Acute and Ambulatory Electronic Health Record System Planning and Implementation


  • To develop measurable goals for Electronic Health Record (EHR) adoption and implementation
  • To formulate plans for change management and communication to the rest of the staff
  • To create specific work plan
  • To formulate a specific feature that will show if EHR is successful

Why the EHR Should Be Promoted

Successful implementation of the acute and ambulatory EHR system will develop hospital performance by improving the quality of health care delivery and deterring sentinel events. In addition, the rate of patients’ readmission and the cost of spending will be reduced significantly (Lammers, et al., 2016). This program will also enable the hospital to fulfill the stipulated Health Information Technology for Economic and Clinical Health (HITECH) Act.

PICO Question

In the acute and ambulatory care, does using electronic health records for patient care documentation improve hospital performance by reducing the rate of patient safety events, improving care quality, deterring sentinel events, reducing patients’ readmissions, and impacting spending within 7 months of big bang implementation?

The big bang approach will be utilized in implementing the EHR system. This method entails turning all the functioning system on, the sole means of documentation will be through the system. In this case, all the nurses, physicians, and other administrative support staff should be computer literate. The EHR steps for adoption will consist of pre-work, assessment, planning, EHR system selection, EHR system implementation, EHR post-implementation evaluation, and clinical system improvement consecutively.

The pre-work steps will involve performing ROI assessment, confirming commitment, selecting an EHR team, and reviewing the functionality of the program (Freytag et al., 2020). In the assessment phase, practice culture and the environment will be assessed if it is fit for change. In addition, the employees’ computer skills will be evaluated together with patients’ satisfaction. The assessment is then turned into action by creating documented plans for training needs, inventory, resource assignment matrix, and process improvement plan.

The staff training blueprint will consist of several plans, such as schedule, associated cost, available resources, and basic typing and computer skills. The plan components of the resource assignment matrix will be made of the required task for implementation, which requires internal assets and backfill of staff resources (Lammers et al., 2016). The funds available and a plan for sourcing additional materials are also considered.

In the software and hardware planning, such inventory as faxes, printers, and workstations are acquired. In addition, new hardware, network, and electrical are also obtained if necessary in this phase. The EHR access method is then suggested and a communication plan between the stakeholders, project sponsors, the implementation team, and the staff is then set. The cost of implementation is critical in determining the success of the change process. For this reason, a budget and a funding plan consist of direct and indirect implementation cost, estimated increase in revenue, information obtained from ROI calculations, and revenue savings (Lammers et al., 2016). The system functionality and wish list will be organized based on assessment.

Planning Steps of EHR Implementation

The first implementation step will be an assessment of the practice readiness, this will involve looking into the hospital administrative processes, office workflow, the current record and medical notes management, finances, and staff’s computers. Additionally, goals, which are attainable, measurable, and timely will also be set in this step. A leadership group will be established to spearhead the hospital vision (Freytag et al., 2020). A physician will be selected to champion the team, select members will learn how to operate EHR software and hardware.

In the second step, an approach for implementation will be planned. This process will involve analyzing and mapping the practice workflow. A contingency plan for issues that may arise during the implementation will be created. A strategy to transition medical notes and other records to electronic from paperwork will be formulated. In addition, obstacles and concerns that may bridge information security and privacy during the transfer process will be identified, and a plan to address these concerns will be made.

EHR Performance Evaluation

The evaluation process will be continuous over 7 months, however, the set points will be done post-implementation. The implementation team will first agree on a metric to be used in measuring the investment. The time line will be set for partial completion of the program. For instance, patient throughput should have increased by 5 % after a month of program implementation. In the fourth month, a 20 % throughput is expected.

The Who Factor

The EHR system to be adopted should be beneficial to the patients, the hospital, and the medics. It is critical to ensure that the chosen system furthers the hospital goals, the electronic record should align with the strategic plan for profitability and growth to be realized (Rumball-Smith et al., 2017). Quality healthcare delivery, medical management, clients’ satisfaction, reduced readmission, and low cost of medication should be realized by the patients after implementation.

EHR system will be utilized by the staff every day; it is, therefore, crucial to develop an intuitive software, which is easy to navigate and use. The interface features, such as shape and color, should be appealing for the integration to be fruitful (Everson et al., 2020). A health data exchange between the clients, providers, and hospital IT systems is an indicator of a successful EHR (Lammers & McLaughlin, 2017). In the hospital, a unified acute and ambulatory EHR will improve performance through enhancing care coordination, improving care quality, clinical diagnosis, and decision support, therefore, it is important to implement this program.


Everson, J., Rubin, J. C., & Friedman, C. P. (2020). Reconsidering hospital EHR adoption at the dawn of HITECH: Implications of the reported 9% adoption of a “basic” EHR. Journal of the American Medical Informatics Association, 27(8), 1198-1205. Web.

Freytag, J., Dindo, L., Catic, A., Johnson, A. L., Bush Amspoker, A., Gravier, A., & Naik, A. D. (2020). Feasibility of clinicians aligning health care with patient priorities in geriatrics ambulatory care. Journal of the American Geriatrics Society, 68(9), 2112-2116. Web.

Lammers, E. J., & McLaughlin, C. G. (2017). Meaningful use of electronic health records and Medicare expenditures: Evidence from a panel data analysis of US health care markets, 2010–2013. Health Services Research, 52(4), 1364-1386.

Lammers, E. J., McLaughlin, C. G., & Barna, M. (2016). Physician EHR adoption and potentially preventable hospital admissions among Medicare beneficiaries: Panel data evidence, 2010–2013. Health Services Research, 51(6), 2056-2075.

Rumball-Smith, J., Shekelle, P., & Damberg, C. L. (2018). Electronic health record “super-users” and “under-users” in ambulatory care practices. The American Journal of Managed Care, 24(1), 26-31.

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