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Hospital Doutor Fernando Fonseca-Electronic Health Record

Hospital Doutor Fernando Fonseca is one of the General health care hospitals in Portugal. It is integrated and affiliated with National Health Services. The mission statement of this organization is to deliver the high class, sympatric care to the patient. The hospital medical activities are supported by professional team members from the multidiscipline field related to general and community mental health and general practitioners. This organization has been considered a progressive healthcare organization that views the affordable healthcare act, the latest clinical development, and changes in operational aspects (Pedrosa, Gomes, Fernandes and Prieto, 2013). Hospital Doutor Fernando Fonseca’s management considers them innovative and forward-thinking organizations as part of their living standard. Advancement in the healthcare sector has revamped itself with the latest payment method techniques, operating models, regulatory regime changes, and advancements in technological methods.

Electronic Healthcare Record System

A significant change at Hospital Doutor Fernando Fonseca (Organizational efficiency through Electronic Health Record (EHR)

The Electronic Medical Record system was launched in 2001 by one of the world’s leading medical technology firms to downsizing interfaces and increasing the overall quality and patient-centered healthcare delivery. These acquisitions of medical approaches to information infrastructure let hospitals streamline and navigate the activities and procedures involved with patient care around the spectrum of care. In Portugal, private healthcare was the first to implement this system in 2006. The first application of this electronic healthcare record solution in a publicly run hospital was adopted in Hospital Doutor Fernando Fonseca to substitute paper-based patient reports.  It covers the electronic clinical repository features, electronic diagnosis and clinical documentation, clinical description, and registration of social workers (Xiao, Choi, and Sun, 2018). The computerization of current workflows and clinical pathways and the interoperability with current Hospital Information System, such as the consultation and imaging of laboratory samples, among others, and the alignment of adjacent structures, from functional management to new medical and therapeutic operations, are additional aspects of the Electronic Healthcare Record system.

Electronic Healthcare Record System

What Are the Positive aspects of Electronic Health Records at Hospital Doutor Fernando Fonseca?

At Hospital Doutor Fernando Fonseca, aspects of the various advantages of electronic Healthcare records include:

  • Improved Quality of Care: Patient profiles with computerized medical and patients reports are also simpler to interpret than written details from the practitioner (Potter et al., 2020). This medical profiling Hospital Doutor lowers the likelihood of mistakes and misinterpretations that can adversely influence the medical patient’s medical treatment.
  • Convenience and efficiency for customers and staff: At Hospital Doutor Fernando Fonseca, nurses and office workers no longer have to spend time digging through medical files and references (Sun and Zhang, 2019). In only a few clicks on a keyboard, users can easily and securely navigate patients’ electronic health information at Electron Healthcare Records. Hospital services have a patient portal that enables patients to choose and display their medical records and details for review.
  • Saving Space: In order to keep the record, the is need to hold paperwork in cumbersome filing cabinets is removed by electronic health reports, which frees up more office space for medical supplies and instruments and other essentials at Hospital Doutor Fernando Fonseca after the implementation of electronic healthcare record (Shawahna, 2019). Further, only a click of a button is required to retrieve the data instead of wasting time searching for the medical record.

What are the negative aspects of Electronic Health Records at Hospital Doutor Fernando Fonseca?

Several disadvantages of electronic medical records at this hospital are.

  • Potential Privacy and Security Issues EHR networks are susceptible to hacking, as with just about any computer network these days, which means confidential medical details may fall into the wrong hands (Osop and Sahama, 2016). The Management of Hospital Doutor is well aware of such security threats, and due to these issues, networking related to our side hospital has been kept restricted.
  • Inaccurate Information: Owing to the instantaneous existence of electronic health reports, they must be checked directly with an appointment to the hospital or if the information is altered (Yadav et al., 2016). Due to this treat, hospital management has instructed to ensure that information has been submitted to patients profiles with dual control that maker checker concept to avoid such risk.
  • Frightening Patients Needlessly. Because an electronic health record system requires patients to view their medical records, a scenario may be generated to misinterpret a file entry (Bowden and Coiera, 2017). This might cause an undue warning or even panic. For such reasons, Electronic Health Records at Hospital Doutor Fernando Fonseca, patients have been provided with the limited and general interpretation of medical reports that could not mentally hurt them.

Electronic Healthcare Record

Procedure at Hospital Doutor before Implementation of Electronic health Care Record system.

