Improving the Quality of Health Care and Patient Satisfaction through EHR Systems
Instructions:
You have been hired as a consultant for ABC Hospital to improve the quality and increase patient satisfaction using innovation and information systems. ABC Hospital has already invested $12M in implementation of a new EHR but this has not improved customer satisfaction. Your job is to do an analysis of the patient experience and identify opportunities for improvement by evaluating the current state of the patient portal, customer satisfaction results, cost transparency, and the electronic transition of care between settings. You will see several documents attached to help with your analysis.
You may need to conduct some mock interviews and make some assumptions. Just remember that results of these have to be documented as appendices.
Applying what you have learned in class describe your approach in doing this review and the best practices that you may recommend. Also provide the organization with some strategic innovation that they should prepare to leverage in the next year or two to make a significant improvement in the patient experience. Be prepared to provide best practice examples to support your recommendation.
In the Powerpoint slides NEU Patient Exp Final.pdf the last section discusses the report and what is in a consulting report template. You are to provide a concise consultant report for ABC Hospital with recommendations.
The paper is to be no more than 2000 words in length, using general APA guidelines – MSWord, 12pt Times New Roman, double-spaced – which should end up being about for the main body of the paper. There should be a header on every page with your name, the course number and submission date. The paper should include a title page and references and citations (which are not included in the page/word count). Appendices and bibliography are not included in the page count of the paper. Please attach your paper as a MS document to the submission – NO PDF’s. Remember spelling and grammar count
HINF 6240 is the course number
Solution
Improving the Quality of Health Care and Patient Satisfaction through EHR Systems
Executive Summary
The effective implementation of an EHR
system in the hospital setting is fundamental for quality improvement and the
enhancement of customer satisfaction. The integration of the EHR in delivering
health care promotes the quality of care, safety, and efficiency and reduces clinical/medical
risks and errors. However, sometimes the implementation of such a system does
not achieve the intended results. The implementation of the EHR system in ABC
Hospital has not improved customer satisfaction. This report assesses the
Hospital system to identify the key issues for the development of efficient
recommendations. By applying a phenomenological study (qualitative research
method) that includes interviews and capturing the experiences and perspectives
of patients, this report outlines the major issue as poor implementation. It
identifies the key issues and outlines effective recommendations for enhancing quality
improvement and promoting patient satisfaction.
Introduction
The integration of innovation in improving the information system of a healthcare institution is essential for enhancing the quality of services. The quality, safety, and efficiency of the services and the institution influence patient satisfaction significantly (Prakash, 2010). The ABC Hospital considers the importance of integrating innovation for the improvement of its information system. Effective information system affects customer satisfaction. The recent implementation of a new EHR was supposed to influence improved percentage of customer satisfaction. However, the process seems ineffective in promoting satisfaction. This report focuses emphasis on developing better strategies for improving customer satisfaction. It looks into ABC’s information system, patient experience, the patient portal, cost transparency, and customer satisfaction results for opportunities for improvement. The in-depth analysis and comprehensive approach used in the development of this report paves way for the various recommendations. Implementing these recommendations will give ABC a chance to achieve quality improvement and enhanced customer satisfaction.
Assessment of the ABC EHR System
EHR systems allow the storage and retrieval of patient information for use by care providers, patients, and in the care setting. The integration of EHR in the information system of a hospital enhances clinical decision-making and improves the quality of services. According to Walker, Bieber, and Richards (2013), evidence shows that the application of EHR in providing care promises safer, effective, and quality services. The systems enhance monitoring, improving, and reporting data on the quality and safety of health care services. The accelerated adoption and implementation of the EHR in the recent past has promoted significant improvement in health care processes and systems. The technology improves patient satisfaction significantly. However, its implementation in ABC Hospital seems to have minimal influence in promoting customer satisfaction. The most probable cause of the minimal impact of the EHR is the ineffective implementation. Even when the company set $12 million for the project, there seems the necessary components for the effective application of the system to improve customer satisfaction were not considered. Integrating innovative approaches in the implementation of the system would guarantee improved customer satisfaction.
This report applies qualitative research approach to identify what inhibited the ABC Hospital from achieving success. The integration of the qualitative research methodology makes the identification of the key issues simpler, attaches credibility and accuracy to the research, and allows an analysis of patient experiences. To start with, the phenomenological study (a qualitative research method) of the patient experiences outlines the perceptions of the patients about the ABC’s EHR. The method involved information and data collection using interviews, observation, and information/data from the hospital. The integration of these techniques led to the finding that the EHR did not satisfy most patients. Additionally, most patients still felt that the EHR system did not play the purpose it was intended to play such as improving the quality of services, safety, and patient satisfaction. The analysis of the data and information received in the course of the study identifies the major issues and necessary measures for improved performance and patient satisfaction.
