Answer

Work Break-Down Structure and Gantt chart for EHR at CMH

As the director of Health Information Management (HIM) department, I have the role of co-managing the roll-out plan and implementation of an electronic health record system for Community Memorial Hospital (CMH). I understand that EHR implementation in hospitals has a high failure rate due to a number of factors namely; challenges managing downtime, disrupted workflow and huge backlog of documents (Adler-Milstein et al 2014). As a result, I am tasked with the preparation of a general list of activities to be completed during the project.

According to Duckert and Rose (2013), the process for implementing a functional and highly effective EHR system has to involve timely planning of activities, best-practice research by colleagues and peers as well as introducing a multidisciplinary leadership approach. These changes are necessary for a seamless transition from manual to an electronic system.

Shepherd (2010) notes that the to-do list of tasks to be considered as art of EHR implementation will include;

1. Creating a steering committee

A committee has to be formed 24 months before the scheduled time for completing the project and go-live. The committee will include representatives from the executive management, governing board, physicians, administration, department leadership, HIM and nursing leadership. The committee sets goals and visions for the project. The role of the committee will be to receive monthly updates and feedback from physicians, and administrative teams through reports and newsletters. This is part of the communication strategy which is very important in the completion of the project. The approach of involving other stakeholders through a committee is to create a sense of ownership and building relationships.

1. Redesigning forms

It is important for the HIM department to scan all the manual forms with accuracy and efficiency. This process can begin 18 months prior to project completion and go live. The process will make use of scanners and EHR imaging systems. This process has to involve gathering of all manual forms and inventorying and redesigning them after which they can be bar coded. The scanner has to be configured to pick all the document.

• Identifying a Start Point

Community Memorial Hospital (CMH), engages in diverse medical procedures which enable it to offer differentiated services. Because of this, it is hard to undertake the project randomly. The first department to consider is the emergency department. This department accounts for 40% of new admissions each day thus giving it priority will reduce backlog of manual files. The second target area is the outpatient department given that it receives many of this patient group. Third, the non-physician department, occupational therapy department and maternal-fetal medicine in that order.

1. Training of HIM staff

It is necessary that trainers, preferably system developers be given an opportunity to train HIM staff at Community Memorial Hospital (CMH). The training has to take 40 hours for each employee and be done 6 months before going live. The HIM staff will be asked to train other individuals in their respective sections. This ensures employees and HIM staff reach a favorable level of competence.

1. Avoid Back-scanning and only scan current records

Being a hospital, we will avoid back scanning of health and medical records made manually prior to go-live. This would pose the risk of accumulating large amounts of manual records which is an equivalent to backlog (Hall 2005). Written orders will have to be transcribed into the EHR system with the help of unit secretaries and nurses.

1. Purchase quality and interconnected hardware

It is necessary that EHR interconnects a dictation phone to enhance multitasking. At the same time, hardware should be of superior quality to avoid breakdown.

• Backup and Downtime

It is important to set up a backup just in case the primary system fails

• Auditing the system to ensure data integrity

It is necessary for the firm to conduct chart audits to ensure that the captured data is similar to that recorded in the system. The review of charts has to be multidisciplinary.

1. Assess meaningful use of EHR

This is last stage of EHR implementation. It entails conducting successful tests and demonstrations of EHR. The process also requires reassessment of content learnt through training and practical experiences gained on a daily basis.

1. Disband Steering Committee

The end of project implementation signifies the end of the work of steering committee.

1. Continuous Review, Audit and Quality Improvement

This process will not only involve making changes to the software and hardware but also on changing the manpower and staff involved in HIM (King & Perry 2009). The review has to ascertain if the project is meeting post-EHR goals as stipulated.