A study in electronic medical records for a community health center Part 3

How will this change the day to day work of the health center?


The introduction of a new system will change the way many staff members function day-to-day. It will be necessary to perform task assessments of each job function within the organization. This data will be used to outline the requirements of each job role. Once this analysis is complete members of management must then determine the needed job process within the new system. Many functions may change greatly but others may not change at all.

Each person in contact with the new system must be trained and comfortable navigating within the application. Thorough training sessions will be required for each job type. This training should be conducted by trainers provided by the application vendor, members of management and power users within the system. It is also very important to consider all input and concerns given by the end-users (Baum, 2006). This real-time information may prove key to future system configuration and honing.

An initial result of a new system is expected to be increased examination time allotment for providers (Groves, 2006). The responsibility of data entry will shift from the medical assistants to the actual providers. Providers will enter this data during examinations. This extra responsibility in itself adds some time to the allotted appointment. Also, as providers learn to use the new system exam time will increase. As providers become more familiar and comfortable with the system this exam time will decrease.

Who will benefit from this change?

Members of RCHC staff and patients will benefit from this system upgrade. Noticeable increases in productivity will not immediately occur. After the system has been in place for a few months members of staff will begin to notice improvements in how they are able to perform their jobs and monetary benefits will follow (Gonzalez, 2008). Unnecessary record organization and filing will become a thing of the past. Providers will see improved efficiency in the form of easily shared and attainable medical records and more complete patient files. Patients will also benefit from this digital and highly portable form of medical record archiving. As patients visit their provider and are referred to specialists their medical documentation will follow with no effort by the patient. Vaccination records, physical information, test results and allergy information will be at the fingertips of any provider a patient might visit.

Paperwork needed to attain a high level of patient care will be greatly reduced. System validation will also give staff member’s confidence in that they can be assured that the data they are entering into the system is accurate and complete. An electronic system also offers staff the opportunity to utilize and even increase computer related skills that can be a valuable asset.

Many members of medical staff are fearful of electronic medical records (Baharozian, 2004). This fear is not related to the use of the new system but related to the misconception that this system will possibly eliminate staff jobs. Clinical staff can view the addition of electronic records as cumbersome, difficult to use and creating more work for them in the long run. Members of management must be aware of these fears toward an electronic system and assure the clinical and office staff that there will be changes but they should not be viewed as threatening or difficult. These new systems do create many procedural changes but they do not serve to eliminate jobs or even make things difficult for clinical staff. After all, why would a health center implement a system that makes routine work procedures more difficult, this defeats the purpose of adding a new system? The best approach to reduce these fears and obtain staff buy-in is through staff involvement (Baum, 2006). When members of staff feel that they are part of the implementation and selection process they are more receptive to the change. Allow staff members to express concerns and ask questions about the system and attempt to answer these questions and address these concerns as promptly as possible.

System summaries

AllScripts
Small and mid-sized businesses can benefit from a proven solution known as AllScripts. All systems offered by AllScripts are expertly implemented, completely supported and easy to use. As a result, the implementation of this solution will streamline workflow; enhance the quality of care and an increase in the bottom-line performance through increased productivity. AllScripts electronic medical record system offers a vast library of built in knowledge for primary and specialty care, features such as patient portal and ePrescribing and is well regarded within the medical community. This solution can stand alone as an electronic medical record system with an interface to an existing practice management system or it can be purchased as an entire solution for seamless implementation and use (Allscripts, 2009).

Benefits of AllScripts
1. Ease of use
2. Strong return on investment
3. Higher quality care
4. Easy transition and training process
5. 24-hour support 365 days/year
6. Smoother workflow
7. Comprehensive knowledge base
8. Anytime access to critical patient and practice information
9. Enhanced patient wellness and patient care quality standards
10. Industry-leading interface capabilities (Conn, 2004)
11. Works in conjunction with existing practice management systems

NextGen
This solution is completely capable of serving the needs of Riggs Community Health Center by also increasing staff productivity and increasing the level of patient care. The electronic medical record portion of NextGen offers standardized documentation which ensures the quality and accuracy of the health care providers (Nextgen, 2009). NextGen also partners with hospitals and large health systems across the nation to improve patient safety through the interoperability of health information systems. Multiple systems can connect using NextGen electronic health records to share data. This sharing created a real-time electronic chart for each patient that can be viewed, appended and reported on with great ease.

Benefits of NextGen
1. Pre-built templates for increased workflow for over 25 specialties
2. Disease management templates
3. Integration with other products in the NextGen application suite
4. Instant access to documentation
5. Specially suited for multi-specialty practices
6. Ongoing support

GE Centricity
Centricity offers an electronic medical record system that enables providers and staff to document clinical information, streamline workflow and securely exchange clinical data with other providers and information systems. Centricity was designed by physicians with a focus on clinical ease-of-use. Centricity also integrates well with other systems such as revenue cycle application and practice management systems. This system was built with the information needs of providers in mind. This architecture allows for fluid streamlined patient visits, increased accuracy and completeness of documentation and enhanced patient care. Embedded clinical content and flexibility in encounter form generation makes this system completely dynamic and compatible for most any medical practice.

Benefits of GE Centricity (GE Healthcare, 2009)

1. Advanced reporting features
2. Macro creation for commonly used functions
3. Improved quality of care
4. Improved workflow management
5. NCQA certified for the diabetic physician recognition program
6. Concurrent user model facilitates real-time info needs
7. Voice-recognition
8. Community health center software configuration

Alliance of Chicago
In attempts to ease the introduction of a new system it is often necessary to request help from others. The most effective implementation will consider the failure and success of other organizations system implementation. It is beneficial to seek a consulting firm that specializes in electronic medical record implementation and support. The alliance of Chicago community health services is an organization that specializes in shared resources and service integration for community health centers (Alliance of Chicago, 2009). The Alliance of Chicago is a group of four community health centers based in the Chicago area that serve under-insured and non-insured patients much like RCHC. Each member of the Alliance of Chicago has systematically implemented electronic medical records within their practice. This experience has created a dynamic resource that can be utilized by any other community health center that wishes to also implement electronic medical records. This alliance specializes in the implementation of a system created by General Electric, titled Centricity. For this reason, GE Centricity is one viable option for RCHC.
Conclusion
Each of the proposed systems will facilitate effective practice management and electronic medical records. The purpose of this study was to evaluate three options and determine the best fit for Riggs Community Health Center. After careful evaluation and demonstration of each system, GE Centricity has been determined as the best fit for this organization. Centricity’s architecture, which is geared toward not-for profit community health centers, completely facilitates the use of a sliding fee scale; this factor alone makes this product stand out from the others. It has been determined that every need of this organization can be met through implementation and use of this product. The amount of support offered by the vendor is assurance that this system and the medical practice will suffer very little down time due to system error. Also, complete and prompt training will occur before, during and long after system implementation. This training will be facilitated through instructors provided by GE and project champions within RCHC. GE Centricity is also completely compatible with the current infrastructure. There will be very few pieces of equipment needed, beyond what is already implemented, to get this system up and running.

The alliance of Chicago will play an important role in the adoption of this system. As experienced consultants, the knowledge of this organization will provide an invaluable tool during preparation, implementation and continued support. The hard work, dedication and even the mistakes of the alliance will benefit RCHC. The Alliance of Chicago has performed this implementation many times and the members of this team know that ins and outs of this system (Rachman, 2009). This knowledge is of great importance to a small organization that cannot afford to learn from mistakes that could possible cost hundreds of thousands of dollars.