HIBBs is a program of the Global Health Informatics Partnership

EMR Implementation Considerations

Y. SINGH

NELSON R. MANDELA SCHOOL OF MEDICINEDEPARTMENT OF TELEHEALTH

SINGHY@UKZN.AC.ZA

Content licensed under Creative Commons Attribution-Share Alike 3.0 Unported

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

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

Why do EMRS Fail

Poor communication

Developers unaware of the environment

No change management in place

Perceptions (resistance to change)

No support from government

To high expectations

Essential Considerations

Needs assessment

Design

Testing

Implementation

Functionality

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

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

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

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

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

System Functionality

Efficiency

Robustness

Add benefit to the clinical environment

Security Confidentiality Integrity Privacy

System Selection

Open source vs. commercial systems

Actual costs

Available support

Small print

Implementation

Phased rollout

Training

User support

Finding champions

Creating super users

Celebrating successes and learning from mistakes

Adequate budget

Ask Questions

“Studies have shown that holding and caressing animals can dramaticallyspeed a person’s recovery”

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?

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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HIBBs is a program of the Global Health Informatics Partnershipwww.ghip.net

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