Electronic Health Records


Change programs was managed as project; clearly setting out the scope, the objectives, success factors as well as the organisation of the program to deliver its objectives. The project management team was skilful and had a good experience in managing projects of electronic health records.

The change management methodology encompassed the following stages:

Initiate Change Project: The Electronic health record system was run as a project with change managers. The change managers had project management skills. The board headed by the owner was responsible for managing the progress of the entire change project. There were a common understanding and commitment to the need for change among team members.

The change was necessary and urgent, and the benefits of change were explained: The present paper system was to be replaced with an electronic health record system. The top issues related to the change were, training and further familiarization with the E.H.R-System.

Business benefits EHR-System::

  1. Reduce healthcare costs; effective way to avoid duplicating expensive imaging procedures, and reduction of medical errors.
  2. Improve the quality of care: It is claimed to help reduce medical errors by providing healthcare workers with decision support. Fast access to medical literature and current best practices in medicine are hypothesized to enable the proliferation of ongoing improvements in healthcare efficacy.
  3. Promote evidence-based medicine: EHRs provide access to clinical data for research that can accelerate the level of knowledge of effective medical practices.
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The reason for improvement was clear and benefits were measureable. Moreover the project was within clinic's fund limits.

Building Change Momentum:

The co-operation and pro-active support of stakeholder was important. Essential Stakeholders and sponsors were identified and their level of influence assessed and mapped through stakeholder analysis. Workshops were conducted to address the issues and stake holder agreed to support and commitment. There was a good communication and common understanding amongst the stakeholders about the degree and scope of change needed.

.MIR was appointed as the key players in the change program and was clear on his and responsibilities.

Developing Change Strategy

There was a clear and detailed vision of the future. The change vision was aligned with the organization's strategy of continuous improvement. It involved key stakeholders in defining and detailing the change vision. Again, workshops were conducted in developing the change strategy. High-level benchmarking was conducted to identify best practices, reference sites and competitor information.

Change planning:

The change vision was defined by key stake holders and readiness of organization was assessed.

The business analyst team reported that the desired change was acceptable and the will be appreciated by the concerned organization and health regular bodies. Also that organization had strength to effectively manage the team with positive outcome.

The organization was ready for the change to the degree as identified by key stakeholder.
Change is underpinned by a state of transition. It is important that we know the difference between change and transition:

Phase 1: denial

None of the stake holder was in denial phase, as all were aware that change was real.

Phase 2: resistance

All the team member were clear that, a very few among patients concerned about the data safety of medical records. They were shown the demonstration that their records were safe and new system of safety will be in practice

Phase 3: exploration

Few members of the team and majority of patients were anxious how they will respond to this new change. Many of them after coaching stopped arguing with the change but begun to ask how to make it work.

Phase 4: commitment (seeing it through)

After repeated workshops and brainstorming sessions and High level benchmarking data, almost all the stake holders reached this phase of commitment and were thinking of actions to take to master the new ways. In this phase all were firmly connected to the future. The change board was satisfied that organization was ready for the change

All elements of the change program were analyzed, designed and planned. The output of this stage was the change program plan.

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The change program plan identified the activities to be carried and a definition of who does what and in what time-scales.

Role and responsibilities

Risk Assessment

Change managers conducted the risk assessment and were fully aware and understood the challenges and anticipated some of the problem project might face. The team made every effort Safeguard change project objectives, schedule, and cost and prevent surprises.

All stakeholders were involved in risk identification. Especially people at the operational level were of great help in risk assessment analysis.

Win Commitment to Change

Change was determined as its actions were consistent with the change vision. Therefore, effective Stakeholder and Communications Management are vital components of winning commitment to and delivering change. Ongoing effectiveness was traced through Staff Surveys.

Stakeholders were managed on an on-going basis. Communication was established through weekend updates, emails, letters and also mobile phone msgs.

A large part of winning commitment is also about managing change resistance.
Questionnaire and staff satisfaction surveys were quite effective in determining the views of employees and allowed people to voice their opinions about the change program.

Role of change agent was vital.

Deliver Change

delivering change is the crux of the change management program.
Change is realised when it becomes the normal way of working, this requires proof that performance has improved and will continue in the future.

Quick wins were identified in the forms of electronic health records being printed and stored in one location. That saved time and efforts that were used in compiling paper records.

Senior management communicated results delivered through quick wins to the organisation.

The quick wins increased the momentum and also early positive feedback was also t was very encouraging essential for the on-going success of a change management program.

First milestone was celebrated after feedback was very positive.