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Hospital Switches EHR Software. Midwest Regional Hospital (fictional) is a 500-b

ID: 362930 • Letter: H

Question

Hospital Switches EHR Software. Midwest Regional Hospital (fictional) is a 500-bed general medical and surgical facility with 25,000 admissions and 7500 annual inpatient and 17,500 outpatient surgeries annually. Its emergency room has 52,000 visits each year. It is a nonprofit hospital that treats both adult and child patients. Over 1200 nurses, technicians, doctors, and physicians practice at the hospital.

An electronic health record (EHR) is an electronic version of a patient's medical history that is maintained by the provider over time, and may include all of the key administrative clinical data relevant to that person's care, including demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data, and radiology reports. The EHR automates access to this information, and the more sophisticated versions of EHR software can also produce an online "digital chart" that displays up-to-date patient information in real time, complete with decision support tools for physicians and nurses. One of the key features of an EHR is that health information can be created and managed by authorized providers in a digital format capable of being shared with other providers across more than one healthcare organization, including laboratories, specialists, medical imaging facilities, pharmacies, emergency facilities, and school and workplace clinics.

Midwest Hospital was an early pioneer in the adoption of EHR software, implementing the technology in 2004. Unfortunately, the vendor that Midwest selected has not been able to keep up with evolving regulatory requirements and the changing needs of its healthcare clients. Its software is fast becoming obsolete, and it is rumored that the firm will soon eliminate support of its software. You have been hired as a consultant to lead a project to replace the original software with software from one of the current leading EHR software providers—Allscripts, Cerner Corporation, or Epic Systems Corporation.

The hospital administrators have made it clear to you that the software vendor must be chosen and the software installed as soon as possible.

What approach should you take to accelerate the process without raising the risk of choosing the wrong software vendor and solution or having a rough system start-up?

a. Interview two or three customers of each software solution to learn about their experience with the vendor and the software.

b. There is no need to define the system requirements; rather, the project team can jump to performing a final evaluation of these three potential solutions. This will save a lot of time and effort.

c. Take a poll of key hospital administrators and physicians, and recommend the vendor and software solution that is most favored by them.

d. Simply choose any one of the three leading contenders, and begin to train users and implement the new system.

Which of the following set of tasks is not critical to completing this project?

a. Develop a prioritized set of requirements

b. Study the existing system and identify its strengths and limitations

c. Perform a feasibility analysis

d. Design the system user interface

A safety-critical system is one whose failure or misuse may cause human injury or death.

Given that an EHR system can be considered to be such a system, which set of tasks associated with software implementation deserve special attention by the Midwest Hospital project team?

a. Conduct an alpha and beta test, perform a direct conversion to start up the new system, and apply the Lewin and Schein three-stage model for implementing the new system to ensure that appropriate changes are made to people, structure, and tasks affected by the new system.

b. Allow sufficient time for site preparation, perform a direct conversion from the old system to the new system, and employ the technology acceptance model to lead to better attitudes about the use of the new system.

c. Train end users, perform user acceptance testing, and provide for ongoing end-user support and training.

d. Perform thorough unit testing, conduct frequent system reviews to ensure that the system is operating as intended, and apply the diffusion of innovation theory to plan the gradual adoption of the new system by the end users.

a. Interview two or three customers of each software solution to learn about their experience with the vendor and the software.

b. There is no need to define the system requirements; rather, the project team can jump to performing a final evaluation of these three potential solutions. This will save a lot of time and effort.

c. Take a poll of key hospital administrators and physicians, and recommend the vendor and software solution that is most favored by them.

d. Simply choose any one of the three leading contenders, and begin to train users and implement the new system.

Explanation / Answer

Answer- a. Interview two or three customers of each software solution to learn about their experience with the vendor and the software.

Explanation- Only a customer’s experience can depict the performance of the vendors. In this case, identifying the right vendor in terms of providing the appropriate software based on the requirements, helping the customers by providing additional services or advice, ability to handle difficult tasks, the responsibilities and accountabilities taken, etc can be found out through customers. Hence, it is important to interview the customers of each software solution providers to know about them before kick starting the project.

2.Which of the following set of tasks is not critical to completing this project?

Answer- b. Study the existing system and identify its strengths and limitations

Explanation- Studying about the strengths and limitations of the existing system is not critical for a project because they do not contribute to the designing of the new software. The new software will be designed based on the requirements of the system and not on the strengths and limitations of the existing software.

3.A safety-critical system is one whose failure or misuse may cause human injury or death. Given that an EHR system can be considered to be such a system, which set of tasks associated with software implementation deserve special attention by the Midwest Hospital project team?

Answer - a. Conduct an alpha and beta test, perform a direct conversion to start up the new system, and apply the Lewin and Schein three-stage model for implementing the new system to ensure that appropriate changes are made to people, structure, and tasks affected by the new system.

Explanation – Alpha testing is a test where the employees of the software development organization use the software and provide feedback. After the completion of the alpha test, the beta test is conducted. A beta test is a test whereby the users outside the organization use the software and provide the feedback. Lewin and Schein three-stage model for change (how change is implemented) includes 1. Curbing the old methods and creating a climate which is receptive to any kind of change 2. Learning the new work methods and systems 3. Reinforcing changes so that the new process is accepted by the employees and feel the importance of the new process.