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| − | == EHR issues in Critical Access Hospitals ==
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| − | 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].
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| − | == Methods ==
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| − | Participants:
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| − | * 16 peer experts
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| − | * 3 vendor representatives
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| − | * 7 implementation experts
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| − | * 6 EHR consultants
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| − | * 3 CAH Regional Extension Center representatives
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| − | * 4 researchers in clinical informatics and HIT policy
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| − | * 2 national EHR policy stakeholders
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| − | These groups were split into CAH peer experts and all experts.
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| − | Questions:
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| − | * 1 "What are the things you'd want to know most about planning and preparation processes for EHR implementation at CAHs? Name two."
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| − | * 2 "What advice would you give CAHs on the planning and preparation processes for EHR implementation?"
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| − | == Results ==
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| − | 19 themes, ranked in order of number of times mentioned, from expert comments:
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| − | * EHR Team
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| − | * Communication
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| − | * Clinician/Physician Buy-in/Ownership
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| − | * Budget/Financial Resources
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| − | * EHR System Selection
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| − | * Preparatory Work
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| − | * Technology
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| − | * Optimization/Ongoing Work
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| − | * Outside Partners/Information Resources
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| − | * EHR Training/Go-live Support
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| − | * Workflow/Productivity
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| − | * Project Management
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| − | * Purpose/Goals
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| − | * Leadership
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| − | * Change/Encouragement
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| − | * Policy/Meaningful Use
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| − | * Governance
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| − | * System Install/Go-live
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| − | * Clinical Decision Support/Knowledge Management
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| − | '''Reoccuring Suggestions that Crossed Multiple Themes'''
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| − | 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.
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| − | 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.
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| − | == Discussion ==
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| − | 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.
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