Lessons Learned From Electronic Medical Record Implementation

Summer issue of Perspectives, AHIMA’s online journal, also features research On integrating diabetes guidelines into a telehealth screening tool

Electronic health records (EHRs) offer significant benefits for better patient care at reduced costs, but their implementation remains a challenge for each individual healthcare organization.

The summer issue of Perspectives in Health Information Management, the online research journal of the American Health Information Management Association (AHIMA), features a case report, “10 Lessons Learned from Electronic Medical Record Implementation in a Large Academic Medical Center,” that offers best practices for a successful implementation.

“This case report will help any organization – regardless of size – take a strategic and coordinated approach to EHR implementation,” said AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, CAE, FACHE, FAHIMA. “

The case report focuses on the Ohio State University Wexner Medical Center (OSUWMC), an academic medical center comprising six hospitals, two campuses and 46 outpatient sites.

The authors identified five lessons about the implementation process: ensure leadership support, select the appropriate approach to implementation for the organization, focus on training, provide support at go-live and for optimization, and flexibility.

The five lessons about the EMR components contributing to successful implementation include: secure communication, referral correspondence, documentation tools, EMR vendor model system, and patient portals.

This summer issue also features the following articles:

• Twenty-five percent of all veterans in the Veterans Health Administration (VHA) have diabetes. The article, “Integrating Diabetes Guidelines Into a Telehealth Screening Tool,” describes the development and implementation of a quality improvement project “to embed an evidence-based diabetes screening tool, based on Veterans Affairs/Department of Defense diabetes clinical practice guidelines, into the VHA electronic medical record. The results were promising:
  • 88 percent increase in the assessment of annual exams and/or labs
  • 16.5 percent increase in disease management assessment and offering of services
  • 50 percent increase in goal-setting activity
• Using robots in intensive care units (ICU) can increase access to off-site supervising physicians and other specialists, which has the potential to reduce wait time for difficult admissions and procedures. The article, “Robotic Telepresence in a Medical Intensive Care Unit -- Clinicians' Perceptions,” finds that the ICU robot can be “an effective tool when it is used to visualize and communicate with patients, bedside staff and families.”
• Hospitals are beginning to use Radio-Frequency Identification (RFID) technology in their transfusion processes. The article, “Benefits and Barriers of Implementation and Utilization of Radio Frequency Identification (RFID) Systems in Transfusion Medicine,” analyzes this trend and the findings suggest “RFID has provided improvements in quality of care and efficiency, while initial costs, security and privacy appear to be the principal barriers of adoption.”
• The article, “Charts versus Discharge ICD-10 Coding for Sternal Wound Infection Following Coronary Artery Bypass Grafting,” describes “an effective algorithm for identifying a cohort of patients with SWI following median open sternotomy for CABG in large databases using ICD-10 coding.”
• The story, “Results from the Veterans Health Administration ICD-10-CM/PCS Coding Pilot Study,” found that while coder productivity is expected to decrease, “a focus on the means to minimize this decrease and an emphasis on continued coding accuracy at current standards may actually result in an insignificant or no actual impact.”

About Perspectives
Perspectives in Health Information Management is a scholarly, peer-reviewed journal, referred to by professors, professionals, public officials, industry leaders, and policy-makers. Since 2004, it has been one of the most credible and respected journals of the HIM industry and is referenced in notable indices such as PubMed Central (PMC), the Cumulative Index to Nursing and Allied Health (CINAHL), and Google Scholar. Learn more about the submission guidelines and the manuscript review process.

About AHIMA
The American Health Information Management Association (AHIMA) represents more than 101,000 health information professionals in the United States and around the world. AHIMA is committed to promoting and advocating for high quality research, best practices and effective standards in health information and to actively contributing to the development and advancement of health information professionals worldwide. AHIMA’s enduring goal is quality healthcare through quality information. For more information, visit www.ahima.org.