HEALTHCARE MANAGEMENT DREAM PROJECT
Date of Submission
My healthcare dream project is helping a local community health facility modify its operations from manual to a digital system. Today, the world has been transformed by the adoption of digital technology. In the same length, the healthcare sector is an impressive arena where the digital transformation should take place. In the process, a seamless flow of information in the digital health care system can be realized through the electronic health records (EHR) (Carayon, Smith, Hundt, Kuruchittham, & Li, 2009). In essence, this leverages and encompasses all digital process in the medical facility and can ultimately transform how care is compensated or delivered. The electronic medical records (EMR) are mainly the electronic versions of all the paper documents that can be found in a doctor’s file and is sometime confused with EHR. In essence, it may include the patients’ medical history, other information about the patient such as diagnoses, symptoms, vital signs, lab results, medications, immunization and other diagnostic tests among others. In this case, however, the EHR system to be designed for the local health facility will go beyond providing electronic form of medical records.
Selecting and implementing an EHR system is a complex and resource intensive activity that requires business and management ideas. Due to my business oriented skills and managerial knowledge, undertaking this project was a wise and feasible idea. Despite the technological advancement and prior preparation and planning, problems undoubtedly tend to occur. Therefore, there is need for an experienced and business minded person in the investment and implementation of such an EHR system within a local community health facility (Simon, Keohane, Amato, Coffey, Cadet, Zimlichman, 2013). This is because the resolve and the knowledge of such a person are necessary to withstand the pressure. To maintain this resolve, the business case appreciation and recognition is paramount. As a community health facility I feel obligated to enhance its status and efficiency through the adoption of the modern technology.
The reason for selecting this project is because the EHR will enhance the overall quality of services in the facility. For instance, it will provide an aspect of interoperability where information will be easily exchanged between departments. The system will enhance decision making as the patient information within the EHR will easily be combined with other external information to guide the physician in care provision. The EHR system will also provide continuity of care due to its ability to interface and exchange the clinical data of a patient with other data from other departments in such as the lab results. In essence, the new system will enhance coordination, communication and decision support. It will also facilitate reduced medical errors while saving the physician time (Versluis, Arie, Vos, & Boonstra, 2014). By digitizing the operations of the local community health facility, there will be enhanced efficiency and effectiveness in the overall operations in the facility. For instance, there will be reduced errors and adverse drug events, provide timely access to patient information for the medical practitioners and supporting clinical decisions thereby improving the quality of care among the patients.
The real problem to solve
One of the main problems towards investing in an EHR is that most of medical practices do not think in business terms such as long term cash flow, return on investment, analysis and projection among others. However, that should not be the case as implementing the HER is a major business decision that a practice can make. Through this investment, various issues and challenges within the facility will be addressed (Walker, Walker, Bieber, & Richards, 2005). For example, the local community health facility has for long been considered to be ineffective in service delivery. In fact, there have been claims of wrong diagnosis in the past due to lack of adequate facilities and accurate data. Access to accurate and complete information by healthcare providers can enable the patients receive quality medical care. Through this EHR, the medical officers will effectively diagnose diseases and prevent medical errors while improving patient outcomes. According to a national doctors survey by (HealthIT.gov, 2017), 94% of care providers reported that EHR made records available at the specific point of care while 86% reported that it produces various clinical benefits during practice. Moreover, the 75% of the surveyed care providers reported that EHR enabled them to deliver quality patient care.
Another challenge that has ailed the local community health facility is the constant loss and misplacement of medical records for the patients. As a community facility, it has been in existence for a long time. Unfortunately, it is hardly possible to locate the records of patients who visited the facility in the past two years. This is because of the large volumes of book works that makes it difficult to trace medical records whenever necessary. For example, emergency cases are often registered a new due to the inability to trace the patient’s medical file within the storage area. This leads to more accumulation of paper records that are easily misplaced. The EHR will enable the local facility to store its records in an easy and effective manner where the data can be retrieved at any time (Slack, Chambers & Johnston, 2010). In addition, EHR will also solve the problem of time wastage particularly in filing department. In the current system of operations, significant amount of time is wasted by the staff in looking to paper charts in files. This contributes to inefficiency in service delivery as well as loss of economic time. The time spent locating such documents can be used to attend to other patients, thereby enhancing efficiency.
Objectives of the project
The goals of the project are mainly based on solving the current problems experienced in the local community health facility by improving the quality of services provided through the adoption of an electronic health records system. The objectives of the EHR include: improving patient care, increasing patient participation, enhancing efficiency and cost savings as well as improving care and coordination (Slack, Chambers & Johnston, 2010).
