NUR 514 Electronic Health Record Implementation Essay

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NUR 514 Electronic Health Record Implementation Essay

NUR 514 Electronic Health Record Implementation Essay

One way informatics can be especially valuable is in capturing data to inspire improvements and
quality change in practice. The Agency for Healthcare Research and Quality (AHRQ) collects
data related to adverse events and safety concerns. If you are working within a practice setting to
implement a new electronic health record (EHR) system, this is just one of the many
considerations your team would need to plan for during the rollout process.
In a paper of 1,500-1,750 words, discuss the following:
1. Consider an opportunity for tracking care improvement. What key information would be
needed in the database? Example: Time lapse from medication order documented in the EHR to
delivery of medication to the patient for the cardiology service.
2. Describe the role informatics plays in the ability to capture this data. What type of project
management strategies and methodologies can be implemented to support informatics initiatives
to help improve quality within the clinical practice?
3. Discuss which systems and staff members would need to be involved in the design and
implementation process. What is the role of the advanced registered nurse in promoting
evidence-based practice and leading quality and performance improvement initiatives within this
4. Outline strategies for implementing the new EHR proposal. Consider communication changes,
transitioning to the new EHR, and managing resources (human, fiscal, and health care
5. Discuss what professional, ethical, and regulatory standards must be incorporated into the
design and implementation of the system.
6. Describe the measures and steps you would take to evaluate the success of the EHR
implementation from a staff, setting, and patient perspective to measure effectiveness and ensure
continuous quality improvement in practice?
7. Explain what leadership skills and theories would be needed to facilitate collaboration with the
interprofessional team and provide evidence-based, patient-centered care?
You are required to cite five to 10 sources to complete this assignment. Sources must be
published within the last 5 years and appropriate for the assignment criteria and nursing content.
Complete the "APA Writing Checklist" to ensure that your paper adheres to APA style and
formatting criteria and general guidelines for academic writing. Include the completed checklist
as an appendix at the end of your paper.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the
Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to
become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical
support articles is located in Course Materials if you need assistance.

Benchmark-Electronic Health Record Implementation Paper SAMPLE
Health informatics comprise one of the most effective ways to enhance quality care and
patient outcomes. Patients receive better medical care if health care providers have access to
complete and accurate information. Many studies demonstrate that electronic health records
(EHRs) can enhance the ability to diagnose diseases and reduce and prevent medical errors that
leads to optimal patient outcomes (Hansen et al., 2019). Implementing an electronic health
records system in a health care facility is one of the critical aspects of attaining quality care and
increasing patient satisfaction. The benefits of EHRs as a form of health informatics are broad.
On this basis, the paper explores the role of nurse practitioners in different situations in
implementing an EHR system in their facilities.

Tracking Opportunities based on the Database

An effective electronic health record system provides the basis for an organization to
develop a functional health information system to enhance efficiencies. However, an EHR
enables nurse practitioners to track healthcare settings opportunities through an array of
information available in such systems. Health data comprises patient information, demographic
data, administrative data, health status, medical history, current medical interventions and
management, and information on outcomes (Health, 2017). A detailed database will
comprise current and potentially sensitive information concerning individual patients and
families or group populations. Health providers frequently enter clinical and laboratory data into
the system as an electronic record for patient care.
The information sources in the database may differ. For instance, data comes from
hospital discharge abstracts, self-completed patent respondents’ questionnaires, submissions of

insurance claims, employees' files, and computerized pharmacy records. Personally identified
data contained pieces of information or facts that refer to an individual, which allows for
identification. Information can also come from the electronic medical records (EMRs) of patients
(Aldosari, 2017). EMRs contain medical information, while EHRs contain data related to the
health of an individual. Therefore, opportunities arise from nurses and providers' ability to use
data from EHRs to make effective decisions using frameworks like the Clinical Decision Support
(CDS). CDS opportunities include improved quality and health care outcomes through avoiding
errors and adverse effects, reduced costs and enhanced efficiency, and patient satisfaction.
Again, data from the EHRs system allow practitioners to use Computerized physician order entry
(CPOE), which entails automation of the medication ordering process. The use of CPOE
improves patient safety and efficiency in care when incorporated with CDSs and EHRs.

