scholarly journals Electronic medical record implementation for a healthcare system caring for homeless people

JAMIA Open ◽  
2018 ◽  
Vol 2 (1) ◽  
pp. 89-98
Author(s):  
Gerald H Angoff ◽  
James J O’Connell ◽  
Jessie M Gaeta ◽  
Denise De Las Nueces ◽  
Michael Lawrence ◽  
...  
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Resource Constraints ◽  
Management Strategies ◽  
Homeless People ◽  
Software Tools ◽  
Homeless Population ◽  
Successful Implementation ◽  
Training Environment ◽  
Workflow Analysis

Abstract Objective Electronic medical record (EMR) implementation at centers caring for homeless people is constrained by limited resources and the increased disease burden of the patient population. Few informatics articles address this issue. This report describes Boston Health Care for the Homeless Program’s migration to new EMR software without loss of unique care elements and processes. Materials and methods Workflows for clinical and operational functions were analyzed and modeled, focusing particularly on resource constraints and comorbidities. Workflows were optimized, standardized, and validated before go-live by user groups who provided design input. Software tools were configured to support optimized workflows. Customization was minimal. Training used the optimized configuration in a live training environment allowing users to learn and use the software before go-live. Results Implementation was rapidly accomplished over 6 months. Productivity was reduced at most minimally over the initial 3 months. During the first full year, quality indicator levels were maintained. Keys to success were completing before go-live workflow analysis, workflow mapping, building of documentation templates, creation of screen shot guides, role-based phased training, and standardization of processes. Change management strategies were valuable. The early availability of a configured training environment was essential. With this methodology, the software tools were chosen and workflows optimized that addressed the challenges unique to caring for homeless people. Conclusions Successful implementation of an EMR to care for homeless people was achieved through detailed workflow analysis, optimizing and standardizing workflows, configuring software, and initiating training all well before go-live. This approach was particularly suitable for a homeless population.

scholarly journals Disaster Planning for Homeless Populations: Analysis and Recommendations for Communities

2020 ◽  
Vol 35 (3) ◽  
pp. 322-325 ◽  
Author(s):  
Stephen C. Morris
Keyword(s):  
Emergency Preparedness ◽  
Resource Constraints ◽  
Homeless People ◽  
Disaster Planning ◽  
The United States ◽  
Lessons Learned ◽  
Homeless Population ◽  
Special Populations ◽  
Population Classification ◽  
Mental And Physical Health

AbstractHomelessness is a growing problem, with perhaps greater than a 150 million homeless people globally. The global community has prioritized the problem, as eradicating homelessness is one of the United Nation’s sustainability goals of 2030. Homelessness is a variable entity with individual, population, cultural, and regional characteristics complicating emergency preparedness. Overall, there are many factors that make homeless individuals and populations more vulnerable to disasters. These include, but are not limited to: shelter concerns, transportation, acute and chronic financial and material resource constraints, mental and physical health concerns, violence, and substance abuse. As such, homeless population classification as a special or vulnerable population with regard to disaster planning is well-accepted. Much work has been done regarding best practices of accounting for and accommodating special populations in all aspects of disaster management. Utilizing what is understood of homeless populations and emergency management for special populations, a review of disaster planning with recommendations for communities was conducted. Much of the literature on this subject generates from urban homeless in the United States, but it is assumed that some lessons learned and guidance will be translatable to other communities and settings.

scholarly journals Electronic medical record implementation in tertiary care: factors influencing adoption of an electronic medical record in a cancer centre

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna Janssen ◽  
Candice Donnelly ◽  
Elisabeth Elder ◽  
Nirmala Pathmanathan ◽  
Tim Shaw
Keyword(s):  
Learning Curve ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Digital Health ◽  
Tertiary Care ◽  
Technical Support ◽  
Successful Implementation ◽  
Administrative Staff ◽  
Cancer Centre ◽  
Wide Range

Abstract Background Electronic Medical Records (EMRs) are one of a range of digital health solutions that are key enablers of the data revolution transforming the health sector. They offer a wide range of benefits to health professionals, patients, researchers and other key stakeholders. However, effective implementation has proved challenging. Methods A qualitative methodology was used in the study. Interviews were conducted with 12 clinical and administrative staff of a cancer centre at one-month pre-launch and eight clinical and administrative staff at 12-months post-launch of an EMR. Data from the interviews was collected via audio recording. Audio recordings were transcribed, de-identified and analysed to identify staff experiences with the EMR. Results Data from the pre-implementation interviews were grouped into four categories: 1) Awareness and understanding of EMR; 2) Engagement in launch process; 3) Standardisation and completeness of data; 4) Effect on workload. Data from the post-launch interviews were grouped into six categories: 1) Standardisation and completeness of data; 2) Effect on workload; 3) Feature completeness and functionality; 4) Interaction with technical support; 5) Learning curve; 6) Buy-in from staff. Two categories: Standardisation and completeness of data and effect on workload were common across pre and post-implementation interviews. Conclusion Findings from this study contribute new knowledge on barriers and enablers to the implementation of EMRs in complex clinical settings. Barriers to successful implementation include lack of technical support once the EMR has launched, health professional perception the EMR increases workload, and the learning curve for staff adequately familiarize themselves with using the EMR.