Key Issues
The implementation of the EHR system failed to consider various issues, which limited its influence and impact in improving health care quality and patient satisfaction. According to Hoyt and Yoshihashi (2014), the comprehensiveness of the EHR system determines its effect on patient satisfaction and in improving the provision of health care. One of the major issues identified was the ineffectiveness of the patient portal. Most of the dissatisfied patients mentioned the inefficiency of the patient portal as the major cause of their dissatisfaction. Some of the patients interviewed stated that response to communication through the portal was slow and dissatisfying. For instance, one of the interviewees asserted that she found sending messages through the portal slower and ineffective. Further, the portal poses a significant navigation challenge for sending messages, booking appointments, receiving results, and accessing health information. These challenges dissatisfied most users, who preferred navigating through the hospital site or physically.
Another key issue identified in the course of the study was the lack of cost transparency through the site and the portal. The EHR system implemented in ABC Hospital did not consider the concern of cost transparency, which influences satisfaction greatly. According to the 3rd interviewee, the portal presented costs inaccurately where the “reflection of costs for different medical examinations and tests was different from what was billed.” The system was not updated to show the most recent increment in the cost of certain services. This issues affected many patients especially those who used the portal and hospital site between November and December 2016. The lack of transparency resulted in numerous disappointments and dissatisfaction. There is a need for improving on this aspect to improve the efficiency of the system, the effectiveness of the portal and site, and the influence of the EHR system towards the improvement of patient satisfaction.
Further, the analysis of the customer satisfaction results show that despite the implementation of the EHR system the Hospital continue to record a poor customer satisfaction score. Most of the patient complain of poor doctor-patient communication, inefficient communication among staff, and seemingly demotivated staff. The 2nd interviewee states that, “the communication among clinicians seems inefficient since sometimes the concerns raised to one before the end of a shift are either ineffectively passed to the incoming clinician or not passed at all.” This shows the ineffectiveness of the EHR system in ensuring smooth electronic transition of care. Additionally, the 1st interviewee supports the 2nd but adds that “some of the care providers seem disinterested or unhappy in the delivery of services.” A rising and dissatisfying concerns is that these issue improve risks and clinical errors. Therefore, there is a need to address the concern by implementing the system efficiently to ensure good communication and improve satisfaction.
Recommendations An effective EHR system that is implemented well must deliver positive results in terms of quality improvement and patient satisfaction. Such a system, according to Health IT (2017), should offer various benefits that allow any hospital to offer better services and improve patient satisfaction. Some of the benefits that ABC Hospital will achieve rom implementing the system efficiently include the reduction of waiting time in making appointments, avoiding pointless tests and immunizations, enhanced communication between clinicians and patients, improvement of patient and clinician access to guidelines and clinical protocols, and a more collaborative care provision including teams. Additionally, the effective implementation of the system will enhance access and retrieval of health information, protect patient’s health information, and ensure effective management of prescriptions (Health IT, 2017). The achievement of these benefits will ensure that patients enjoy quality, safe, and efficient services. These aspects are the major determinants of patient satisfaction. As such, the Hospital will record improved customer satisfaction. However, the implementation of the following recommendations is necessary for attainment of success and the above benefits.
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The achievement of success in improving patient satisfaction requires the improvement of the EHR system. One of the best ways of achieving success in developing a system that appeals and leads to patient satisfaction is by involving the patient’s concerns, perspectives, and ideas (Merlino, 2017). The ABC Hospital must create a platform for collecting comments and gathering information from the patients. Integrating the needs and suggestions of the patients will ascertain success in developing an efficient system. For example, the patients complained of inefficiency of the portal in sending messages and communicating with the health care providers. It is important that the management of ABC considers improving the efficiency of the system by establishing a way of notifying specific departments and specialists if a request or communication is made. The portal should include departments and offices to enhance communication by ensuring messages go to a specific office mail or individual. This will improve response, facilitate efficient communication and, most importantly, improve customer satisfaction.
Source: http://4.bp.blogspot.com/-lhCnUriHyOY/TkAVsh3tzbI/AAAAAAAAAQU/jJ7etdCg6dw/s320/Figure1.jpg
The creation of different sections for the departments and specialist offices will promote the efficiency of the portal and site, thus an improvement in appointment scheduling and a reduction of waiting time. Currently, patients waste a lot of time waiting for response from the ABC EHR, especially on requests and scheduling of appointments. The integration of the EHR in such a way that requests made through the portal or site notify the intended office is important for minimizing time wastage. Customers want to make appointments with instantaneous immediacy. Interviews found that customers want to visit the ABC site or portal make an appointment and receive immediate response. Improving the portal using an integrated scheduling system will minimize the time used by customers waiting for response, reduce time used to respond, and promote appointment scheduling, which enhance customer satisfaction (Miner, 2014).
The improvement of the navigability of the site is essential for improving the experience of the customers. The navigation of the site and the Hospital portal should be easy and convenient to avoid time wastage and ensure efficient communication. According to the interviews and the customer satisfaction scores, the portal presents a challenge to new users who find it difficult to navigate. There is a need for its simplification to ensure that even groups that are not users of online platforms find it easy to use (Hoyt & Yoshihashi, 2014). For example, the different department should be group under Departments and have distinctions therein in case a customer who wants to access a specific department. The inclusion of the element in the EHR will improve its usability and promote customer satisfaction.
