Change Management with Electronic Health Records

The EHR really changes how people do their jobs, and change management is needed. However, change management may look different for a team of medical records clerks versus an orthopedic surgeon.

You were hired to put together a change management plan for each of these employees or groups of employees at Rasmussen Hospital. Write a brief Change Management Plan for each scenario given, using the four R’s shared in the Change Management reading in this class. Be sure to address any fears or concerns the employees may have.

SCENARIO ONE: Medical Records Clerical Team

This team of five spent most of their day pulling paper medical record folders off of shelves, pulling paper out of them, filing paper back into them, and putting the folders back on the shelves. The folders could be thin or very thick. The job involved bending down to very low shelves or stretching up to high shelves. They also had to push carts from place to place, delivering and picking up charts from clinics. With the new EHR, all of the paper will be scanned into the EHR, and they will no longer be using paper charts. They will need to learn to use the computer, which many of them have not done before. Their new jobs will involve scanning paper records received by the clinic, and keying in the Medical Record Number so that the scanned document goes into the correct patient’s record. Accuracy will be very important.

SCENARIO TWO: Dr. John Smith, Orthopedic Surgeon

Dr. Smith is an orthopedic surgeon who has been working at the hospital for 30 years and is 10 years from retirement. He does not like to use computers. His normal workflow is to see patients, dictate his notes into a tape recorder, and send the tape to a transcriptionist who will type the note on paper. The paper is delivered to his office three days later for his signature. It often sits on his desk for several days before he signs it, and then it is picked up by a medical records clerk and filed to the medical record. With the EHR, Dr. Smith will be expected to use a computer template with picklists, checkboxes, and free text in the patient’s record in the EHR to create his patient documentation himself, meaning they will be available immediately instead of three days later. He will no longer be able to dictate. He is not very happy about this as he is not used to using a computer, and he feels that this will add a lot more time to his day and take time away from the patient. He does not understand what benefits the EHR will bring to the organization. He is very busy and does not have time for long training classes.

SCENARIO THREE: Lab Technicians

There are 10 lab technicians. Their current work flow is that the patient comes to get their blood drawn. The lab tech takes their blood and puts a hand printed label on the tube. When the lab is completed, the results go into the Lab System, and are printed on paper out of the lab system. The paper is sent to Medical Records to be filed in the chart. The lab technician will have to call the doctor with the lab results if they are important and need to be known immediately. With the EHR, the patient will come to the lab with a label already preprinted with their information on it. The label will be placed on the tube. The Lab System will have an HL7 Interface into the new EHR, (You will learn more about HL7 in the following module.) and the results will flow electronically right from the Lab System into the EHR via the interface, so no paper will have to change hands, and the lab results will go right to the patient’s chart and be ready for the doctor to review online. If the lab results are important, they will send an urgent message to the doctor’s in basket and may even automatically page the doctor.

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