Choice of the HIT system
The HIT system chosen for review is the ‘Aprima EHR’ system which is a complete healthcare package solution offering both practice management and revenue cycle solution. Aprima which uses the SNOMED CT type of vocabularies, offers an intelligent navigation for clinical operations that are based on current symptoms, the diagnosis and the preferred treatment and management (Aprima Inc., n.d.). The system is well integrated and allows the users to work from anywhere regardless of whether there is an internet connection. The system also includes a mobile application that allows users to use Aprima on gadgets such as phones and tablets making it easier to operate as compared to other applications in the market currently. For the personal computer versions, Aprima can be operated using different operating systems (OS) including Windows (7, 8 and 10) as well as the Mac OS and an agonistic OS which is web based (Aprima Inc., n.d). The Aprima EHR is used by several facilities including the Christian Hospital, SSM St Joseph Health Center and the Delaware Health Information Network.
Medical data analysis software
Phases of the HIT Systems Life Cycle
The life cycle of Aprima begins with the analysis of the needs of a healthcare organization with the aim of identifying the user needs and also the functions that a developer must integrate into the system. The completion of the analysis process yields a functional requirement document that is used to cross check the system during the integration and testing phases (Jha, 2010). The planning aspect of the system cycle includes development of a plan on which the project is implemented and also outlining the principles of acquiring resources required for the implementation of Aprima EHR.
During the design stage, the focus is to transform the user requirements into detailed functions in the system. The phase is more focused on ensuring that Aprima can deliver the required functionality as per the user. The developers ensure that they provide a prototype that can be easily modified to the needs of the users change over time (Persell et al., 2011). During the design phase, Aprima makes the determination of the output requirements that as per the users’ requirements with the choices ranging from custom reports that are electronic or those that are paper based (Aprima Inc., n.d). The input requirements are also defined at this stage with the users choosing between the voice and keyboard inputs. Aprima allows users to combine the different methods for input based on the needs of various departments. At the design stage, Aprima also determines the controls and backups as well as other security functions and recovery in case of a system failure.
Implementation and Evaluation
During this stage, Aprima focuses on converting the existing platforms to meet the functions requested by the users. The phase also consists of actions that are aimed at converting the existing equipment to meet the functional elements that are required by the Aprima system such as computer specs. The implementation phase also includes the training functions of the processes involved to ensure that the target hospital can make use of the available functions of Aprima. During this phase, the system is also audited to determine if all the functions are being utilized as required while at the same time lying ground for the contact persons who will be responsible for the maintenance process (Persell et al., 2011).
Medical Maintenance and Support
Aprima also offers the required maintenance and support as required to ensure that EHR systems remain functionally reliable. During the phase, the user groups are determined, and the issues that arise among these user groups are communicated to evaluate the required support (Romano & Stafford, 2011). The maintenance and support functions are also used to evaluate the arising issues such as data losses and make the required plans to ensure that the hospital operations are not affected.
Elements for Needs Assessment
The needs assessment when implementing the Aprima EHR mirrors that of other systems that are available in the market. First, there is a need to ensure that the system meets the criteria of being patient-centered which are critical in ensuring that all the information obtained and documented feeds into the objective of improving the quality of care (Jha, 2010). The system also needs to foster teamwork and collaboration as seen in the continuity of documentation as seen in the Aprima system where different staffs can document their work at various point during the delivery of services without losing continuity of care and the final report. The ability of the Aprima to integrate with other system has also been upgraded with the integration of “Note Swift” which significantly reduces the time spent in the documentation procedures as the inclusion lead to the use of clicks as opposed to typing (Aprima Inc., n.d).
Medical Product Selection Strategy
The product selection is based on the ability of Aprima to meet the needs of the healthcare organization. The first criteria inform the selection strategy is the ease of use as evidenced by the ability of the system to save on time while still ensuring that the staffs can document the most important aspects of their care (Menachemi & Collum, 2011). The informatics included in the system play a critical in the selection strategy as these determine if the Aprima adopts an approach that supports evidence-based care practices. The adoption of the evidence-based approaches into a system plays an integral role as these determine the level of quality care that is achieved in the delivery of care. The safety of the EHR is also a critical aspect of the product selection strategy given that patient information needs to be treated with the highest level of confidentiality (Romano & Stafford, 2011). The quality improvements that are required for the maintenance of the EHR system are also determinants of the selection strategy as there is need to evaluate the levels of integration of Aprima with existing systems in a specific organization.
Potential Training for Users
Aprima offers several training options for the users based on their needs and the skills in the organization. The basic training begins with the web-based training that is carried out in the pre-implementation phase focusing on the meaningful use of the system, the CQM functions and also the product features for non-technical staff (Menachemi & Collum, 2011). The non-technical staffs are trained on how to use the different functions that are designed for their different work areas such as clinical management, accounting, and other records. The technical staffs are offered training on how to unlock different features of the system which allows the organizations to control the roll out of the system based on their emerging needs to reap maximum benefits and also ensure that the implementation of Aprima is less destructive to the existing platforms. Whenever Aprima introduces an upgraded version of its product into the market, it offers some training to ensure that users are in a position to take utilize all the new functionalities which are integrated into their systems.
Errors in medication are often associated with illegible handwriting and unclear abbreviations on prescriptions. With the constant adoption of information technology, using abbreviations in drug data libraries as well computer entry screens will constantly threaten the safety of patients. The most common abbreviations that often result in errors include ‘QD,' which means ;once daily; and accounts for 43.1% of all errors, followed by ;U,' which represents ‘units,' at 13.1%, and ;MS; or ;MSO4; meaning ;morphine sulphate.' Incorrectly placed decimal points also contribute to medication errors.
Various negative results can develop as a result of lapses in communication that originates from such common error-prone abbreviations. For instance, errors from prescribing medication have the propensity of being perpetuated and can result in harm to the patient when scheduling instructions are not clear. Additionally, improper dosage might lead to sub-therapeutic drug level that might contribute to treatment failures, drug failure or increased hospital stay.
Aprima Inc. (n.d.). Aprima EHR, PM, RCM: About the Aprima medical software. Accessed at: www.aprima.com
Jha, A. K. (2010). Meaningful use of electronic health records: the road ahead. JAMA, 304(15), 1709-1710.
Menachemi, N., & Collum, T. H. (2011). Benefits and drawbacks of electronic health record systems. Risk Manage and Healthcare Policy, 4, 47-55.
Persell, S. D., Kaiser, D., Dolan, N. C., Andrews, B., Levi, S., Khandekar, J., ... & Baker, D. W. (2011). Changes in performance after implementation of a multifaceted electronic-health-record-based quality improvement system. Medical care, 49(2), 117-125.
Romano, M. J., & Stafford, R. S. (2011). Electronic health records and clinical decision support systems: impact on national ambulatory care quality. Archives of internal medicine, 171(10), 897-903.