Article Review
Article 1
Banas, Colin A, Erskine, Alistair R, Sun, Shumei and Retchin, SheldonM. Phase Implementation of Electronic Health Records Through an Office of Clinical Transformation. Journal of the American Medical Informatics Association, 2011; 18: 721-725.
Article Synopsis
This article is a case report that delves into the implementation of electronic health records. While electronic health records present various benefits to the health care system such as improved patient outcomes and cost savings, their uptake and diffusion through the healthcare sector has been rather slow and limited. Therefore, this article presents information on the phased implementation of electronic health records by examining a case study of the implementation of an online provider documentation at Virginia Commonwealth University Health System. The case study outlines the implementation strategies of health information technologies at this academic health center and these strategies include process re-design, end-user adoption and practice transformation strategies.
This article adopts a qualitative design and utilizes the case study research method or approach. Case studies allow for in-depth examination of phenomena or real-life context for purposes of theory development and testing and investigation. The research object in this case study is the phased implementation of electronic health records. The case selected is an academic health center that has an office of clinical transformation (OCT), which is the Virginia Commonwealth University Health System. With the OCT being a data-driven entity that has the goal of converging educational, clinical, financial and research activities through health information technologies, the three levels of measurement are diffusion of innovation, impact assessment and interoperability. The case study adopts a three-phased implementation with phase one being a 6-month preparatory phase, phase two being a 6-month adaptive period and phase 3 being a 2-week practice transformation.
Findings
Results indicated that 1491 physicians converted to using electronic-based documentation. This translated to an adoption rate of 99.7 percent within 6 months. Therefore, creating a clinician-led approach to electronic conversion through an OCT is effective, and such a structure can assist in mitigating resistance.
Article 2
Campbell, Emily M, Sittig, Dean F, Ash, Joan S, Guappone, Kenneth P, and Dykstra, Richard H. Types of Unintended Consequences Related to Computerized Order Entry. Journal of the American Medical Informatics Association, 2006; 13(5): 547-556.
Article Synopsis
Health care organizations implement and use CPOE in their efforts to reduce health care costs and improve medication safety. However, there are unintended adverse consequences that come up as a result of CPOE implementation and maintenance. This article seeks to identify and describe the major types of unintended adverse consequences that result from CPOE implementation. The study’s focus is on CPOE impacts that affect health care employees who use, manage or maintain CPOE systems. Perspectives are gathered from 3 groups which include the IT staff, clinical end-users and administrators.
The context of this study is the health care setting and is narrowed down to 3 groups which are the IT staff, clinical end-users and administrators. Clinical end-users include pharmacists, physicians, ward secretaries and nurses. IT staff are people who configure, support, configure and maintain CPOE systems. Administrators are those who manage the CPOE’s organizational implementation. As such the context of this study is explaining unintended adverse consequences of CPOE implementation on these 3 groups. The study adopts a qualitative research method to collect data from five hospital sites. The data collection methods used include expert group discussions, participant observation, and semi-structured oral interviews. Data analysis was done through the card sort method.
Findings
Works Cited
Banas, Colin A, Erskine, Alistair R, Sun, Shumei and Retchin, SheldonM. Phase Implementation of Electronic Health Records Through an Office of Clinical Transformation. Journal of the American Medical Informatics Association, 2011; 18: 721-725.
Campbell, Emily M, Sittig, Dean F, Ash, Joan S, Guappone, Kenneth P, and Dykstra, Richard H. Types of Unintended Consequences Related to Computerized Order Entry. Journal of the American Medical Informatics Association, 2006; 13(5): 547-556.
