March, 19, 2012
Need for proposed change
As the push towards patient safety increases with regulatory agencies such as the Florida Agency for Healthcare administration (ACHA) and The Joint Commission (TJC), formerly the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), highlighting the need for higher qualities of standard, hospitals such as Memorial Hospital Pembroke in Hollywood Florida are interested in finding ways of achieving optimal patient care standards and propel themselves up the list of top performers on key quality measures. Of equal importance is the need to optimize the cost effectiveness of this quality of care by reducing length of hospital stay and reducing instances of readmissions for the same or related complaints. Individual department such as pharmacy, radiology and laboratory each have computerized systems specifically aimed at task completion within the department taking no thought of the dissemination of that information across the spectrum of not only medical departments but also to administrative and clerical departments. With the advent of care possesses such as computer physician order entry(CPOE) and electronic medication administration record systems(EMARs) aimed at both quality and cost effectiveness the necessity exist to provide all needed information including medical records, radiological imagery such as CT scans, MRIs, and laboratory results at the immediate disposal of the practitioner. Administrative departments such as billing, medical records, medical supplies, and social services requiring real time updates on care administered, supplies expended in administering this care and follow up required in order to complete the continuum of care. There is therefore the need to integrate all these various clinical and administrative processes into a single efficient hospital based system of delivery of care. Electronic Health Record systems (EHRs) are not only designed to provide such services but also information to patients and stores and manages data collected on patients. The American Recovery and Reinvestment Act (ARRA) of 2009 provided $34 billion via Medicare and Medicaid for the implementation and use of EHRs. Two such systems EpicCare and HCS eMR respectively define themselves as follows. “The EpicCare Inpatient Clinical System spans all hospital departments and specialties, giving providers the tools they need to deliver safe, high-quality care. EpicCare's role-based navigators simplify relevant information access for physicians, nurses, therapists, dietitians and any other provider in the hospital setting” “HCS eMR meaningful use software is a Workflow Driven / Focused solution focused on high User Adoption. HCS eMR works for your hospital because it:
• Builds on existing processes such as Medication Reconciliation • Integrates with existing technology to streamline processes • Leverages sophisticated rules and timely alerts to drive success • Can be implemented quickly and is fully adopted
• Is economical “
Organizational and individual barriers to proposed change
Several potential barriers exist to the implementation of an integrated electronic health records system (EHRs), these include structural, financial/business, technical/professional, and cultural.
Memorial Hospital Pembroke is not a standalone hospital rather it is one of five hospitals in the Memorial Hospital System (MHS) formerly known as the South Broward Hospital district of Florida, as such much consideration has to be given to the eventual implementation across the system not only to Pembroke itself. Diversity in buyers and payers of supplies and services across the system would impact...