Hcs 571

Capital Project HCS/571 Capital assets are generally purchased to improve quality of care, or to provide needed equipment for a new service or expansion of an existing service. The key element in capital budgeting is that the building or piece of equipment being acquired has a lifetime that extends beyond the year of purchase and it is a capital asset or long-term investment for the hospital. Capital assets are good financial investments for the organization. (Finkler, Ward, & Baker, 2007). The Electronic health record software system is one of the important operational priorities in the US healthcare.

The change from paper-based record system to electronic record system supported by technologies and help for reducing errors and improving quality of care based on best practice. (Song, McAlearney, Lausanne, Robbins, & McCullough, 2011). Research a capital purchase of software for filing patient records costing more than $5000 Health care organizations have invested heavily in computer technology. The health care organizations use computer technology and electronic health record in the actual delivery of care and to support clinical areas.

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The four principal uses of computers for nursing are for general information, clinical applications, research, and financial management. (Finkler, Ward, & Baker, 2007). The health care organizations are in the process of major transformation, and becoming more complex. It is very important to maintain the safety of patient and to provide high quality care. (Ting, Tsang, Ip, & Ho, 2011). The electronic health record system is considered as a means of technological efficiency to reduce the cost in healthcare organization.

The need for EHR in healthcare organization is based on certain evidences like, It supports guideline-based care, increased patient monitoring, act as an efficient technological tool for effective communication in areas related to patient care, and improves coordination of care(Song, McAlearney, Lausanne, Robbins, & McCullough, 2011). The electronic health record system act as an easy access for medical literature and it is considered as a fast access system due to the effective utilization of information technology and enhances the healthcare efficiency system. Hillestad, 2005). Employee development The computer software and electronic health record advances will continue to evolve and that computer use by staff nurses will become commonplace in most healthcare organizations. In the long run this will likely increase the quality of patient care due to more accurate and timely information, while creating at least some efficiency in the use of nursing time. This should release more nurse time for patient care. (Finkler, Ward, & Baker, 2007). Computerization should work both to reduce nursing shortage and to increase nursing satisfaction.

The health care organizations struggle to allocate sufficient funds for information system implementation, maintenance, and upgrade. The computerization of the nursing units has been a potential solution for nursing shortage. (Finkler, Ward, & Baker, 2007). Management goals The EHR implementation and governance are related to each other and it is mainly focus on the mission, vision, and behavior related to the management. The decision and action from managers level management is very essential factor for the effective purchase of EHR. Jarvenpaa & Ives, 1991). The support system in the organization related to EHR implementation helps to support and motivate the employees in difficult situation related to the technical failure of the system. (Miller & Sim, 2004). The successful implementation of EMR depends upon the team and technology of the organization. Team refers to people and issues related with organization. The technology related to the choice of the software, hard ware, and design set up of the organization to meet the implementation process.

The main components of implementation process are people, process, and technology. The main focus of the change management is people and the related objective is to change the behavior for the acceleration of change process. (McCarthy & Eastman, 2010). Cost containment The software related Electronic health record implementation need to be appropriate for the needs of the organization and budget. (Swab, & Ciotti, 2010) The EHR software system has many areas of market depending upon the size of the hospital bed size.

The first criteria for the vendors according to the bed with 100 and small hospital The Electronic health record system cost about between $ 1 million and 2 for the electronic health record system The electronic health record software cost for the organization about medium hospital cost is much larger than the first one. It comes around three to ten million. The hospital and organization with more than average bed cost for the electronic health record system will be higher amount than the other one.

The cost and amount of electronic health record system will depend upon the size of the hospital . The management has to decide about the budget for the organization. (Swab, & Ciotti, 2010). The organization must evaluate its mission and goals in light of its particular strengths and weakness and in light of the demand for services and competition in the external environment. Based on that evaluation it can make a plan that will take advantage of opportunities like Electronic health record implementation according to the goals of an organization. (Finkler, Ward, & Baker, 2007).

The planning process explicitly address whether the implementation of new services and programs that make up the majority of operations of the organization are being retained at a steady-state level or whether they are to be contracted or expanded in scope. (Finkler, Ward, & Baker, 2007). The successful implementation of EMR depends upon the team and technology of the organization. Team refers to people and issues related with organization. The technology related to the choice of the software, hard ware, and design set up of the organization to meet the implementation process.

The main components of implementation process are people, process, and technology. The main focus of the change management is people and the related objective is to change the behavior for the acceleration of change process. (McCarthy & Eastman, 2010). The computerization of the nursing units has been a potential solution for nursing shortage. (Finkler, Ward, & Baker, 2007). Quality assurance The management of the organization need to review the costs of the software system related to Electronic health record implementation with users of the selection committee before the system demos.

The committee includes staff from clinical areas like pharmacy, radiology, laboratory, operating room, and emergency department. The committee needs to invite physician champions to participate and observe EHR system demonstrations before selecting the system. (Swab, & Ciotti, 2010). The management of the organization needs to clarify the all of the costs such as travel costs, training class tuition fees, files conversion fees, and other ancillary system fees with the vendors. Another factor need to consider while implementing Electronic health record system is the costs of additional staff required to operate the EHR system.

