Articles

An Assessment of Readiness for Pre-Implementation of Electronic Health Record in Iran: a Practical Approach to Implementation in General and Teaching Hospitals

Abstract

Readiness assessment provides a proper image of the existing conditions and an explanation of facilitated operational plans and functional approaches to successful implementation of electronic health record. Readiness assessment requires indices adjusted to particular conditions in each country. Therefore, the present study attempts to provide an acceptable model in Iran and to provide an assessment of public and teaching hospitals in medical education university. After reviewing related papers and descriptive study of five selected countries, the initial model was designed in the form of a questionnaire for analysis through Delphi and distributed among 30 experts nationwide. Along identification of components in the proposed method, a 7-point Likert scale was used to determine priority of each component. Then, all general -education hospitals at Tehran University of Medical Education were examined based on this model in terms of total, relative, or no readiness. The final model was designed in five dimensions: cultural, leadership and management, technical infrastructure, governance and operational dimensions; Educational Hospitals were evaluated in this dimension. 28.6 % of general--teaching hospitals are ready for pre-implementation. It seems to establish uniform strategic and executive team in Health center is essential for the preparation them in abovementioned area in the least possible time.

Ammenwerth E, Brender J, Nykanen P, et al. Visions and strategies to improve evaluation of health information systems: Reflections and lessons based on the HIS-EVAL workshop in Innsbruck. Int J Med Inform 2004;73(6):479-91.

Committee MDoHatMe-HIA, editor. A Prescription for Meeting Minnesota’s 2015 Interoperable Electronic Health Record Mandate A Statewide Implementation Plan. 1st ed. Minnesota: Minnesota Department of Health and the Minnesota e-Health Initiative Advisory Committee; 2008: p. 103.

Community Clinic EHR Readiness Assrssmentn Introduction & Instruction. AHRQ. (Accessed in Mar 2014, 10, at http://www.norc.org/6275/Module2/Community%20Clinic%20EHR%20Readiness%20Assessment%20Tool.pdf).

Ajami S, Ketabi S, Isfahani SS, et al. Readiness Assessment of Electronic Health Records Implementation. Acta Inform Med 2011;19(4):224-7.

Ventures IH, editor. Medical Center Electronic Health Record Readiness Assessment. InTech Health Ventures; 2008.

Health Care Leader Action Guide on Implementation of Electronic Health Records. LabInter Operability Collaborative. (Accessed in Mar 2014, 10, at http://labinteroperabilitycollaborative.org/pdfs/implementation-ehr.pdf).

WHO, editor. Electronic Health Records Manual for Developing Countries. 1st ed. Geneva: world health organization; 2006: p. 17-24.

Ahlstrom J. Electronic Health Records (EHR) - Assessing Organizational Readiness. (Accessed in Mar 2014, 10, at http://www.wipfli.com/resources/images/11935.pdf).

Assessing Your Practice for Electronic Health Record Adoption. (Accessed in May 2014, 14, at https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0CCg...).

California Community Clinics EHR Assessment and Readiness. National Association of Community Health Centers. (Accessed in Mar 2014, 10, at http://www.nachc.com/client/EHR_Starter_Assessment_final.pdf).

Morton ME. Use and Acceptance of an Electronic Health Record: Factors Affecting Physician Attitudes [Dissertation]. Drexel Univ., 2008.

Hendriks J, editor. Realizing the Goal of Electronic HealthRecords in the United States- Lessons Learned from Canada Sierra Systems; 2009.

Davies NE. Making IT Happen: Strategies for Implementing the EMR-EHR. (Accessed in Mar 2014, 10, at http://apps.himss.org/davies/docs/Davies_WP_Implementation.pdf).

Khoja S, Scott RE, Casebeer AL, et al. E-health readiness assessment tools for healthcare institutions in developing countries. Telemed J E Health 2007;13(4):425-31.

Canada Health Infoway. EHRS Blueprint/an Interoperable for Sharing EHR. (Accessed in Mar 2014, 10, at https://www.infoway-inforoute.ca/index.php/resources/technical-documents/architecture/doc_download/284-ehrsblueprint-v2-full).

National Board Health. National IT Strategy for the Danish Health Service 2003–2007. Sundhedsstyrelsen; 2003.

Li J, Pek Wee Land L, Ray P, et al. E-Health readiness framework from Electronic Health Records perspective. Int J Internet Enterp Manag 2010;6(4):326-48.

Working draft on Integration of healthcare services-role of primary care by the. Ministry of Health; 2010.

Health Do, editor. EMR Champion Guide. Saskatchewan: Saskatchewan Ministry of Health; 2010: p. 18.

Muttitt S. Is Sustainability of Healthcare Possible without eHealth? (Accessed in Mar 2014, 10, at http://www.worldofhealthit.org/sessionhandouts/documents/PS6-1-Muttit.pdf).

NHSCfH. The National Programme for IT Implementation Guide/Guidance to support trusts that form Local Health Communities in implementing National Programme products and services. Leeds: NHSCfH; 2007: p. 83.

Esterle L, Kouroubali A. Political and organisational factors influencing large scale implementation of electronic health records. CNRS. (Accessed in Mar 2014,14, at http://www.cermes3.fr/IMG/pdf/EHRI_Recommendations.pdf).

Edwards J. Case Study: Denmark's Achievements with Healthcare Information Exchange. Gartner. (Accessed in May 2014, 14, at https://www-304.ibm.com/industries/ca/en/healthcare/files/gartnercase_study-denmarks_achievementswHIE.pdf).