Role of Informatics in Capturing Data

Health information technology allows facilities to collect data monitoring the effects of a
new EHR to enhance performance. Health informatics manages health information and utilizes
information technology tools to organize health records to improve health outcomes. Informatics
nurses must manage, interpret, and communicate health information with the primary purpose of
improving care quality. Informatics has improved care through better documentation, improved
care coordination, and minimization of medical errors (Yen et al., 2017). Caring for patients
begins with collecting data on the patient's medical history, clinical symptoms, history of
allergies, and the current list of medications. Nurses collect this data and document it in the
electronic database. Nurses and other health professionals can retrieve and record information in
the system in real-time to reduce medication errors by effectively integrating alerts for medical

reactions and allergies. The implication is that informatics nurses have a critical role in capturing
data included in the electronic health record system for patients in their facilities.
Systems and Staff Members Involved in Designing and Implementation Process and Team
The selection and design of an EHRs system rely mainly on the organizational needs,
However, while corporate needs should influence the system selection, the organization and its
management must develop an effective implementation strategic plan consisting of many experts
and professionals from different areas and departments within the entity. The system should
demonstrate the ease of interaction between other users, especially patients and care providers,
and should not impede communication between the critical stakeholders.
The multidisciplinary approach in initiating the EHR system indicates the need for
stakeholders to understand the new framework, ensuring consistency based on protection and
security, structure work processes, and preparing group consideration (McCororie, 2019).
Practical training on EHR usage allows practitioners to adjust to the new model that benefits
patients, nurses, doctors, and other healthcare providers. The implication is that the organization
must have an effective team that understands or designs an implementation process based on an
information strategy that emphasizes information governance.
The organization should create an execution group or team from different departments,
design the product or system, identify equipment needs, share information, and enhance pre-
dispatch processes. Successful implementation will entail having an effective team and having
insight and expertise in their respective areas. As a new project in the organization, the EHR
system should have a leader, project manager, and top users, mainly nurses, and patients. The
lead physicist connects health care professionals and other staff using the system. The project
manager is in charge of the entire project and ensures that all deliverables are attained

(Bjarnadottir et al., 2017). Nurses, top users of the new system, and IT experts in the
organization, and administrative staff and physicians will provide essential inputs in designing
and implementing the system. Collaboration is a crucial aspect of the successful implementation
of the new system, and all these individuals are critical to the plan.
Professional, Ethical & Regulatory Standards in Designing and Implementation of the


It is essential to consider different ethical, professional, and regulatory requirements and
standards in designing and implementing the EHRs system. Professional standards entail
requirements set by professional associations that guide decisions of nurse practitioners in
different settings. The American Nurses Association emphasizes the need for safety and positive
patient outcomes in deploying information technologies in health care (Balestra, 2017). The
association asserts that informatics nurses should ensure data accuracy and proficiency when
collecting, storing, scrutinizing, and reporting information. Ethical principles are also essential
and consist of different areas related to privacy, confidentiality, and security. Health care
providers must design, execute, and evaluate the EHR system's use within their health care
The integration of regulatory requirements by existing federal legislation like the Health
Information Technology and Clinical Health Act (HITECH and Health Insurance Portability and
Accountability Act (HIPAA) is a critical aspect of compliance. Health care organizations must
protect patient's health data and personal information. Privacy, security, confidentiality
requirements should also be considered to attain practical and effective use of electronic health
information. The HITECH regulations emphasize the need to comply with HIPAA standards and

increase the legal responsibility for entities that fail to comply with set requirements on data use
and security.

Order Sets as part of the New Record

Health care entities are deploying evidence-based practices to improve quality care.

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use of clinical order sets based on evidence-based guidelines within the EHR system reduces
errors and enhances patient outcomes. Consequently, to attain useful and current order sets, the
team should incorporate these components into their design. Therefore, to achieve success in this
model, get a buy-in from the main stakeholders, and satisfaction from providers, the team needs
to have a lead physician's formal governance structure (Balestra, 2017). Imperatively, clinical
order sets should have the best practices and organizational standards that entail identifying and
selecting data content sources, reviewing content, and maintaining and updating these resources.
The team should establish a process to identify and replace content that can impact patient safety
or care quality if the content is not current.