The organization need to consider adding the IT staff, Nurse informaticist, and Chief medical information officer. (Swab, & Ciotti, 2010). Once the plan has been finalized and formalized, it serves as a guide for a number of years. Long- range plans are typically prepared only once every three or five years. Creating a new plan each year would only lead to constant changes in the organization’s direction. This would lead to wasted efforts, and money. The long-range budgets or strategic plans look in general terms at the entire organization over a period of years. Finkler, Ward, & Baker, 2007). Program budgeting techniques are equally effective for reviewing the operations of an ongoing unit as for evaluating a new program like Electronic health record implementation. Business plans are becoming essential for the introduction of new programs. Such plans help managers complete a comprehensive examination of a proposed program. By making such a thorough review, the manager and the organization gain an in-depth understanding of the program as well as its financial implications for the organization. Finkler, Ward, & Baker, 2007). Patient care, clinical research, and leadership role The Electronic health record software system support efficient and good health care. Electronic health record improve the completeness and accuracy of patient records and they improve communication among health care professionals. (Hayrinen,Saranto, &Nykanen, 2008). The larger hospitals, especially academic medical centers with a high acuity case mix, may benefit from investing in Electronic health record adoption.

The hospitals with high patient volumes and with complex medical problems need to adopt Electronic health record as a capital asset for the organization. (MCcullough, Casey, Moscovice, & Prasad, 2010). Team refers to people and issues related with organization. The technology related to the choice of the software, hard ware, and design set up of the organization to meet the implementation process. The main components of implementation process are people, process, and technology. The main focus f the change management is people and the related objective is to change the behavior for the acceleration of change process. (McCarthy & Eastman, 2010). The monitoring of EHR implementation process mainly focused on areas like project costs, project progress, schedule controls, control changes, scope of the project, quality management, and risks. (Noblin, Cortelyou, & Ton, 2011). The EHR implementation is considered as a high-cost project. The management needs to consider and monitor equipment costs including hardware and software costs.

The workflow inefficiencies need to monitor and need to redesign during the implementation phase is an important step to overcome the failure. (Spector, 2010). The workflow reflects the ability of the employee to use the resources to complete the work in an effective manner to achieve better results and it also shows the efficiency of team work. (Lee, Cain, Young, Chockley, & Burstin, 2005). The EHR implementation requires strong leadership and all workers need to participate to deliver their own role for the success of the implementation process.

The redesigning process improves the work efficiency and job satisfaction. (Spector, 2010). The change from paper medical records to electronic medical record system improve the quality of healthcare, reduce the administrative cost, reduce medical errors, and decrease the unnecessary expenditures for the issues related to medical errors occur during paper charting. (Huryk, 2010). The electronic medical record system is considered as a means of technological efficiency to reduce the cost in healthcare organization.

The need for EHR in healthcare organization is based on certain evidences like, It supports guideline-based care, increased patient monitoring, act as an efficient technological tool for effective communication in areas related to patient care, and improves coordination of care(Song, McAlearney, Lausanne, Robbins, & McCullough, 2011). The electronic health record system act as an easy access for medical literature and it is considered as a fast access system due to the effective utilization of information technology and enhances the healthcare efficiency system. Hillestad, 2005). Research studies shows that the paper record system is inadequate to give all informations regarding patient to caregivers for the effective care. (Thakkar & Davis, 2006) The effective use of EHR minimize the problems related to healthcare disparities, allows the involvement of patients and their families in treatment plan, and maintain adequate privacy and security. (Podgurski, 2008). Computer uses for clinical care fall into two general areas. The first area is assement of patients.

This includes computers used in laboratories to measure blood levels, in radiology for magnetic resonance imaging, and for physical assessment measures such as blood pressure. The second clinical area is storage and management of patient information. Often called the hospital information system, these computer systems store data such as patient demographics, admission, transfer, and discharge information, and documentation of nursing care provided. (Finkler, Ward, & Baker, 2007).

Although clinical information systems are not directly related to financial management, data produced by these systems can be used to make financial decisions. Clinical systems are used to directly link the use of services to the billing for them. Ultimately, financial management is based on the allocation of resources; clinical information systems offer the manager data about the use of resources in the organization. Clinical information systems that combine information from a variety of sources such as laboratory, radiology, dietary, and nursing are called fully integrated systems.

In these systems the data are entered once and are accessible all over the organization with appropriate confidentiality precautions. These integrated systems improve the flow of information. (Finkler, Ward, & Baker, 2007). The implementation of EHR in healthcare organization is influenced by human and technological factors. The implementation process depends upon many factors starting from employee attitudes and concerns to various technology.

The main factors are readiness for the employee to accept the changes related to EHR implementation, resources available for the change, technical concern, availability of finance for the implementation of EHR, motivation of the employee, time, and ability of the individual to use computer for the effective implementation of EHR. (McGinn, Grenier, Duplantie, Shaw, Sicotte, Luc, Leduc, Legare, & Gagnon, 2011). The managers need to take interventions to overcome the factors influencing the implementation process early in the planning stage. (Spector, 2010).

