| 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/Usability | Not 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 definition | Define Optimisation – Continually fine-tuning and improving your product to make it more usable and more efficient for end users | Not 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 | |