Successful Introduction of an Emergency Department Electronic Health Record

Douglas Propp

doi:10.5811/westjem.2012.1.11564

Abstract

Our emergency department had always relied on a paper-based infrastructure. Our goal was to convert to a paperless, efficient, easily accessible, technologically advanced system to support optimal care. We outline our sequential successful transformation, and describe the resistance, costs, incentives and benefits of the change. Critical factors contributing to the significant change included physician leadership, training and the rate of the endorsed change. We outline various tactics, tools, challenges and unintended benefits and problems.

Highlights

IntroductionWith 60,000 annual visits, our clinicians had always relied on a paper medical record
In our suburban, academic, emergency department (ED)with 60,000 annual visits, our clinicians had always relied on a paper medical record
The financial costs for Electronic Health Record (EHR) implementation were assumed by the hospital, which sponsored the new enterprise-wide information system (Cerner FirstNet) rather than an ED-niche application alternative

Summary

Introduction

With 60,000 annual visits, our clinicians had always relied on a paper medical record. The catalyst for our Electronic Health Record (EHR) adoption was a desire to be “state of the art” with the latest technology, enhanced efficiency for the clinicians and improved documentation, while providing high quality patient care.[1,2] We were invited to be the first site within the hospital with a fully integrated EHR. The financial costs for EHR implementation were assumed by the hospital, which sponsored the new enterprise-wide information system (Cerner FirstNet) rather than an ED-niche application alternative. All of our clinicians (physicians, nurse practitioners, nurses) use the EHR beginning with the initial nursing triage assessment and note. The focus of this article is how our emergency physicians (EP) assimilated this technology and process improvement into their customary work flow

Objectives

Findings

Discussion

Conclusion