|
|
(2 intermediate revisions by one user not shown) |
Line 1: |
Line 1: |
− | == EHR issues in Critical Access Hospitals ==
| |
| | | |
− | Implementation of an EHR is an overwhelming task no matter where it is done. However, achieving this task in a critical access hospital (defined as a hospital that provides 24-hour emergency services with less than 25 acute care and swing beds and is more than 35 miles from another hospital) with limited resources is more challenging. A recent study addressing this issue is EHR Implementation Advice to Critical Access Hospitals from Peer Experts and Other Key Informants http://aci.schattauer.de/en/contents/archive/issue/1824/manuscript/20820.html].
| |
− |
| |
− | == Methods ==
| |
− |
| |
− | Participants:
| |
− | 16 peer experts
| |
− | 3 vendor representatives
| |
− | 7 implementation experts
| |
− | 6 EHR consultants
| |
− | 3 CAH Regional Extension Center representatives
| |
− | 4 researchers in clinical informatics and HIT policy
| |
− | 2 national EHR policy stakeholders
| |
− |
| |
− | These groups were split into CAH peer experts and all experts.
| |
− |
| |
− | Questions:
| |
− | 1 "What are the things you'd want to know most about planning and preparation processes for EHR implementation at CAHs? Name two."
| |
− | 2 "What advice would you give CAHs on the planning and preparation processes for EHR implementation?"
| |
− |
| |
− | == Results ==
| |
− |
| |
− |
| |
− | 19 themes, ranked in order of number of times mentioned, from expert comments:
| |
− | EHR Team
| |
− | Communication
| |
− | Clinician/Physician Buy-in/Ownership
| |
− | Budget/Financial Resources
| |
− | EHR System Selection
| |
− | Preparatory Work
| |
− | Technology
| |
− | Optimization/Ongoing Work
| |
− | Outside Partners/Information Resources
| |
− | EHR Training/Go-live Support
| |
− | Workflow/Productivity
| |
− | Project Management
| |
− | Purpose/Goals
| |
− | Leadership
| |
− | Change/Encouragement
| |
− | Policy/Meaningful Use
| |
− | Governance
| |
− | System Install/Go-live
| |
− | Clinical Decision Support/Knowledge Management
| |
− |
| |
− | '''Reoccuring Suggestions that Crossed Multiple Themes'''
| |
− |
| |
− | Although some suggestions were specific to a theme, it is interesting that some suggestions were given with multiple themes. These included the suggestion that a group from the CAH travel to see each EHR in use at another CAH before purchase. This delegation should include key stakeholders at the institution as well as end-point users. The delegates should meet with their peers at the CAH already running the system and elicit comments about build, go-live, vendor support, difficulties, resolution of those difficulties, and ongoing use.
| |
− |
| |
− | It was also mentioned across several themes to involve all departments including those who will use the system on a day to day basis, not just management. These employees can often give better feedback on how the system will work in the daily operations than department managers can.
| |
− |
| |
− | == Discussion ==
| |
− |
| |
− | Ranking of comments generated by CAH peer experts vs. all experts shows a different order of importance, showing that either CAH peer experts or non-CAH experts have a knowledge gap.
| |