Monthly Archives: September 2015

Sep 4 2015

Suus*

Disclaimer: Suus is a Latin word for a third-person possessive pronoun. 🙂

It seems like blogging would be a thing for this semester. Hehehe.

For our 2nd blog post for MI 227, we are tasked to read an article on the barriers to EMR adoption and implementation. After reading it, we are to create an “article” about this scenario:

You have been selected to be the project manager for a DOH project with the task of implementing a national EHR that all government hospitals will implement. Select at least three barriers to EHR implementation from the article that you believe to be the most important ones that might adversely affect your implementation. Explain and provide supporting cases/articles/information.

I will responding to this scenario based on my experience in the Health IT industry. More or less I won’t be able to provide articles for it. Anyway, here is my response:

If I were to think as a Project Manager with a goal of rolling out “THE” EHR of hospitals, the first thing I would ask DOH is (1) “Do we the money to materialize this goal?” This leads me to my first barrier – lack of financial resources. Things in this world we live in does not come for free. Like with any Health IT projects, you need money for the staffing, software, hardware, training, and others. According to Francis (2015), materials, equipment, a website, and business cards cost money and it has to come from somewhere. You need to look for money, from an investor, a small business loan, or even the owner’s savings account, to get the business started.

EXAMPLE: Based on my experience from a hospital scenario, we have a system that had been frequently hanging up due to its very outdated server. I then asked one of my seniors what kept us from upgrading the server. He said only this, “Walang budget eh.” (There is no budget) And the argument is over, meaning the availability of the funds could start the project or not, and we just have to endure the system failing every now and then.

My next questions would be (2) “Who would be using the EHR?” and (3) “Who are the target source of data of this EHR?” along with “What information would we be using?”. With that being said, these are the next two barriers which I think is important affecting the implementation of the EHR – complexity of the system and privacy and security issues of patient information.

Complexity of the System: This is a very important factor when it comes to usage of the EMR, coming from a User Support’s perspective. In our generation right now, people tend to have a very short attention span and an “easy-way-out” attitude. With that being said, we have to consider how to simply the design of the system without compromising the important information that a EHR should provide. I found a website called “Treehouse” that gave their 10 User Interface Design Fundamentals. The following fundamentals are:

  1. Know your user.
  2. Pay attention to patterns.
  3. Stay consistent.
  4. Use visual hierarchy.
  5. Provide feedback.
  6. Be forgiving. – The system should allow user error.
  7. Empower your user.
  8. Speak their language.
  9. Keep it simple.
  10. Keep moving forward.

I highlighted in bold what I think is my personal important fundamentals for checking complexities in an EHR.

EXAMPLE: True Story: I was looking for a specific item in the order search in our system using its item code. Knowing that the item code is unique in itself, I know that searching that item would be easy. However, the search results showed nothing. As an administrator user of the system, I tried different ways to look for it, and it took took me 30 minutes before giving up and asking the person who designed the system on how to look for that item code. Then, I found out that I need to tick a checkbox for it to show up. I then scratched my head on why should I bother ticking the checkbox if the item code itself is already unique. Since it was not ‘my’ system, I decided to let it go.

Privacy and Security Issues of Patient Information: Another factor that a project manager should look into is on how I should be upholding privacy and security of patient information especially since the information being inputted in the EHR are mostly sensitive. We have to remember that patients have a right on who should be seeing their personal information. Also, there is the Health Insurance Portability and Accountability Act that upholds privacy and confidentiality of the patient information. Unfortunately, this law is only observed in the United States. In the future, we should also have our own HIPAA law. Even though we have a Data Privacy Act, I think we should still have a law specializing in patient information.

EXAMPLE: No personal experience worth sharing about privacy and security. 🙂

My last question would be (4) “What is needed for this EHR to be working for a long time?”, leading me to the last major factor – lack of computers/hardware. With regards to this factor, the hardware serves as the medium into using the EHR. The EHR won’t be able to become an EHR without the desktop, laptop, printer, server, barcode scanner, and others. Being a third world country, turnover of hardware and computers is very low. As much as possible, the people will endure using the same set of hardware that they bought more than five years ago. According to Mann and Amprimoz (2011), the average life span of a desktop computer is about three to five years. Until now, in my current work, I had witnessed areas where they are still using CRT Monitors and ball and wheel mouse. Aside from that, rollout of an EHR would entail a lot of hardware requirements that not all institutions are capable of doing. There should be some consideration when it comes to this as well.

Summing it all up, there are really many factors on rolling out of an EHR project. We have to remember that just like patients, different institutions will have different needs. Thus, we still have to ‘individualize’ the needs of each institution. Differences should be embraced and should be accepted in order for us to move forward. 🙂

DesmondTutu

(c) Pinterest

REFERENCES:

  1. “The Importance of Funding for Business.” 2015. Small Business – Chron.com. Accessed September 4. http://smallbusiness.chron.com/importance-funding-business-59.html.
  2. http://blog.teamtreehouse.com/10-user-interface-design-fundamentals
  3. “How Long Will My PC Last? What Is the Average Lifespan of a Computer?” 2015. Bright Hub. Accessed September 4. http://www.brighthub.com/computing/hardware/articles/14363.aspx.