Both patient reports were maintained on paper before introducing the electronic health records at Doutor Fernando Fonseca Hospital. The medical staff is expected to use their man’s efforts to attach the duties performed related to the patient in their medical record file (Retno, Rangga, Suyoko, and Slamet, 2020). Manual file systems have been placed in a position where it is crucial to store all the patient records. Diagnoses, lab results, visit records, and prescription orders were written and preserved in the medical record using sheets of paper linked together. These documents must be appropriately labeled with the names of the patients to which they have been associated. They were numbered using the last name of the patient, the last few digits of the patient’s social security card, or some chart numbering system. The papers were then filed and retrieved from specifically created shelves equipped to house directories of vertical files.

Healthcare Record System

Triggers for the need for Electronic Health Record at Hospital Doutor Fernando Fonseca

The triggering point related to adopting a new electronic health record at the hospital was the requirement of an effective decision-making process. The organization considers different options by using qualitative approaches. The manual system currently implemented at Hospital Doutor must have certain deficiencies such as the inaccuracy of recorded information, archival issues of patients’ records, and medical record profiling for centralized review. The management of Hospital Doutor considers these factors as essential to improve patient satisfaction levels. In such a scenario, an electronic health record (EHR) is an electronic version of patients’ medical history that the hospital retains over time. It contains all the primary institutional clinical records related to patients’ treatment under a specific provider, including profiles, progress reports, problems, prescriptions, vital signs, prior medical history, immunizations, laboratory details, and radiology. The EHR can also actively or implicitly endorse other care-related practices across different interfaces, including evidence-based policy support, quality control, and monitoring results.

The next triggering point of Hospital Doutor Fernando Fonseca was Pareto Analysis’s exercise (Sarkar, Mukhopadhyay and Ghosh, 2013). Five steps are carried out to identify the need to implement an Electronic healthcare record system. It included identifying and listing problems, root cause analysis of each problem, scoring the problem based on their severity, group these problems to remove the duplicate ones, and finally taking action in the shape of implementation. The problem identified in manual systems was information accuracy, customer profiling, contact details, medical history maintenance, and record archival. For these problems, hospital management required an electronic system such as a customer relationship management system containing patient information at the click of a mouse to its user. After consultations with different vendors and research, an electronic healthcare record system has been finalized to cater to Hospital Doutor Fernando Fonseca’s needs. These facts affected the management impact-based analysis to brainstorm and identify significant evaluating status changes (Chaudhry et al., 2006).

 

Feasibility of implementation of Electronic Health Record at Hospital Doutor Fernando Fonseca

Several requirements need to be present for electronic health reports to help overcome the problems of doing studies on data viability. To reach the feasibility of an electronic health record system, it essential to consider the TELSO framework comprised of Technological, economic, legal, organizational, and scheduling of the task (Jeusfeld, Rose and Jarke, 1993).

Applying from the technical side, the management has considered different aspects, which included timely delivery, accessibility of technology, skills, knowledge attitude, and confidence of effective implementation of the electronic health record system. The management has also considered the economic side of this framework, It includes, project funding, financial viability via quantitive pros and cons techniques, and financial constraint from the organization side to meet the capital need for this implementation (Sale, Lohfeld and Brazil, 2002).

To remain compliant with the legal regulations, the management of the hospital has also taken legal opinion before the implementation of such changes in the organization. This legal compliance needs approval from regulatory bodies to avoid any conflict of interest between the government and hospital management. Before implementing the project, hospital management considered the shortage of training and skill required to implement the change. Certified change agents professionals had been hired to train the staff for such implementation.

Organizations need to check whether the alignment of activities can be done. The implementation is quite a prolonged exercise and is a set of events completed for the electronic health care record system. These events are required to modify the events according to the phases of implementation. For such implementation, the speed of change has aligned with activities with change implementation. From the organization structure point of view, inspirational change management techniques have been applied. These included changes in structural design, size, and radical changes. Any suggestion shall be considered as important as the large implementation does not guarantee its positive results.

Planning for implementation of Electronic Health Record at Hospital Doutor Fernando Fonseca