Communicating Changes

Managing change requires the deployment of principles, techniques, and prescriptions
that allow people to accept the transition and improve overall implementation. Kotter's change
model is sufficient, and the team must use it to generate leadership and momentum for change.
Health care providers may possess different responses to change processes in the organization, as
some may accept, while others may require time. Therefore, it is essential to communicate these
changes by laying out how the team will roll out the EHR system. The unit can use Kotter's 8-
Step Model to communicate the changes based on the steps that include creating an urgency for
transformation, forming a powerful coalition, and developing a vision for the changes. The team
should then communicate the vision, remove any hurdles, and create short-term wins while

building on the changes (McCororie et al., 2019). Finally, they should incorporate the change as
part of their organizational culture. The team can communicate the changes using different layers
of communication channels that include banners, posters, and creating flyers and emails to
individual practitioners.
Evaluation of the EHR Implementation from a Staff, Setting, and Patient Perspective
Before the implementation of the project, a set of parameters of what constitutes success
should be created. Kotter's 8-Step Model for change can offer guidelines for milestones at each
step of the implementation. Short achievement and developing milestones are some of the goals
established in the initial plan before implementation. For instance, the team can set milestones
and goals like assessing the stakeholders' readiness to transition and plan on how to launch the
EHRs system based on the assessment and attainment of meaningful utilization. Secondly, keen
preparation at the start is critical to the successful implementation of the EHR, but having
realistic anticipations and a manageable time frame is essential (Laukka et al., 2020). Once the
performance is complete, continual tracking is critical in assessing how internal users deploy the
new system. The monitoring is essential as it will ensure the successful implementation of the
EHR system.
Leadership Skills and Theories to Facilitate Collaboration with Inter-Professional Team
The implementation of the EHRs system is intricate and presents significant challenges.
Therefore, practical leadership skills are essential for successful implementation. Leadership
skills will enhance the Lead physician and team's ability to attain buy-in from users and other
stakeholders. The requisite skills include excellent communication attributes, critical thinking,
problem-solving skills and techniques, and project management skills.

Communication skills are essential because the team and management must engage
employees and other stakeholders like patients on the system's benefits. Importantly, successful
designing and implementing the EHRs system requires staff participation from diverse expertise,
perspectives, and experiences. Therefore, communication skills are a critical aspect of the overall
project’s success (McCororie et al., 2019). The team and its leadership require effective project
management and technical skills to ease the understanding and deliverable of the expected
Transformative and contingency leadership theories will be appropriate in designing and
implementing the EHRs system in the facility. Transformational leadership will ensure that
stakeholders collaborate to attain a common goal. Leaders have to motivate, stimulate, and
inspire all providers to embrace the innovative way of interacting with customers. The situational
leadership model means that leaders will make decisions based on the circumstances and
enhance all stakeholders' effective participation. These theories implore leaders to nurture their
subordinates and provide directions based on the situation.

Implementing the EHR system is a critical aspect of improving care quality and getting
different opportunities for providers, primarily through the deployment of CDSs and CEOs.
Therefore, healthcare organizations' leaders should implement EHR systems to enhance
efficiency, quality care, and other benefits from health information technologies. An integrative
approach is essential in implementing an EHR system where all stakeholders are incorporated
into the plan. Most importantly, leaders implementing EHR should deploy effective leadership
styles and possess relevant skills to attain such projects' goals.

