hibbs is a program of the global health informatics partnership emr implementation considerations y....
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HIBBs is a program of the Global Health Informatics Partnership
EMR Implementation Considerations
Y. SINGH
NELSON R. MANDELA SCHOOL OF MEDICINEDEPARTMENT OF TELEHEALTH
Content licensed under Creative Commons Attribution-Share Alike 3.0 Unported
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Learning Objectives
To give you an idea of how to assess the value of a medical informatics solution
Make you aware of some of the questions you need to ask before rolling out any type of electronic medical record system
Points that will help ensure the successful implementation of an medical informatics solution
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An Example
Information systems too manage medical information is beneficial
Peter Littlejohns BMJ 2003;326;860-863
Three quarters of information systems fail
Limpopo Province IBM 134 million rands
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Why do EMRS Fail
Poor communication
Developers unaware of the environment
No change management in place
Perceptions (resistance to change)
No support from government
Too high expectations
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Essential Considerations
Needs assessment
Design
Testing
Implementation
Functionality
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Needs Assessment
Most important part directly results in success or failure
High end and sophisticated technology is not always the correct solution
Where are the developers from Workflow AnalysisActual vs perceived benefitCollecting data without analysis or
using it, is not beneficial to you
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Design
Ensure that you are fully involvedRemember … you need to tell the
developer what you wantInsist that the developer uses the
spiral development modelMust take into account the
environmentFlexible
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Testing
Testing must not be done in a lab
Have a trial run of the system in the actual environment with the full participation of the developers
Independent evaluator
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System Functionality
Comprehensiveness of information Does the system capture and store all the necessary
information
Degree of structure of data Retrieval and analysis of the data
Ubiquity of access Multiple read privileges
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System Functionality
Backups How are they done How often are they done Where is it stored
What happens if the system fails Second system with essential functionality Paper based batch entry back-up
Ease of use and flexibility
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System Functionality
Efficiency
Robustness
Add benefit to the clinical environment
Security Confidentiality Integrity Privacy
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System Selection
Open source vs. commercial systems
Actual costs
Available support
Small print
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Implementation
Phased rollout
Training
User support
Finding champions
Creating super users
Celebrating successes and learning from mistakes
Adequate budget
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Ask Questions
“Studies have shown that holding and caressing animals can dramaticallyspeed a person’s recovery”
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Important Questions
Is there clinical need for the system?Do all the components function?
correctlyIs it reliable?Is it accurate?Is it fast and accurate?Is the system well built? Are people likely to use it?
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More Important Questions
Which parts cause what effect?How can it be maintained?How can it be improved?Is the interface intuitive and easy to
use?Does it communicate effectively with
other components/hospital systems?Is it robust?
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