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. 2019 Oct;10(5):964-971.
doi: 10.1055/s-0039-3402450. Epub 2019 Dec 18.

An Evaluation of System End-User Support during Implementation of an Electronic Health Record Using the Model for Improvement Framework

Wendy Kiepek  1 , Patricia P Sengstack  2
Affiliations

An Evaluation of System End-User Support during Implementation of an Electronic Health Record Using the Model for Improvement Framework

Wendy Kiepek et al. Appl Clin Inform. 2019 Oct.

Abstract

Background: Electronic health record (EHR) system implementation is complex. Strong support for clinicians and other end-users during the initial phase of implementation requires dedicated resources and commitment to ensure a smooth transition, reduce frustration, and assist in adoption.

Objectives: Evaluate end-user support processes and personnel employed during the initial phase of EHR implementation at an academic medical center and identify facilitators of success, challenges, and lessons learned.

Methods: Using the model for improvement framework, this case report describes the activities that follow the concepts of planning, doing, studying, and acting (PDSA) when providing on-site support to system end users during an EHR implementation in a complex health care system.

Results: Strengths included engaged and supportive leadership, use of internal support personnel, use of zone leaders, daily huddles for effective dissemination of information, and an evaluation survey tool to provide data supporting rapid changes in support personnel allocation. Challenges primarily surrounded the management of over 1,000 external support personnel which included limited EHR system knowledge, scheduling, and transportation logistics.

Conclusion: Implementation of EHR systems continues. Supporting end users is one aspect of these complex projects that require dedicated resources to manage effectively. Organizations taking a more proactive approach, based on learning from experiences, as well as from other health care organizations, can improve their ability to take on this challenge armed with best practices and lessons learned.

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Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Support evaluation survey tool results.
See this image and copyright information in PMC

References

    1. Shahmoradi L, Darrudi A, Arji G, Farzaneh Nejad A. Electronic health record implementation: A SWOT analysis. Acta Med Iran. 2017;55(10):642–649. - PubMed
    1. Office of the National Coordinator for Health Information Technology.2018 Report to Congress: Annual update on the adoption of a nationwide system for the electronic use and exchange of health informationAvailable at:https://www.healthit.gov/sites/default/files/page/2018-12/2018-HITECH-re.... Accessed December 5, 2019
    1. Research KLAS.U.S. hospital EMR market share 2017Available at:https://klasresearch.com/report/us-hospital-emr-market-share-2017/1182. Accessed December 5, 2019
    1. Shachak A, Montgomery C, Dow R et al. End-user support for primary care electronic medical records: a qualitative case study of users' needs, expectations and realities. Health Syst (Basingstoke) 2013;2(03):198–212. - PMC - PubMed
    1. Boonstra A, Broekhuis M. Barriers to the acceptance of electronic medical records by physicians from systematic review to taxonomy and interventions. BMC Health Serv Res. 2010;10(01):231. - PMC - PubMed

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