Research questionsCodes (110)Comments
1) What do hospitals do with implemented EHR systems to demonstrate the benefits of the deployed systems and to meaningfully use the systems?Characteristics post go-live – Clinicians dealing with inefficiency
Characteristics post go-live – Clinicians feeling burden of documentation
Characteristics post go-live – Cognitive overload for end users
Characteristics post go-live – Dissatisfaction of end users
Characteristics post go-live – Expectation pre go-live
Characteristics post go-live – Experiencing integrated system
Characteristics post go-live – Increased time to document
Characteristics post go-live – Informatics people workload change
Characteristics post go-live – Little/No focus on optimisation
Characteristics post go-live – Nurses over-charting/under-charting
Characteristics post go-live – Poor documentation
Characteristics post go-live – Requests increase exponentially
Characteristics post go-live – Working on increasing users’ proficiency with EHR
Optimisation processes – Adoption to standardisation
Optimisation processes – Adoption to standardisation – Standardising physician ordering
Optimisation processes – Effectively tracking metrics
Optimisation processes – Forming committees/teams/groups
Optimisation processes – Getting to/Maximising ‘model’ or ‘foundation’ system
Optimisation processes – Improving documentation
Optimisation processes – Improving outcomes
Optimisation processes – Improving patient care quality
Optimisation processes – Improving physician/end user adoption of EHR
Optimisation processes – Increasing efficiency – General
Optimisation processes – Increasing efficiency – Making workflow more efficient
Optimisation processes – Increasing efficiency – Minimising time with EHR
Optimisation processes – Increasing efficiency – Right data at right time
Optimisation processes – Increasing safety
Optimisation processes – Meeting regulatory requirements
Optimisation processes – Optimising practice/process/workflow
Optimisation processes – Prioritising/validating requests/identifying requests & opportunities
Optimisation processes – Realising ROI, value, cost-savings
Optimisation processes – Smarter decision support
Optimisation processes – Smarter decision support – Outcome-focused by driving actual intervention, not simple alerts
Optimisation processes – Stabilising the implemented EHR
Optimisation processes – Thoughtful change management
Optimisation processes – Upgrade and implementing/building new features/modules
Optimisation processes – Using data in EHR
2) What advancements are hospitals making, post go-live, by leveraging the implemented EHR?Results of optimisation – Capturing more core measure reporting
Results of optimisation – Improved clinical outcome
Results of optimisation – Improved collaboration
Results of optimisation – Improved compliance to best practice
Results of optimisation – Improved documentation/charting
Results of optimisation – Improved efficiency
Results of optimisation – Improved EHR system
Results of optimisation – Improved practice/process/workflow
Results of optimisation – Improved quality of care
Results of optimisation – Improved safety
Results of optimisation – Improved usability
Results of optimisation – Increased end user/physician satisfaction
Results of optimisation – Increased patient satisfaction
Results of optimisation – Less training required
Results of optimisation – Little improvements in clinical care
Results of optimisation – Reduced burden of documentation of clinicians
Results of optimisation – Reduced time spent with EHR
Results of optimisation – ROI, value, cost savings
3) Are there any pattern(s) of optimisation processes in hospitals and, if so, what are they specifically?Principles governing optimisation prioritisation – Efficiency/UsabilityNot limited to these codes only
Principles governing optimisation prioritisation – Process Improvement
Principles governing optimisation prioritisation – Quality
Principles governing optimisation prioritisation – Regulatory requirements
Principles governing optimisation prioritisation – ROI
Principles governing optimisation prioritisation – Safety
Misc. – Converging of clinical, administrative, and financial data
Perspective – Not IT project but organisational project
Perspective – Outcome oriented, beyond successful implementation
4) What are barriers and facilitators to optimisation?Barriers – Bureaucratic process and/or multiple layers of approval
Barriers – Complexity of EHR
Barriers – Difficulty in engaging end users
Barriers – Lack of coordination between requests
Barriers – Lack of standardised practice/process/policies
Barriers – Limited resources
Barriers – Misunderstanding optimisation as IT project
Barriers – People, resistance to change
Barriers – Poor communication/channel to connect IS
Barriers – Reaching consensus among stakeholders
Barriers – Technically not possible to make it happen
Barriers – Time
Facilitators – Advisory/executive committees/councils/groups
Facilitators – Connection with users & business owners face-to-face/indirectly
Facilitators – Culture of organisation driving improvement
Facilitators – Dedicated resources/Commitment
Facilitators – Demonstrating value in optimisation
Facilitators – Engaging operation/leadership
Facilitators – Engaging super users, end users, physicians
Facilitators – Good timeline to train users, not rushing
Facilitators – Identifying champions
Facilitators – Informatics people
Facilitators – Organisational change (e.g. leadership change)
Facilitators – Process improvement engineer
Facilitators – Regular meetings
Facilitators – Regulatory changes
Facilitators – ROI
Facilitators – Setting specific vision aligned with the organisation’s goals/strategies
Facilitators – Supportive leadership
Facilitators – Usability test
Facilitators – User training/learning/education
Facilitators – User’s needs
Advice – Important to plan and execute optimisation
Advice – Keep learning and open to changes
Advice – Learning/networking other organisations who have done
Advice – Partnership with vendors
Advice – Putting dedicated resources for optimisation
Advice – Support clinical workflow, not dictate
5) Overall understanding of EHR optimisation including its definitionDefine Optimisation – Continually fine-tuning and improving your product to make it more usable and more efficient for end usersNot limited to these codes only
Define Optimisation – Continued process by nature, always working progress
Define Optimisation – Finding a balance within limited resource while not overwhelming the clinician with change
Define Optimisation – Having a seamless health information records
Define Optimisation – Improving efficiency of clinician’s practice
Define Optimisation – Increasing efficiency
Define Optimisation – Increasing end-user satisfaction
Define Optimisation – Usability, more usable for end users