leaders to successfully implement change programs in their organizations, especially with regard to the new standards for electronic health records (EHRs). The article provides insights on change management, the reasons people resist change, and the ways to establish a culture that is more open to change initiatives.

Gruber, N., Darragh, J., Puccia, P. H., Kadric, D. S., & Bruce, S. (2010). Embracing change to improve performance. Long-Term Living: For the Continuing Care Professional, 59(1), 28–31.

This text describes the implementation of a new electronic health record system at a 105-bed hospital related-facility. The authors highlight five key elements that were deemed necessary for a successful EHR implementation.

Hyrkäs, K., & Harvey, K. (2010). Leading innovation and change. Journal of Nursing Management, 18(1), 1–3.

According to the authors, the health care field is in need of more effective leaders who understand innovation, who appreciate diversity and change, and who can foster and implement innovation and creativity. The authors describe how nurse leaders can be instrumental in embracing and disseminating innovation throughout the health care system and provide scaffolding for subsequent articles in this issue of the journal.

Mooney, B. L., & Boyle, A. M. (2011). 10 steps to successful EHR implementation. Medical Economics, 88(9), S4–6, S8–S11.

The authors of this article describe the incentives and requirements for electronic health records (EHRs) outlined in the Health Information Technology for Economic and Clinical Health (HITECH) Act. The authors then provide 10 steps for health care leaders and organizations to follow when implementing EHRs.

Murphy, J. (2011). Leading from the future: Leadership makes a difference during electronic health record implementation. Frontiers of Health Services Management, 28(1), 25–30

In this article, the author examines the causes behind the increasing complication of EHR implementations. In addition, the author explores the role of leadership in guiding successful EHR implementations.

Electronic health records (EHRs) are at the center stage of the effort to improve health care quality and control costs. In addition to allowing medical practitioners to access and record clinical documentation at much faster rates, EHRs are also positively influencing care delivery and nurse-patient interaction. Yet despite the potential benefits of EHRs, their implementation can be a formidable task that has broad-reaching implications for an entire health care organization.

In this Discussion, you appraise strategies for obtaining the benefits and overcoming the challenges of implementing and using electronic health records.

To prepare

  • Review the Learning Resources focusing on the implementation of EHRs in an organization. Reflect on the various approaches used.
  • If applicable, consider your own experiences with implementing EHRs. What were some positive aspects of the implementation? What suggestions would you make to improve the process?
  • Reflect on the reactions of others during the implementation process. Were concerns handled effectively?
  • If you have not had any experiences with an EHR implementation, talk to someone who has and get his or her feedback on the experience.
  • Search the Walden Library for examples of effective and poor implementation of EHRs.

By Day 3

Post an overview of at least three challenges in the implementation of electronic health records and provide an example of each challenge. Develop strategies for addressing each challenge based on what has been demonstrated to be successful. Cite your resources.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

  • Ask a probing question, substantiated with additional background information, evidence or research.
  • Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
  • Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
  • Validate an idea with your own experience and additional research.
  • Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
  • Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

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