HIMS 661 Managing Change Discussion
Hi, Please, read and respond to peer discussions in 100 words minimum with credible references in APA style.
Implementing a new EHR system, and/or transitioning an organization from paper records to EHR can be a radical change in terms of advancing health information technology development for a particular institution, or rerouting clinical workflows entirely. Clinician workflow is especially recognized as the greatest change brought upon facilities when transitioning EHR systems. Evidence has shown that physician and other clinician workflows and levels of work are greatly impacted when EHR systems become integrated (Carayon et al., 2015). Administratively, EHR impacts the processes for scheduling appointments, documenting patient information, retrieval and storage of patient records, billing and claims, and overall communication. Clinically, triage, recording patient medical history, patient examinations, treatment plan development, prescriptions, orders, follow-ups, and patient education are all disrupted (Bowens et al., 2010). Such a long list of changes creates uncertainty in individuals. Large changes often cause people to fear losing self-esteem in their abilities to do their jobs as well as encourage resistance in the form of team pressures (HealthIT.gov, 2013).
As a project manager, developing strategies to mitigate apprehension to change in affected clinicians and streamline the integration process is vital to the success of the project as a whole. Even if the technological aspects of the implementation are successful, if the clinical teams are unable or unwilling to utilize them, the project will be a failure. Some managerial tools that can combat changes to workflow are engaging clinicians in early stages of implementation, as well as throughout the integration process so that clinicians feel included and supported (Shah et al., 2020). Additionally, using peer-led and regularly scheduled training programs and identifying physician champions to foster change can result in more reported clinician satisfaction and capability with new systems. Lastly, incorporating workflow redesign into the initial implementation plan can provide insight into predicted workflow changes, establish strategies and plans to minimize adverse reactions to the new system, and help prepare clinicians ahead of time for expected changes. In conclusion, the project manager needs to have consideration for the individual and team workflows that will undoubtedly be disrupted due to the new system. Keeping the clinicians in mind from the very beginning will serve to make them feel heard, and help provide strategies for them to adapt effectively and quickly to changes.
Bowens, F. M., Frye, P. A., & Jones, W. A. (2010). Health information technology: integration of clinical workflow into meaningful use of electronic health records. Perspectives in health information management, 7(Fall), 1d. PMID:
Carayon, P., Wetterneck, T. B., Alyousef, B., Brown, R. L., Cartmill, R. S., McGuire, K., Hoonakker, P. L. T., Slagle, J., Van Roy, K. S., Walker, J. M., Weinger, M. B., Xie, A., & Wood, K. E. (2015). Impact of electronic health record technology on the work and workflow of physicians in the intensive care unit. International Journal of Medical Informatics, 84(8), 578–594.
Implementing a new system that requires a lot of change, such an EHR, is an involved process. EHR systems impact workflows in many areas across an organization so appropriate planning is needed to ensure a successful migration. For this reason, it is recommended that organizations proceed with an EHR project only if they have sufficient time to invest into planning and implementing (Lorenzi et al., 2009).
There are a few ways to manage change related to implementing an EHR system. Setting a positive attitude and preparing staff for the upcoming changes is a great start (Lorenzi et al., 2009). There should also be a thorough understanding of the needs of staff, clinicians, patients, and other health systems (Lorenzi et al., 2009). Understanding current workflow processes is also important. Workflow considerations include how appointments are scheduled, what happens during and after a patient visit, etc. (Lorezi et al., 2009). Having a clear idea of current workflows will help make the transition smoother and the changes easier to adopt. Additionally, ensuring that the staff understands why the change is happening is also important (ONC, 2016). Moreover, educating staff on how the changes will impact them and their work is critical (ONC, 2016). Overall, project managers need to make sure that all who will be impacted are aware the changes so that they are on-board and willing to cooperate.
An EHR project manager should take various considerations into account when managing a project that is “high change” event. Having a clear understanding of the current processes is a must. Documenting current workflow can be helpful to have a point of reference. The PM should also consider how the workflow will “translate” over to the new system, whether they will be handled similar or be completely redone. Also, some workflows may need to be eliminated if they are redundant or counterproductive. The PM should consider how the new system can be used to improve workflows and better meet the needs of the staff.
Lorenzi, N. M., Kouroubali, A., Detmer, D. E., & Bloomrosen, M. (2009). How to successfully select and implement electronic health records (EHR) in small ambulatory practice settings. BMC medical informatics and decision making, 9, 15.
ONC. (2016). Change Management in EHR Implementation | HealthIT.gov. The Office of the National Coordinator for Health Information Technology.
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