Implementation of Electronic Records in a Medical Practice Setting

2015 ◽  
pp. 96-106
Author(s):  
Jami M. Clark
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Medical Center ◽  
Physical Space ◽  
Electronic Medical Record System ◽  
Care Practice ◽  
Successful Implementation ◽  
Record System ◽  
Positive Message ◽  
Medical Record System

Seneca Medical Center is a primary care practice that implemented an electronic medical record system in 2005. Since implementation, the practice has added different practice locations and its own lab. The implementation was smooth because the practice leadership had a positive message about the change and reasons for it. Physical space for housing charts of a growing practice, the drive toward quality, safety, efficiency, and future growth were factors that led to the transition to an electronic medical record system. Choosing a quality vendor, understanding the concerns and components involved, and excitement about change create an environment for a successful implementation.

Digital disruption ‘syndromes’ in a hospital: important considerations for the quality and safety of patient care during rapid digital transformation

2018 ◽  
Vol 42 (3) ◽  
pp. 294 ◽  
Author(s):  
Clair Sullivan ◽  
Andrew Staib
Keyword(s):  
Patient Care ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Large Scale ◽  
Digital Transformation ◽  
University Hospital ◽  
Scale Transformation ◽  
Successful Implementation ◽  
Digital Disruption ◽  
Roll Out

The digital transformation of hospitals in Australia is occurring rapidly in order to facilitate innovation and improve efficiency. Rapid transformation can cause temporary disruption of hospital workflows and staff as processes are adapted to the new digital workflows. The aim of this paper is to outline various types of digital disruption and some strategies for effective management. A large tertiary university hospital recently underwent a rapid, successful roll-out of an integrated electronic medical record (EMR). We observed this transformation and propose several digital disruption “syndromes” to assist with understanding and management during digital transformation: digital deceleration, digital transparency, digital hypervigilance, data discordance, digital churn and post-digital ‘depression’. These ‘syndromes’ are defined and discussed in detail. Successful management of this temporary digital disruption is important to ensure a successful transition to a digital platform. What is known about this topic? Digital disruption is defined as the changes facilitated by digital technologies that occur at a pace and magnitude that disrupt established ways of value creation, social interactions, doing business and more generally our thinking. Increasing numbers of Australian hospitals are implementing digital solutions to replace traditional paper-based systems for patient care in order to create opportunities for improved care and efficiencies. Such large scale change has the potential to create transient disruption to workflows and staff. Managing this temporary disruption effectively is an important factor in the successful implementation of an EMR. What does this paper add? A large tertiary university hospital recently underwent a successful rapid roll-out of an integrated electronic medical record (EMR) to become Australia’s largest digital hospital over a 3-week period. We observed and assisted with the management of several cultural, behavioural and operational forms of digital disruption which lead us to propose some digital disruption ‘syndromes’. The definition and management of these ‘syndromes’ are discussed in detail. What are the implications for practitioners? Minimising the temporary effects of digital disruption in hospitals requires an understanding that these digital ‘syndromes’ are to be expected and actively managed during large-scale transformation.

Implementation of Electronic Records in a Medical Practice Setting

2014 ◽  
pp. 211-225
Author(s):  
Jami M. Clark
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Medical Center ◽  
Physical Space ◽  
Electronic Medical Record System ◽  
Care Practice ◽  
Successful Implementation ◽  
Record System ◽  
Positive Message ◽  
Medical Record System

Seneca Medical Center is a primary care practice that implemented an electronic medical record system in 2005. Since implementation, the practice has added different practice locations and its own lab. The implementation was smooth because the practice leadership had a positive message about the change and reasons for it. Physical space for housing charts of a growing practice, the drive toward quality, safety, efficiency, and future growth were factors that led to the transition to an electronic medical record system. Choosing a quality vendor, understanding the concerns and components involved, and excitement about change create an environment for a successful implementation.

Virtuelle Medizin in der Behandlung von Sucht in den USA, Kanada und darüber hinaus

Suchttherapie ◽  
2020 ◽  
Vol 21 (04) ◽  
pp. 189-193
Author(s):  
R. Michael Krausz ◽  
Farhud Shams ◽  
Maurice Cabanis
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Electronic Medical Record Systems

ZusammenfassungInsbesondere während der aktuellen Corona-Pandemie hat der Gebrauch virtueller Lösungen in der Medizin international stark zugenommen. Es gibt eine zunehmende Akzeptanz gerade auch in dem Bereich der hausärztlichen Versorgung, der Behandlung psychischer Störungen und der Abhängigkeitserkrankungen.Die Entwicklung ist international unterschiedlich, v. a, wenn man die USA und Kanada auf der einen Seite und Europa, insbesondere Deutschland, andererseits vergleicht. In Nordamerika hat bei dem Einsatz von moderner Technologie die Einführung von „Electronic Medical Record Systems“ eine dominierende Rolle gespielt. Diese ist insbesondere auf Abrechnung und Dokumentation zu Versicherungszwecken fokussiert. Daneben gibt es zunehmend Apps, die spezifische therapeutische Ansätze zu implementieren helfen. Die Anwendung virtueller Ansätze im Suchtbereich ist begrenzt, aber in Teilen sehr innovativ und auf deutsche Verhältnisse anwendbar. Wie in Europa gibt es auch in Nordamerika nur sehr begrenzte Forschungskapazitäten und prinzipiell Widerstand bei den medizinischen Berufsgruppen bezüglich der Anwendungsmöglichkeiten und der Rolle im Behandlungsprozess. Mehr Kooperation würde international zu einer Beschleunigung der Entwicklung und der Etablierung gemeinsamer Standards beitragen sowie die Behandlungssysteme bedeutend verbessern.

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