Aldosari, B. (2017). Causes of EHR projects stalling or failing: A study of EHR projects in Saudi
Arabia. Computers in biology and medicine, 91, 372-381. DOI:
Balestra, L. M. (2017). Electronic Health Records: Patient Care and Ethical and Legal
Implications for Nurse Practitioners. The Journal for Nurse Practitioners. Vol 13(2),
Bjarnadottir, R. I., Herzig, C. T., Travers, J. L., Castle, N. G., & Stone, P. W. (2017).
Implementation of electronic health records in US nursing homes. Computers,
informatics, nursing: CIN, 35(8), 417. Computer Information in Nursing, 35(8):417-424.
DOI: 10.1097/CIN.0000000000000344
Hansen, M. B., Nørup, I., Elmholdt, K. T., Kidholm, K., Nøhr, C., & Schmidt, T. (2019,
November). Managing Change of EHR Systems. In SHI 2019. Proceedings of the 17th
Scandinavian Conference on Health Informatics, November 12-13, 2019, Oslo, Norway
(No. 161, pp. 104-107). Linköping University Electronic Press.
Health (2017). Improved Patient Care Using EHRs. Retrieved from
Laukka, E., Huhtakangas, M., Heponiemi, T. & Kanste, O. (2020). Review: Identifying the Roles
of Healthcare Leaders in HIT Implementation: A Scoping Review of the Quantitative and
Qualitative Evidence. International Journal of Environment Research and Public Health,
17(2865). doi:10.3390/ijerph17082865
McCrory, C., Benn, J., Johnson, O. A. & Scantlebury, A. (2019). Staff expectations for the

implementation of an electronic health record system: a qualitative study using
normalization process theory. BMC Medical Informatics and Decision Making, 19 (222).
Yen, P. Y., McAlearney, A. S., Sieck, C. J., Hefner, J. L., & Huerta, T. R. (2017). Health
information technology (HIT) adaptation: refocusing on the journey to successful HIT
implementation. JMIR medical informatics, 5(3), e28. DOI: 10.2196/misinform.7476

Benchmark Information
This benchmark assignment assesses the following programmatic competencies:
MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology;
MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and
Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing
2.3: Develop leadership skills to collaborate on interprofessional teams in the provision of
evidence-based, patient-centered care.
5.2: Apply professional, ethical, and regulatory standards of practice in the provision of safe,
effective health care.
Topic 8 DQ 1
Open and clear communication is critical for the effective functioning of the interprofessional
team and the delivery of safe patient care. Discuss the way communication technologies can
enhance coordination of care by interprofessional teams. Be sure to discuss a specific
communication technology in your response.
Topic 8 DQ 2
Virtual care and telehealth technologies have the capability to greatly expand access to quality
health care. Discuss some benefits and drawbacks of virtual care/telehealth, particularly related
to the collaboration and coordination of care and the role of the advanced registered nurse.
Topic 8: Interprofessionalism and Interrelationships in Informatics and Information Systems

1. Analyze the role of the advanced registered nurse in promoting evidence-based practice and
leading quality and performance improvement initiatives.
2. Analyze quality standards and performance measures related to the use of informatics for
continuous quality improvement in practice settings.
3. Discuss project management strategies and methodologies for implementing health care
informatics initiatives that improve quality within clinical practice.
Study Materials
Nursing Informatics and the Foundation of Knowledge
Read Chapters 16 and 20 in Nursing Informatics and the Foundation of Knowledge.
Health IT
Explore the website.
Artificial Intelligence Research: The Utility and Design of a Relational Database System
Read "Artificial Intelligence Research: The Utility and Design of a Relational Database System,"
by Diling, from
Advances in Radiation Oncology (2020).
Application of Project Management Tools and Techniques to Support Nursing Intervention
Read "Application of Project Management Tools and Techniques to Support Nursing
Intervention Research," by Rew, Cauvin, Cengiz, Pretorius, and Johnson, from Nursing Outlook
How Data Can Save Lives: Informatics for Health 2017
Read "How Data Can Save Lives: Informatics for Health 2017," by Cookson, from BMC Series
Blog (2017), located on the BioMed Central website.

Electronic Health Record (EHR) System Testing Plan
Read "Electronic Health Record (EHR) System Testing Plan," located on the
EHR Testing: Specifics and Best Practices
Read "EHR Testing: Specifics and Best Practices," by Mikhailau (2019), located on the Health
IT Outcomes website.
Health IT Standards
Read "Health IT Standards," located on the website.
Perspectives of Healthcare Practitioners: An Exploration of Interprofessional Communication
Using Electronic Medical Records

Topic 8 Participation
Grade Categories
Assignments (%) Points Percentile
APA Assignment: Leadership Style Reflective Essay 125.0 —
Emerging Technology Brief 125.0 —
Benchmark – Electronic Health Record Implementation Paper

The Evolution of Nursing Informatics Presentation 150.0 —
Implementing Change With an Interprofessional Approach Presentation

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