  • Need for change implementation. At Hospital Doutor Electronic healthcare record systems are configured to reliably archive data and to capture a patient’s condition over time. It removed the need to monitor the past paper medical history of a patient and ensure reliable and legible details. As there is only one modifiable file, it will minimize the risk of data replication, which ensured that the file is more likely to be up to date and eliminated the likelihood of missing documentation (Haughom, 2011). After implementing electronic medical records, it becomes more reliable when extracting medical evidence to analyze potential patterns and long-term improvements in a condition, owing to the digital details being searchable and in a single file.
  • Development of Goals of changes. Hospital Doutor has thrived the change during the development of goals by keeping the target of implementation with specific modules of Electronic health care records (Rothman, Leonard and Vigoda, 2012). The factors which came across were the expandable opportunities, prospective future implementations, and other assignments.
  • Planning of implementation. Hospital Doutor has adopted different approached to adopt the planned activities. These activities have different phases and stages of the Electronic Healthcare record system. For such reasons, management had adopted risk-based analysis (Peng et al., 2020) to proceed with the implementation phase. The risk analysis technique is used in the implementation to identify different threats during the implementation phase. These treats included a lack of knowledge, organizational structure issues, and availability of infrastructure. After identification, a risk estimation exercise has been conducted to identify the probability of treatment and its expected cost. For example, the likelihood of project phases its success rate.

Lastly, management would consider avoiding, accepting, controlling, or eliminating issues related to the risk identified.  Planning against the identified risk and their subsequent importance lead the organization to adopt the planning effectively.

  • Obtaining buy-in and communication with stakeholders developing a specific plan related to obtaining stakeholder buy-in relies on a useful review of the problems or opportunities and adequately addressing their concerns. Following are the critical stakeholders at Hospital Doutor and kept informed based on stakeholder analysis (Kivits, 2011).
  • Practitioners. Doctors are essential stakeholders at Hospital Doutor because of their placement on the front lines of delivering healthcare services by providing input into the design, workflow sign-off process, and live support. It is critical to encourage many clinicians to validate the method before purchasing and to have at least one clinician representative in the selection phase.
  • Nurses and Medical related staff. The nurses and medical staff at Hospital Doutor are critical players in the hiring phase of the EHR because they are responsible for supplying all inserting patients’ medical data and report in their profiles who may come into the practice with billing and contact details. Nurses and Medical staff community will include vital insight into problems and possibilities, particularly about how an EHR or ancillary practice management software poses challenges or can potentially change concerns such as channeling patients to providers and waiting times.
  • Billing staff. The management of Hospital Doutor considers the billing stake as a significant stakeholder from the financial perspective. The billing staff can identify the problems with current billing systems, which can offer a modern billing system through which it is possible to quickly and accurately manage claims.

Implementation changes

The change management of Hospital Doutor decides to carry out an independent review of the changes which had applied from manual procedure to electronic data management. For such purpose, a team of members had been formulating, which had tested the implemented steps (Grol and Wensing, 2020). The committees have adopted the deployment of electronic health records through comparison of its objective requirements through the below steps

  • Firstly, in terms of technological ability and attitude, the committee determined where implementation has been position currently.
  • Later on, the committee members have adopted a move back approach to the new workflow. In such a way, committee members will compare the current implementations results and the implementation objective
  • The committee members will identify the gaps between the planned activities and results obtained against the implementation results .i.e carrying out a gap analysis exercise (Hacker et al., 2020).
  • After the gap analysis, the committee at Hospital Doutor carried out the decision tree exercise. This exercise provided different options and their expected results at Electronic health care record-keeping systems. In light of the electronic health care system’s software and technological viability at the hospital, the committee members will select the best possible rectification action to reach the desired target implementation modules.

Follow-up and monitoring of results Electronic Health Record at Hospital Doutor Fernando Fonseca

This is the step at which the hospital management has to compare the results of implementation and necessary changes with updating, which stakeholders require time. Usually, Hospital Doutor Fernando Fonseca’s management has kept specific provision in a system whereby new requirement that rises after time to time can be addressed. Further, to monitor the system’s usefulness and viability, a separate department has been created responsible for addressing any problem or malfunctioning that arises during day-to-day activities.  Usually, this department is consisting of change management who has implemented the electronic health recording system. These team members will be better positioned to address the problem of stakeholders quickly compared to new professionals. These team members can also be utilized for the future development of different modules instead that kept dependent on outside sources to save cost and time.

Conclusion

The electronic health record (EHR) rendered it simpler and more convenient, plus more precise and secure details and knowledge accessed. EHR is now considered one of the most common health innovations, changing all aspects of health care while providing correct patient records and instant access. Moreover, several doctors have embraced it because of advantages and patients’ happiness that has also been improved. Because of patients who can now engage in his condition and make the correct decision with the care professional, the patients are now very conscious.

Bibliography

    Sarkar, A., Mukhopadhyay, A., and Ghosh, S., 2013. Issues in Pareto analysis and resolution. Total Quality Management & Business Excellence, [online] 24(5-6), pp.641-651. Available at: https://www.tandfonline.com/doi/abs/10.1080/14783363.2012.704265

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