Improving patient care is one of the main objectives of investing and implementing the EHR within the local community health facility. This will be well achieved when the service provider has access to reliable and complete health information of the patient. In that case, the comprehensive picture can foster effective diagnosis which facilities immediate and effective treatment. The EHR not only transmits the information but also computes the received medical data. For instance, the electronic system automatically checks for problems in case of a prescription of new medication and eventually alerts the clinician on the potential conflicts. With these capabilities, patients care within the facility will ultimately be improved.
The EHR seeks to increase patient participation in matters regarding to their health conditions. Patients and providers that share access of the electronic medical information can eventually collaborate in making informed decisions (Reiser &Dempsey, 2011). This is most important, especially, in treating and managing chronic conditions such as diabetes, obesity and asthma. With the new digital health system, the level of patient participation will be high thereby increasing the quality of care. In this case, the care providers will offer their patients full and precise medical information status. This also include follow-up updates after a hospital stay and even provide the patients with resources.
The EHR will also aim to enhance efficiency and cost savings within the local health facility. Efficiency will be in different forms including increased number of patients successfully served in a day or the effectiveness in the overall quality of service provided in the facility. This will be facilitated by the electronic system that will reduce the time wasted in looking for medical records of a single patient. In the process, many patients will be served within a short time as their files will be easily retrieved from a digital database. Moreover, the system will aim to save costs by reducing the maintenance costs of the records department and the personnel outsourced to arrange and maintain the filing zone.
Investing in the EHR is intended to foster improved care and coordination among the medical professionals. Through the electronic data, coordination among the caregivers will be enhanced. This will enhance the quality of care as the medical staff will rely on rich patient information to make their decision.
The project Scope and target groups
This project is mainly aimed at enhancing the quality of service in the local health facility by adopting an electronic health record system. Therefore, the scope of the project will be limited to the health facility alone where the system will be implemented. In addition, the project will only need the information of network coverage within the area as this will foster effective implementation of the digital system. The affected entities will include the local community and the facility staffs and management.
The reason for choosing to implement this project in the local health facility is because the local community does not have the resources and the general knowhow of the advancements in technology particularly regarding increased use of digital systems on the medical facility (Walker, Walker, Bieber, & Richards, 2005). Moreover, this facility has been in existence for a long time without the support of the local authorities. All the major developments have been funded by the community, thereby making it their own. Having been born and raised in the area, I desired to improve the well being of the community through the enhancement of their medical services within the local facility. The local community is made up of a mixed population in terms of age and races. However, the fabrics and the social synergy of this community are incomparable. For example, they have always contributed towards paying for some of the services provided within the facility or volunteering to do them such as cleaning the facility. The community is small in numbers and this facility serves them all unless it is an emergency case. The dominant population is of the elderly who require high quality of medical services and care. Therefore, implementing a digital system of operations within the local facility will enhance the quality of care and service they require. The main limitation for the local community is the lack of resources to implement such a project.
Also, the facility staff is directly affected in the implementation of the EHR within the local facility. The staff involves leaders in all levels of management, the physicians and the other technical and non-technical employees working in the facility. This project would directly affect their performances in various ways. At the moment, however, they all face various challenges in delivering services to the community. For example, the lack of a streamlined system of operations causes them to waste time and this affects their overall productivity. The quality of medical care is also a major concern as the medical personnel are challenged in matters of diagnosis which is a basic activity for the medical professionals. Moreover, the level of coordination and collaboration is a major limitation due to the lack of supporting systems. Therefore, this investment will be a major realization for the local facility as will lead to enhanced quality of medical service to the local community.
The medical practitioners within the health facilities will highly benefit from this system due to the enhanced communication capabilities. They will be able to communicate with their peers on medical matters at their remote offices within the health facility and resolve major medical issues. Moreover, the medical professionals will be able to manage and prevent deaths in cases of emergencies. In the past, emergency cases could worsen as doctors sought for previous medical records in case the patients were incapacitated and could not respond. It could be difficult to know what medications react with the patient and other critical information required in emergency cases. With the EHR, the patient information can be easily available in emergencies (Slack, Chambers & Johnston, 2010). This is because the system will only need identification information on the doctor’s system and comprehensive information on the patient such as the health issues, medication issues, and other tests is easily retrieved. This in turn can ensure that the emergency caregivers are well informed about the background of the patient which informs their decision making.
The organization strategic alignment
The emergence of EHR’s has been a major revelation in the medical field. As a result, majority of the major medical facilities within the nation are well served by this unique technology. However, its adoption in majority of small, medium-sized and community medical facilities is still low. Over time, these health facilities have invested in small scale levels of electronic systems to foster their operations. In the same length, the adoption of the electronic system will put the local facility in a league of the major hospitals within the country. This will make it one of the digitized facilities which will enhance coordination and collaboration among the medical professionals and ultimately lead to quality services. Moreover, the system will facilitate exchange of best practices among the medical professionals from other hospitals that have their systems digitized. For example, the doctors within this local facility will be in a position to consult with other medical experts from other facilities within the city or beyond. This will be in form of inquiries about special medical issues where third and fourth opinions may be required. In such a case, the doctors may share the records of the patient with the specific condition and eventually come up with an informed opinion on how to handle it.
