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Challenges Of Introducing Electronic Health Records System

Student’s Name

Institutional Affiliation

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Background of the Issue

Change is not an easy thing to implement.
It often trigger resistance from stakeholders who feel uneasy about it.
The issue discussed in this presentation refers to a time I introduced Electronic Health Records (EHR) system in my healthcare organization.
EHR refers to an electronic version of patient’s medical records or history.
Using EHR attracts legal, ethical, social, economic, and political concerns.
The main ones that affected my project were ethical, social, and economic concerns.

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Background (Continued…)

The first challenge affecting my intention to introduce EHR in my organization was ethical concerns.
Stakeholders feared that their confidentiality would be lost.
They believed unauthorized people may access the records.
The second challenge was related to the social environment.
Some employees resisted the changes for fear they would render them less useful.
Lastly, the process was expensive and required a lot of resources to install, implement, and maintain.
The project did not attract legal and political complications.

Ethical concerns affect the use of EHR. Many people find it risky to have patients’ records stored in electronic methods that are susceptible to hacking. Stakeholders like patients and nurses feared that in case of a cyber-attack or hacking, the records could be used to manipulate or hurt patients. According to Shenoy and Appel (2017), EHR is a good solution to accuracy challenges but exposes records to confidentiality risks. For example, leaked social security numbers could be used to hurt the patients. The social difficulties were that some nurses and other staff members felt the system could render them useless or take away their jobs. For example, the people in charge of maintaining records felt EHR could take away their jobs. Therefore, they resisted embracing it. Lastly. The implementation required financial resources to buy and implement the computer systems and train workers. Fortunately, the project did not attract legal and political issues because the organization had met all legal requirements and political leaders supported the idea.

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Role of Advanced Registered Nurse in the Change Process

An advanced registered nurse understands the needs of patients.
Therefore, they act as the agents of change.
The first role is identifying the areas that require changes.
The second role is evaluating alternative solutions to the challenge.
Thirdly, they help in implementing the changes.
Lastly, they evaluate and assess the solution to determine its effectiveness.
The dynamic and inter-professional healthcare environment requires nurses to play these roles effectively.
The nurses also help other nurses adapt changes.

The advanced registered nurse plays a significant role in ensuring successful changes in healthcare. First, since they are close to patients and understand operations in organizations, they identify the areas that require changes. Secondly, they evaluate alternative solutions that could help change the situation. Once the best solution is chosen, advanced registered nurses help in its implementation. The nurses also engage people from other professions like Information Technology (IT), finance, and management in ensuring successful changes. Lastly, they evaluate the effectiveness of the solution. Any reviews that may require attention are used to make the necessary adjustments. The nurses should also help other nurses accept and embrace the changes. The roles are crucial to any changes in healthcare organizations. Without their contribution, projects are likely to fail.

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Inter-professional Stakeholders (Internal)

The change process involves internal and external stakeholders.
Internal stakeholders are those working within the organization.
Such stakeholders usually play a critical role in implementing changes.
They include accountants, management specialists, human resources, and the IT department.
Accountants help in analyzing the costs and benefits of the proposed changes.
Management specialists help in predicting the impacts of the changes.
The human resources are involved in hiring and recruiting the necessary additional staff and training them.
IT department helps in implementing and maintaining the EHR system.
Nurses help in evaluating the effectiveness of the system.

Internal stakeholders help in implementing and maintaining the proposed system. The accounting department may not understand any nursing work but can calculate the cost and benefits of the system. For example, they help determine if the system will break even soon enough. The management specialists help analyze the impacts of the changes on employees' motivation, job satisfaction, and resistance. Such information helps in planning for the project. The human resources department are involved because the system may require recruiting and hiring new employees and training the existing ones. The IT department is critical because they implement and maintain the system. Lastly, the nurses are involved in analyzing and evaluating the changes to determine their effectiveness. Efforts by these internal stakeholders are inevitably important.

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Inter-professional Stakeholders (External)

The external experts are crucial to implementing the changes because they are affected by them.
Suppliers are part of the critical stakeholders.
Their supplying process could be affected by the EHR.
Therefore, they should know about it.
Marketing partners should also be involved to ensure their marketing messages resemble the changes.
Donors and government should also be involved to ensure they support the changes.
Referral partners should also know the way records are handled going forward.

Suppliers are crucial to the organization's supply chain. Therefore, they should be involved in the changes so long as their activities are affected. For example, EHR could reduce medical services, leading to reduced money to pay suppliers. Consequently, suppliers who deliver materials like files and stationery to be replaced by the new system should be involved. Suppliers of computer accessories should also be included because they will provide the required materials. Marketing partners should be involved so that their communication with customers could include improved healthcare services in their advertising and promotional messages. Lastly, referral partners, including clinics in the area that refer patients to the healthcare organization, could be involved to comply with the required record-keeping measures.

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Applying Kurt Lewin’s Change Management Theory

The most effective change management theory to use in the change process is Kurt Lewin’s change management theory.
The theory is divided into three.
Unfreezing is the first stage.
It involves creating awareness on the need to change.
Changing is the second step and it involves implementing the changes.
The last stage is freezing.
It involves solidifying and stabilizing the changes (Saleem et al., 2019).
The theory helps in avoiding social, ethical, legal, economic, and political challenges.

Kurt Lewin divided the change process into three. In the first stage, the organization unfreezes by explaining to stakeholders why the current status quo creates bottlenecks in the organization's success. This step is important because it reduces resistance to the changes. The second step is implementing the change. Changing is difficult and could attract resistance from many stakeholders. At this step, people learn new ways of doing things, and this could trigger resistance. Therefore, it is the most difficult step. The last step is freezing when the organization accepts and gets used to the changes. At this step, people accept the changes as the new status quo. Managing the changes in this way reduces the chances for resistance. It also reduces errors and enhances the chances of achieving all goals.

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Initiating the Changes

As an advanced registered nurse, I would first explain to all stakeholders the reason for the changes.
I would then invite people to suggest solutions.
I would then analyze all suggestions and determine the best solutions.
Next, I would choose the alternative with the least negative impacts.
It would also be advisable for me to engage all stakeholders I implementing the changes.
I would then evaluate the changes and make necessary changes.

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Impacts of Failing Again

Failing again would damage the organization’s reputation among stakeholders.
It would also damage employees’ motivation.
It could also reduce trust that stakeholders have on the organization.
Such impacts may have significant impacts on the organization's success.

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Impacts of Failing Again (continued)

The failure could also lead to reduced attraction to the organization.
Patients may consider the failure to be a sign of poor services delivery.
Potential workers may also avoid working for the organization.
Such a trend could affect the hiring and recruitment process.
Lastly, second failure could reduce advanced registered nurses’ confidence in implementing changes.

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Additional Factors to Change

The upcoming changes could be triggered by three factors.
The first one is technological changes.
The second one is political influence.
Third, demand by stakeholders could lead to the changes.
Nurses can act as change agents by connecting stakeholders and helping them achieve the goals.

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Conclusion

Change management is critical in all sectors.
Advanced registered nurses act as change agents in organizations.
Applying effective tools, models, and procedures could reduce resistance to change and increase chances of success.
The evaluation shows how change could be implemented successfully in a healthcare organization.

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References

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.
Saleem, S., Sehar, S., Afzal, M., Jamil, A., & Gilani, S. A. (2019). Accreditation: Application of Kurt Lewin’s Theory on Private Health Care Organizationanl Change.
Shenoy, A., & Appel, J. M. (2017). Safeguarding confidentiality in electronic health records. Cambridge Quarterly of Healthcare Ethics, 26(2), 337-341.

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