Martinella Community Hospital implemented a new clinical Electronic Health Record system nearly one year ago and retired their manual systems. After several problems and many complaints from physicians and staff the administrator decided to “pull the plug” on the system after the medical staff refused to use the system. Physicians made nurses print out everything so they could manually review documents and wrote out physician orders and notes asked the nurses and medical scribes to enter the orders and notes manually in the CPOE and progress notes sections.
Some physicians had tried to use the system, but found it to be too confusing, time consuming and unreliable Other the system would go down for 4 and 5 hours at a time requiring patient care to have to fall back on manual records, basically 2 system had to be maintained to safe guard the patient care. The excess amount of down time was also creating significant overtime costs for the IT department since no maintenance contract was included in the systems contract.
The HIM Department have been having patients and outside requesting parties complain about the excessive delays in getting patient information and are threating to contact OCR regarding HIPAA violations of time delays. When the HIM Department’s ROI division tries to print out PHI reports to complete ROI requests the copies look more like screen prints with some areas unable to be read. They are having to prepare transcripts and abstracts for all requests costing hours and hours of overtime in the HIM Department.
This system was the “brainchild” of Dr. Smith. He is a retired cardiac surgeon who went into business with a group of other retired physicians and software developer to create this clinical EHR system that he offered the hospital at a significant discount. Unbeknown to the facility, this system was still untested when it was implemented nearly a year ago. Dr. Smith and his “team” where the ones who controlled the implementation of the system. There was no input from anyone else in the facility other than the IT Department regarding hardware installation. The screens are cluttered, not flowing for ease of data entry, difficult to use and have no data quality built in. The system will not be in compliance with Conditions of Participation, state licensing and HIPAA requirements until their next version due in 6 months or more.
The HIM Director, the Assistant HIM Director (which your role), physicians, nursing staff and other clinical direct care providers learned about the system only 3 weeks prior to implementation and Go Live. The only training physicians received was a demonstration at the quarterly Medical Staff Meeting. Nursing and other clinical staff were given 3 hours training 2 weeks prior to implementation and system go live. The HIM Director was so upset with being left out of the loop that she resigned leaving after only 4 days’ notice. The hospital Board of Directors have terminated the administrator and have involved their legal counsel to deal with Dr. Smith and his group. An interim administrator has been placed at the hospital by the Board. He has asked the new HIM Director, who has just started to prepare a fact-finding analysis of this issue. She has asked for your help since you’ve been here and have been working with this system. Here are the questions she has asked you to prepare a summary for her to take into the meeting with the new administrator and the Board of Directors.