By and large, the facility will have partners who will seek to share the same technology such as the neighboring medical facilities. However, the local facility will face competition from other major medical facilities that have invested and implemented these systems. These competitors will facilitate the creation of a competitive environment for medical services as patients will seek to get services in the most efficient and effective medical facilities. In the process, the healthcare providers will be forced to improve on their quality of services for the benefit of the people.
The main stakeholders in this implementation of this project include the local health facility management and staff, the local community and the IT consulting team. These entities have distinct roles which when combined lead to the realization of the electronic system required in the hospital. The hospital management will be the most significant stakeholders as their contribution and decision to have the digital system will result into its realization. They will be responsible for funding the project as well as offering the managerial skills in the implementation and operation phases. The local communities who are the custodians of the local facility are also important as their contributions and support for the new system will lead to the realization of that dream. Finally, the IT experts are responsible for implementing the electronic system in the health facility (Walker, Walker, Bieber, & Richards, 2005). They will also be required to train the hospital’s IT team and the staff on basic operations of the new system to promote independence. Moreover, they will be required to maintain the system in operations at all times.
Key Tasks and Work Breakdown
First, the project will be implemented within a period of six months. The first one month will be for planning and mobilizing resources in the form of finances and personnel. At the planning stage, the key stakeholders will be represented in the planning team to ensure that all factors and considerations are incorporated in the plan. For the project to be fully implemented and operational, various activities must be carried out by differently entities. These activities will be allocated to entities in order of their professions and expertise (Slack, Chambers & Johnston, 2010). Between the second and the fifth months, the managers will be required to spearhead the overall project planning and implementation. The first activity in the project implementation is designing the layout of the new system this will be done by the outsourced IT consultancy team with the support of the management and the facility’s IT department. After the design is completed, the purchase of the various infrastructures will be done by the management through the guidance of the consulting team. Once, acquired, the consulting team of IT experts will be assisted by the IT department members to install the physical infrastructure required for the system.
After the installation of the physical infrastructure, the software and hardware equipment for supporting the new system will be laid down. This will ensure that there is an element of synergy in the entire health facility. Afterwards, the database and servers will be installed into the established system to support connectivity between remote workstations and departments. The completion of the installation process will be followed by training of the facility staffs to orient them to the new system of operations. At the same time, the It department personnel will be undertaken through intensive training on the technical matters for them to ensure a smooth running of the new system. The Consulting team will be involved in monitory and evaluation in the first quarter of its operations and eventually delegate this duty to the IT team within the facility.
The Management Design of Healthcare Facility
The modification of the operations in the local facility will not alter the existing organizational structure. Instead, it will ensure that the various systems and structures in the organization remain functional and coordinated towards a common goal of enhancing efficiency in the health facility. In that case, the organizational structure should remain vertical and horizontal (Reiser & Dempsey, 2011). Vertically, the management of the facility is on top while all the other departments follow below with each having a departmental head. The employees will fall under their departments and report to the departmental head, who then is accountable to the management. The leadership style of the facility will also remain autonomous where every department is responsible for its activities and the main decisions are made by the management in consultation with the representatives of the departments. This will prevent any possibility of micromanagement.
In the same length, the culture of the facility will be maintained and even enhanced. In that case, the values of professionalism and other codes of conduct will have to be followed at all times in serving the people (Rivard & Lapointe, 2011). This will also be considered by the human resource personnel in recruiting personnel to serve in the facility. Integrity and excellence should guide the recruitment process. The facility will also carry out training on every cohort of recruits to orient them to the culture and the value system of the health facility. Moreover, the departments should ensure that their staffs are well motivated through developing a reward system where the most outstanding employee in the department is rewarded. All the medical professionals whether nurses or doctors will be subjected to national and international conferences to be constantly informed on the advancements in their areas of expertise. This will guarantee a high quality status of service delivery to the people.
To promote professionalism and high performance within the facility, the management should create an environment that supports creativity and innovation among the employees. At the same time there should be regular evaluations on the quality of care and services provided by the employees. This will promote professionalism and efficiency in service delivery. The quality management should be promoted to ensure that the working environment is not polluted by poor management. In that case, the employees should be allowed to exercise freedom and responsibility. At that time, they should be accountable to their departmental heads. Such a management system would lead to quality and high levels of professionalism in the local health facility.
