This HIBBS presentation provides background on how to assess the value of a medical informatics solution, explains implementation issues with regard to rolling out any type of electronic medical record system, and mentions points that will help ensure the successful implementation of a medical informatics solution. Learning Objectives: Assess the value of a medical informatics solution Be aware of issues associated with the rolling out of any type of electronic medical record system Explain what is necessary for a successful implementation of a medical informatics solution

1. EMR Implementation
Considerations
Y. SINGH
NELSON R. MANDELA SCHOOL OF MEDICINE
DEPARTMENT OF TELEHEALTH
SINGHY@UKZN.AC.ZA
HIBBs is a program of the Global
Health Informatics Partnership
Content licensed under Creative Commons Attribution-Share Alike 3.0
Unported

2. Learning Objectives
 To give you an idea of how to assess the
value of a medical informatics solution
 Make you aware of some of the questions you
need to ask before rolling out any type of
electronic medical record system
 Points that will help ensure the successful
implementation of an medical informatics
solution

3. An Example
 Information systems too manage
medical information is beneficial
 Peter Littlejohns BMJ
2003;326;860-863
 Three quarters of information systems
fail
 Limpopo Province
 IBM 134 million rands

4. Why do EMRS Fail
 Poor communication
 Developers unaware of the environment
 No change management in place
 Perceptions (resistance to change)
 No support from government
 To high expectations

5. Essential Considerations
 Needs assessment
 Design
 Testing
 Implementation
 Functionality

6. Needs Assessment
 Most important part  directly results
in success or failure
 High end and sophisticated technology
is not always the correct solution
 Where are the developers from
 Workflow Analysis
 Actual vs perceived benefit
 Collecting data without analysis or
using it, is not beneficial to you

7. Design
 Ensure that you are fully involved
 Remember … you need to tell the
developer what you want
 Insist that the developer uses the
spiral development model
 Must take into account the
environment
 Flexible

8. Testing
 Testing must not be done in a lab
 Have a trial run of the system in the
actual environment with the full
participation of the developers
 Independent evaluator

9. System Functionality
 Comprehensiveness of information
 Does the system capture and store all the necessary
information
 Degree of structure of data
 Retrieval and analysis of the data
 Ubiquity of access
 Multiple read privileges

10. System Functionality
 Backups
 How are they done
 How often are they done
 Where is it stored
 What happens if the system fails
 Second system with essential functionality
 Paper based batch entry back-up
 Ease of use and flexibility

11. System Functionality
 Efficiency
 Robustness
 Add benefit to the clinical environment
 Security
 Confidentiality
 Integrity
 Privacy

12. System Selection
 Open source vs. commercial systems
 Actual costs
 Available support
 Small print

13. Implementation
 Phased rollout
 Training
 User support
 Finding champions
 Creating super users
 Celebrating successes and learning from
mistakes
 Adequate budget

14. Ask Questions
“Studies have shown that holding and
caressing animals can dramatically
speed a person’s recovery”

15. Important Questions
 Is there clinical need for the system?
 Do all the components function?
correctly
 Is it reliable?
 Is it accurate?
 Is it fast and accurate?
 Is the system well built?
 Are people likely to use it?

16. More Important Questions
 Which parts cause what effect?
 How can it be maintained?
 How can it be improved?
 Is the interface intuitive and easy to
use?
 Does it communicate effectively with
other components/hospital systems?
 Is it robust?

17. Thank You
HIBBs is a program of the Global Health
Informatics Partnership
www.ghip.net
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