Moreover, there is a need for ABC Hospital to improve the system to integrate patient-created data. The miscommunication experienced in the hospital between clinicians and patients and between caregivers can only be solved with the improvement of the system so that patient-generated data can be incorporated into the system easily (Prakash, 2010). A patient should be given the platform, through the portal, to create data concerning the needs and health concerns as they arise while maintaining the identity to avoid mix up. The development of the system in this way will ensure that patients do not have to experience inefficiencies where there is poor communication between the caregivers. The development of the system to integrate the data will make transition efficient. These improvements will influence health care delivery positively. It will improve the safety, quality, and efficiency by reducing medical/clinical errors and risks. Enhanced communication will further make patients acknowledged as an important component of the team.
The system should create an effective platform for efficient longitudinal care provision and collaborative care delivery team. The improvement of the existing EHR system should focus on facilitating the delivery of longitudinal care and the involvement of teams in the provision of care. The poor transition is limited by the inability of the EHR system to ensure effective transition across settings. The EHR should be able to support care provision across different venues and times. The ABC Hospital HER system improvement must focus on making it efficient for capturing and managing structured data and though processes and uncertainties. The development of the system to accommodate these aspects will improve customer satisfaction significantly. This will occur as the patients receive quality and coordinated care from organized teams that communicate efficiently.
Moreover, the documentation contained in ABC Hospital’s system must align and support the caregiver’s cognitive processes in the course of documentation. Navigation through the information must be made as simple as possible and include hybrid notes. Additionally, the system improvement should focus on enhancing the EHR’s ability to collect and interpret data and analyse information coming from various sources. Most importantly, as Nelson, Batalden, Godfrey, and Lazar (2013) assert, the improvement of the EHR should focus on enhancing its ability to allow easy search for data and information. This improves the quality of care and enhances safety and efficiency. These aspects are critical for promoting patient satisfaction. Clearly, the implementation of this strategy will play an important role in promoting the efficiency of ABC, the quality of its services, safety, and patient satisfaction.
Conclusion
The ineffective implementation of
the ABC EHR system could not allow the achievement of significant success in promoting
quality and patient satisfaction. The system shows multiple weak areas that
must be improved for enhanced efficiency and patient satisfaction. The EHR
system must focus on reducing the waiting time, better management of patients,
improving communication, enhancing access to information such as clinical
guidelines and patient information by patients and team members, and allowing
patients to take part in decision-making. These will improve the quality of
care and customer satisfaction.
References
Health IT. (2017). How can electronic health records help me improve patient satisfaction? Retrieved from HealthIT.gov: https://www.healthit.gov/providers-professionals/faqs/how-can-electronic-health-records-help-me-improve-patient-satisfaction
Hoyt, R. E., & Yoshihashi, A. (2014). Health informatics: practical guide for healthcare and information technology professionals. Raleigh, N.C.: Lulu.com.
Merlino, J. (2017). How to Improve Patient Satisfaction Scores By Using Data. Retrieved from HealthCatalyst: https://www.healthcatalyst.com/how-cleveland-clinic-improve-patient-satisfaction-scores-data-analytics
Miner, L. (2014). Practical predictive analytics and decisioning systems for medicine: informatics accuracy and cost-effectiveness for healthcare administration and delivery including medical research. Amsterdam: Academic Press.
Nelson, E. C., Batalden, P. B., Godfrey, M. M., & Lazar, J. S. (2013). Value by design: developing clinical microsystems to achieve organizational excellence. San Francisco, California: Jossey-Bass.
Prakash, B. (2010). Patient Satisfaction. Journal of Cutaneous and Aesthetic Surgery, 3 (3), 151–155.
Walker, J. M., Bieber, E. J.,
& Richards, F. (2013). Implementing an Electronic Health Record System.
London: Springer-Verlag London Ltd.
Appendix
Interview Questions
- On a scale of 1 to 5 (1 – least satisfying to 5 – very satisfying), how do you rate the ABC Hospital in terms of satisfaction?
- How can you describe your experience using the ABC portal for the first time? Did you experience any challenge? If any, describe.
- How transparent is the institution in terms of costs? Kindly answer in regard to your use of the patient portal.
- How can you describe the overall communication between you and the clinicians? What about between the clinicians?
- What would you recommend that ABC changes in its EHR system, and why?
Some of the Interview Quotes
- The communication among clinicians seems inefficient since sometimes the concerns raised to one before the end of a shift are either ineffectively passed to the incoming clinician or not passed at all.
- Reflection of costs for different medical examinations and tests was different from what was billed.
- Some of the care providers seem disinterested or unhappy in the delivery of services.
- The portal is difficult to navigate, and that’s not all, communication over the platform is very poor. Trying posting a message and it takes minutes to hours to receive your response.