The Research Project Resources
The implementation of this project within the local health facility will require adequate resources. Due to the medium size nature of the medical facility, the quantity of resources will not be extremely high. Despite this, the facility will accrue substantive financial resources for this project to be actualized. This is because of the high expenditures needed in the acquisition of the infrastructural systems needed to support the EHR system. In that case, the local facility should outsource more funds from the responsible departments within the ministry of health (Slack, Chambers &Johnston, 2010). This can be done by writing to these departments seeking support to implement the electronic system of operations within their facility. By including the project proposal, they can highly get financial support to move to the digital system of operations within the facility
In addition to the financial resources, the facility will require physical resources such as way leave where the infrastructural equipment will be installed. Furthermore, there are also the human resources with the technical knowhow that will be required in this process. These are the IT experts that are deeply versed with the field and will be important in promoting and attaining the expected outcome. In this case, they will be outsourced in form of a consultancy team of IT experts who will be responsible for the implementation of the digital system. Moreover, they will be required to train the IT experts in the facility to ensure that they can operate the new system without help.
In this case, the budget of implementing the EHR system within the local health facility should be done by the planning team. This time will be made up of all departmental representatives, the management team and the Consulting team. Due to the medium sized nature of the local health facility
|Purchase of related to hardware, software, peripherals, and network connections.
|IT and other outside support||3,094|
From this major investment within the local health facility, there will be a massive return on investment once the facility breaks even. This is because the facility will be able to serve more patients within the local community as well as attracting others from different areas. In addition to efficiency, the quality of services by the medical officers will also contribute to major traffic within the community health facility leading to the realization of major profits.
Monitoring and Control of the Project
To determine whether the set objectives of digitizing the operations in the local community health facility have been met, there should be a thorough surveillance on the operations from the initial stages when the EHR system began operating. In this case, the management that was responsible for the monitory purpose can record the performances of the facility on daily basis for about four months to evaluate whether there are changes. This can be recording the numbers of patients being effectively served within the facility on a daily basis. Moreover, the cases of errors and wrong diagnosis can be recorded and computed at the end of the four months. The findings can be compared against similar results of the last four months of operation for the facility before the hospital. At the same time, the entire facility should also realize profit increase due to the increased number of patients being served in the facility. By comparing the financial performances of the facility before and after the implementation of the EHR, it is possible to note the impact of the digital system.
In addition, the HER system should be monitored regularly be evaluating the efficiency of operation over time. In most cases, the speed of a digital system can be affected by various factors such as virus attacks. Therefore, it is advisable for the system to be monitored for efficiency on monthly basis to ensure that it remains controlled. Control can also be enhanced by regular maintenance of the system. In addition, the patient and community review and feedback can be sued to ascertain the impact of the facility in service delivery in fulfilling the set objectives. By evaluating the feedback, it is also possible to ascertain whether the facility is moving to the desired direction or not.
The Future Vision of the Healthcare Research Facility
The medical field is in a rapidly advancing sector where the players are daily investing I the latest technologies to enhance the quality of care. Therefore, investing in the EHR system within the community health facility is a major step towards the global status that will be achieved within the sector in the next 10 to 20 years. Today, some of the digitally operating medical facilities are using this ability to share information and exchange best practices with the facilities of their status (Reiser & Dempsey, 2011). In fact, health service providers are collaborating with other hospitals, doctors and health plans to identify means of sharing information. In essence, the information within the EHR system can be easily shred with other organizations as long as their computers are synced to share. Therefore, the future of the medical field is bound to be very liberal as medical facilities will be linking with other facilities from different cities and exchanging information at will. Furthermore, doctors are going to be more effective due to the possibility of enhanced collaboration and coordination.
HealthIT.gov. 2017. Benefits of EHRs: Improved Diagnostics and Patient Outcome. https://www.healthit.gov/providers-professionals/improved-diagnostics-patient-outcomes
Carayon, P., Smith, P., Hundt, A. S., Kuruchittham, V., & Li, Q. 2009. Implementation of an electronic health records system in a small clinic: the viewpoint of clinic staff. Behaviour and Information Technology. 28, 5-20.
Reiser, R.A. and Dempsey, J.V., 2011. Trends and issues in instructional design and technology. Upper Saddle River, NJ: Pearson Merrill Prentice Hall.
Rivard S, Lapointe L, Kappos A. 2011. An Organizational Culture-Based Theory of Clinical Information Systems Implementation in Hospitals. J Assoc Inf Syst, 12(2):123–162.
Simon SR, Keohane CA, Amato M, Coffey M, Cadet M, Zimlichman E. 2013. Lessons learned from implementation of computerized provider order entry in 5 community hospitals: a qualitative study. BMC Med Inform Decis Mak, 13:67.
Slack, N., Chambers, S. and Johnston, R., 2010. Operations management. Pearson education.
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Versluis, Arie, Vos, J.F.J., & Boonstra, A. (2014). Implementing electronic health records in hospitals: a systematic literature reviewBottom of Form
Walker, J. M., Walker, J. M., Bieber, E. J., & Richards, F. 2005. Implementing an electronic health record system. London, Springer.