ARTICLE REVIEW ASSESSMENT Your group has been appointed the selection panel for an EMR that is to be introduced into an existing 800 bed tertiary teaching hospital. The selection panel has been asked by the hospital's Executive Board to review what the major barriers to EMR (Electronic medical record ) adoption are likely to be and research what measures can be put in place to mitigate these risks. Prepare a written Executive Summary (1600 words) that succinctly explains your findings, covering: • What the likely major barriers to adoption are • What mitigations can be put in place to overcome these barriers • What the effectiveness of each mitigation approach has been in real world implementations Referencing: APA 6th All work must be referenced with intext citation. Ensure you use credible sources of information dated within the last 5 years. Points to be noted: Construction & Flow: The document is properly constructed and the content is logical and flows well from introduction through to conclusion Demonstration of Understanding: The content of the document demonstrates understanding of the subject matter Argument Development: Idea development is logical and orderly, presenting a cohesive argument and demonstrating understanding of the topic Critical Thought: There is evidence of critical thinking, indicating an ability in analysis and interpretation Conclusion: A rational conclusion is offered and supported Lecture notes: The typical barriers to the adoption of an EMR solution include: • The total cost of owning and implementing an EMR solution can lead to adoption issues as a compromised solution is delivered, i.e. one not fit for purpose. • The business process / workflow changes an EMR introduces are significant and the current organisation does not change to the new business processes / workflows; • The selected EMR solution is difficult to user and slower than traditional methods; • Staff do not participate actively in the selection and implementation process leaving them disenfranchised; • Interoperability with other existing electronic systems is poor making access to the full range of patient data difficult; • The selected EMR solution does not meet the requirements of the organisation meaning it isn’t fit for purpose; • There is not enough (or not enough appropriate) End User Computing (EUC) or Mobile Computing devices to support the EMR solution; • The organisational culture is not supportive of change and innovation; and • The support requirements of an EMR solution are significant and an under resourced support team will not be able to respond to the organisation in a timely fashion which can lead to users resisting adoption. How to promote better EMR adoption As noted in previous weeks the key to good EMR adoption is overcoming barriers and a strong Change Management and Communications strategy and plan can provide the framework to support this adoption. Of course the strategy and plan alone will not lead to better adoption, but it will help focus on adoption concerns and the removal of barriers to adoption throughout the EMR implementation. The following things need to be considered when trying to overcome barriers to adoption (either as part of the Change Management and Communications strategy and plan or in isolation as part of the EMR implementation project): • Completing comprehensive training that is delivered to as many people as possible; • Having strong leadership of the change in place, particularly during any uncertainties and setbacks in the programme of work; • Identifying clinical champions and having them advocate for the EMR solution; • Having wide consultation with a broad range of roles and all levels of the organisation; • Addressing workflow concerns raised and remodelling business processes / workflows collaboratively with users; • Identifying and selecting the solution that is the correct fit for the organisation’s requirements; • Removing technical barriers, e.g. if typing notes is seen as a major barrier select an EMR with speech recognition software; • Identify the key stakeholders with significant misgivings and work hard to turn them into supporters of the change; • Ensuring legacy systems that will remain are properly integrated with the EMR solution; • Realigning the organisations priorities to focus on patient safety and showing the EMR solution is part of the safety improvement; and Electronic Health Information Systems • Leveraging external influence on the organisation, e.g. public concern about patient safety.