The budget development in the initial phase of change process reflects the initial cost and all other related expenses of an electronic health record system. The hardware expense needs to be classified on a yearly basis. The organization need to consider the cost of upgrading the hardware and software system to maintain the efficiency of the system. The cost for the replacement of hardware and maintenance of the computer need to be considered. The Information System Success Model evaluation measures the quality and technical achievement of the system.

The system quality depends on the elements like reliability, accessibility, and security of the system. (Delone, & McLean, 2003). The user satisfaction level needs to be evaluated because it reflects the level of competency, skills, and experience of the users. The overall measurements include quality of care in terms of patient safety, and effectiveness of care, accessibility of care, and productivity. ( Lau, Hagens, &Muttitt, 2007)The implementation process requires skilled people in areas like computer networking, informatics, administration, management, and clinical workflow.

The monitoring and controlling of the proper utilization of the resource specialist will help for the cost management. (Wang, 2003). Consultant packages The consultant from outside the organization for any change process need to be assessed, monitored, and controlled as per the organizational policy and management decision. The health care organization may need assistance from outside consultants for the effective implementation of EHR and that will cause an extra cost for the implementation process and the management need to monitor the necessity of the consultant for the process. Noblin, Cortelyou, & Ton, 2011). The quality assurance of the Electronic health record software system can be done by the evaluation process. The evaluation process need to focus on certain elements like care, human, educational, administrative, technical, and social aspects. (Shaw, 2002). The care aspect of evaluation consists of monitoring the quality of care, continuity, system acceptance from patients and other professionals. The evaluation of organizational aspects mainly focuses on examining the interconnection between different care providers in different settings. (Shaw, 2002).

The educational aspects of evaluation focus on the quality of the information system for the retention of the staff, training of employees, and user satisfaction related to EHR implementation. The administrative aspect of evaluation addresses the changes related to EHR implementation and the after effect on health care services and mainly focus on areas like access to care, interactions between clients and health care workers, and changes in cost effectiveness related to new electronic system. The technical aspects of evaluation measure the technical quality, reliability, and security of the settings.

The social aspects of evaluation focus on the changes in the level of social interaction after the implementation of new system. (Shaw, 2002). The other measurement strategies include evaluating the output of new system by reviewing employee satisfaction and user satisfaction. The organization need to conduct post go-live reviews after the implementation process to assessment of system. Conclusion The Electronic health record software system is one of the important operational priorities in the US health care and it should be capital assets for the organization.

The health care organizations that are decided to purchase an Electronic health record system should always search for the software system with right vendors, share the costs with selection committee members, and need to think about the costs of additional staff members required to operate the software system. (Swab, & Ciotti, 2010). The other measurement strategies include evaluating the output of new system by reviewing employee satisfaction and user satisfaction. The organization need to conduct post go-live reviews after the implementation process.

The successful implementation requires teamwork and effective communication technique between the vendors, health care staff, management, administration, and outside consultants. The health care organization may need assistance from outside consultants for the effective implementation of EHR and that will cause an extra cost for the implementation process and the management need to monitor the necessity of the consultant for the process. (Noblin, Cortelyou, & Ton, 2011). References Delone, W. H. , & McLean, E. R. (2003). The DeLone and McLean Model of Information Systems Success: A Ten-Year Update.

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Health Affairs, 29(4), 647-654. McGinn, C. A. , Grenier, S. , Duplantie, J. , Shaw, N. , Sicotte, C. , Luc, M. , Leduc, Y. , Legare, F. , ; Gagnon, M. (2011). Comparison of user groups’ perspectives of barriers and facilitators to implementing electronic health records: a systematic review. BMC medicine, 9(46), 2-10. Miller, R. H. ,Sim,I. (2004). Physician’s use of electronic medical records : Barriers and solutions. Health Affairs, 23(2),116-126. Noblin, A. M. , Cortelyou, K. W. , & Ton, S. (2011). Electronic Health Record Implementations- Applying the Principles of Monitoring and Controlling to Achieve Success.

The Health Care Manager, 30(1), 45-50. Podgurski, S. A. (2008). Finding a cure : The case for regulation and oversight of electronic health record system”. Harvard journal of law and technology, 22(1), 107-110. Shaw, N. T. (2002). ‘CHEATS’: a generic information communication technology (ICT) evaluation framework. Comput Biol Med, 32(3), 209-220. Song, P. H. , McAlearney, A. S. , Lausanne, E. F. , Robbins, J. , & McCullough, J. S. (2011). Exploring the business case for ambulatory electronic health record system adoption. Journal of healthcare management, 56(3), 169-180.

Spector, B. (2010). Implementing organizational change: Theory into practice (2nd ed. ). Upper Saddle River, NJ: Prentice Hall. Swab, J. , Ciotti, V. (2010). What to consider when purchasing an EHR system. Health care Financial Management, 64(5), 38-41 Thakkar, M. , & Davis, D. C. (2006). Risks, barriers, and benefits of EHR systems: A comparative study based on size of hospital. Research Journal in Health Information Management, 3(5), 10-12. Wang, S. (2003). A cost-benefit analysis of Electronic medical records in primary care. American Journal of Medicine, 114(5), 397-403.