Nt1330 Unit 3 Assignment

Unit 5 Assignment: Implementing systems
Sabrina Hill
Information Technology & Systems for Healthcare
HI300-01 Professor Sweet
June 23, 2013

IMPLEMENTING SYSTEMS
When implementing an EMAR/BC-MAAR in acute settings; the user must first have a clear understanding what this system and devices have to offer. Followed by the objection versus the technical support in a medical setting; understanding the system is a basic support system of many functions. Most ambulatory care environment (LaTour, Eichenwald-Maki, & Amatayakul, 2011).When an organization chooses to use the E H R system, they usually convert the existing information while incorporating new information (LaTour, Eichenwald-Maki, & Amatayakul,
2011).Addressing the organizations applications and carefully implementing the new (LaTour, Eichenwald-Maki, & Amatayakul, 2011).The factors to consider when implementing an E H R system are to consider the overall goal of the system. The overall goal is to tap the operational systems for the clinical information (LaTour, Eichenwald-Maki, & Amatayakul, 2011).Thus, meaning the natural enhancement of the operational functions upon the clinician entering the health information (LaTour, Eichenwald-Maki, & Amatayakul, 2011). Once the health information is entered into the system, it is then the system’s duty to provide clinical support and decisions and improving the safety and quality of care of the patient (LaTour, Eichenwald-Maki, & Amatayakul, 2011).
When the organization takes the next step to implementing the system they must consider the following factors. Is the organization ready for the system, and are all clinicians including Physicians comfortable with the system and the overall goal. First factor to consider, will the system come from a different vendor or will the organization stick with the available finances and the administrative support. This is also called the best-of-fit strategy and may be weak because the vendor may not be compatible with the data and changes made to the system. When changes come in, the system must be able to connect to other systems to receive other data. Which also makes it difficult in implementing a system when the best-of-breed strategy is used; this strategy is can cause problems because it may not be easy to integrate the data to other systems (LaTour, Eichenwald-Maki, & Amatayakul, 2011).Overall, the “best-of-fit” strategy provides low services and designed to use low cost (LaTour, Eichenwald-Maki, & Amatayakul, 2011).Today, the rip and replace strategy is most common. The organizations are getting rid of old systems and replacing them with new systems (LaTour, Eichenwald-Maki, & Amatayakul, 2011).
Other factors include the Physician and the use of the COPE system. The issue with organizations, is when to use the system (LaTour, Eichenwald-Maki, & Amatayakul, 2011).Not knowing when to use the system; in the beginning or end of the implementation of the E H R system (LaTour, Eichenwald-Maki, & Amatayakul, 2011).With patient safety a big concern, the system is often implemented from the beginning (LaTour, Eichenwald-Maki, & Amatayakul, 2011).There have been considerations of whether or not, nurses should adopt a BC-MAR system prior to the Physician starting a COPE system (LaTour, Eichenwald-Maki, & Amatayakul, 2011).This scenario may make the nurse available to support the Physician and share what they have learned (LaTour, Eichenwald-Maki, & Amatayakul, 2011).Nurses using the BC-MAR system may also be able to support the decision if the COPE is really needed for that particular organization (LaTour, Eichenwald-Maki, & Amatayakul, 2011).
Other factors in implementing the overall system, and may also include the technical end as well. The infrastructure may also play a role in whether or not to install a system. For example, what some people believe to be most important in implementing the E H R system. Some say clinical data repository or best-of-fit approach again. The overall effective method to running systems, are to replace some existing operational systems, and enhancing the technical infrastructure (LaTour, Eichenwald-Maki, & Amatayakul, 2011).This process is believed to be the best for new clinical systems (LaTour, Eichenwald-Maki, & Amatayakul, 2011).After gaining a brief understanding of the E H R system; the user must look into other functions that support the system. One function is bedside barcodes.
Bedside bar codes are referred to as EMAR/BC-MAAR; they are a device that has similar abilities as the E H R system.
The device or system supporter has many functions, these function are to allow the clinician to be have portable access to health information about a patient. This device can cover safety about medication administration, and for billing purposes. Most hospitals use them today and the hospital bracelets are tagged with a bar code on them. Hospitals and other organization need to consider the challenges that may be faced using this kind of device; the hospital must already have a COPE system installed. Having the COPE system already installed means that the medication information would not need to be entered manually. The COPE system would take care of most of the medication business for the clinicians (LaTour, Eichenwald-Maki, & Amatayakul, 2011).The device also depends on the ability to detect barcodes of medication bottles (LaTour, Eichenwald-Maki, & Amatayakul, 2011).The bar codes must also be present on the medication bottles in order to receive data on the dosages or calculations (LaTour, Eichenwald-Maki, & Amatayakul, 2011).In fact, the FDA has required that all medication bottles have bar codes on the bottle. Having the barcodes on the bottle, will give the clinician information about the drug. Use of this device can be a big challenge for smaller hospitals because purchasing drugs by unit is very expensive (LaTour, Eichenwald-Maki, & Amatayakul, 2011).Lastly, not all drugs are easy to scan the barcode. For example, multiple IV bags that may be used in intensive care, are difficult to scan by unit (LaTour, Eichenwald-Maki, & Amatayakul, 2011).Another challenge may include the names of the drugs; they may not be the same has the names in the pharmacy (LaTour, Eichenwald-Maki, & Amatayakul, 2011).This is a problem because the pharmacy uses a system that brings up the drug name, serial number, and manufacturer for example (LaTour, Eichenwald-Maki,
& Amatayakul, 2011).The clinician may use medical terminology that is relevant to the situation making it more difficult to interpret (LaTour, Eichenwald-Maki, & Amatayakul, 2011).
Another challenge that clinicians face using the device is the medical errors that may occur. Medical errors on the device may be adverse drug event which is an actual error in medication management (LaTour, Eichenwald-Maki, & Amatayakul, 2011).Near-miss, is something that could have happened but did not. A near-miss situation is an example of a patient with an allergy and receives the medication but has no reaction to the medication (LaTour, Eichenwald-Maki, & Amatayakul, 2011).The system may be able to identify these errors (LaTour, Eichenwald-Maki, & Amatayakul, 2011).Other errors have occurred in using the system such as over scanning a bar code (LaTour, Eichenwald-Maki, & Amatayakul, 2011).the clinician should consider changes, education, equipment use, any technical problems, and reporting results during a medical error (LaTour, Eichenwald-Maki, & Amatayakul, 2011).

References
LaTour, K., & Eichenwald-Maki, S. (2009). Information Technology & Systems for Healthcare (3rd ed.). Chicago, IL: AHIMA