Kaye R, Kokia E, Shalev V, et al. Barriers and success factors in health information technology: A practitioner's perspective. J Manag Marketing Healthc 2010;3(2):163-75.

Jones V, Jollie C. eHealth strategy and implementation activities in England: Report in the framework of the eHealth. (Accessed in May 2014, 14, at http://www.ehealthera. org/database/documents/ERA_Reports/England_eHealth_ERA_Country_Report_final_07-06-2007.pdf).

Deutsch E, Duftschmid G, Dorda W. Critical areas of national electronic health record programs--Is our focus correct? Int J Med Inform 2010;79(3):211-22.

Clinics EHR Readiness Starter Assessment. Professional Systems. (Accessed in May 2014, 14, at http://www.profsystems.com/psi_ehr_readiness_assessment_starter.pdf).

Doolan DF, Bates DW, James BC. The use of computers for clinical care: a case series of advanced U.S. sites. J Am Med Inform Assoc 2003;10(1):94-107.

NHSCfH, editor. The National Programme for IT Implementation Guide/Guidance to support trusts that form Local Health Communities in implementing National Programme products and services. Leeds: National Health Services; 2005: p. 72.

Are you EMR ready? Physician office electronic medical record system pre-implementation guide Canada Health Infoway. (Accessed in May 2014, 12, at https://www.infoway-inforoute.ca/lang).

Muttitt S. Enter Once, Use Many Times Unleashing the Value of Reusable Clinical Data. Ltd MP; 2010.

Lorenzi NM, Riley RT, Blyth AJC, et al. Antecedents of the people and organizational aspects of medical informatics. J Am Med Inform Assoc 1997;4(2):79-93.

WP5 - National reports of EHR implementation Denmark, in EHR Implement. (Accessed in May 2014, 12, at http://www.ehrimplement.eu/index.cfm?objectid=5BF4F332-1143-DEB7-7424B463EB2D48EE).

Synergy across borders [monograph on the internet]. Danish Centre for Health Telematics. Medcom. (Acceseed in May 2014, 14, at http://www.medcom.dk/wm1).

Canada PHCTFH, editor. The EMR Toolkit. Ottawa, Canada: Ontario The authority of the Minister of Health/Health Canada; 2006.

Ltd MP, editor. Muttitt C, Sarah Singapore’s National Electronic Health Record, The Roadmap to 2010. MOH Holdings Pte Ltd; 2009.

Health Do, editor. Informatics Planning 2009/2010 For the NHS in England. NHSCfH; 2008.

deployment guide for clinicians involved in deploying IT system/a one Stop Guide to Clinicians Involved in Deploying IT Systems. (Accessed in May 2014, 14, at http://www.connectingforhealth.nhs.uk/engagement/clinical/publications/guide.pdf).

Synergy across borden odense. Danish center for health telematics. (Accessed in May 2014, 14, at http://www.medcom.dk/dwn).

McKinnon S. National Electronic Health Record Procurement. MOHHolding Pte Ltd; 2009.

Moghaddasi H, Sheikhtaheri A. CEO is a Vision of the Future Role and Position of CIO in Healthcare Organizations. J Med Syst 2010;34(6):1121-8.

Successful Preparation and Implementation of an Electronic Health Records System, Best Practices. California Medical Sciences. (Accessed in May 2014, 14, at http://www.cmanet.org/files/pdf/ehr/best-practices-7.pdf).

Medical Center Electronic Health Record Readiness Assessment. Arizona: Medical Center 2008.

National policies for EHR implementation in the European area. EuroRec. (Accessed in May 2014, 14, at http://www.eurorec.org/RD/ehr_implement.cfm).

Tan JKH, editor. Medical informatics: Concepts, methodologies, tools, and applications. 2nd ed. Medical Information Science Reference; 2009: p. 28-30.

Asadi Z. Health system in United Kingdom. (Accessed in May 2014, 14, at http://if3m.blog.com/2011/08/19/%D9%86%D8%B8%D8%A7%D9%85-...).

An overview of the Electronic Health Record Privacy and Security Conceptual Architecture. Canada Health Infoway. (Accessed in May 2014, 14, at https://www.infowayinforoute. ca/index.php/component/docman/doc_download/286-ehr-privacy-and-security-architecture-summary).

Electronic Health Records: A Global Perspective. MISS. (Accessed in May 2014, 14, at http://www.himss.org/files/HIMSSorg/content/files/Globalpt2-edited%20final.pdf).

California Behavioral Health Electronic Health Record (CA BH-EHR) Request for Information. Information Technology Division. (Accessed in May 2014, 14, at http://s3.amazonaws.com/zanran_storage/www.dmh.ca.gov/ContentPages/610596817.pdf).

The National Programme for IT in the NHS: an update on the delivery of detailed care records systems. National Audit Office. (Accessed in May 2014, 14, at http://www.nao.org.uk/wp-content/uploads/2011/05/1012888. pdf).

Doctor’s office quality –information technology (DOQIT). EHR Assessment and Readiness Starter Assessment. (Accessed Jul 2014, 8, at http://www.himss.org/files/HIMSSorg/content/files/Code%2049%20Masspro%20Practice%20Starter%20Assessment.pdf.)

Petersen D. Development and implementation of electronic health records in Denmark. NVMA conference of national EHR/ International session 4; 2008 12 june; Amsterdam. (Accessed Jul 2014, 8, at http://www.ifhima.org/docs/AmsterdamabstractEHRDarleyP.doc.)

Carter JH. Electronic Health Record Implementation. In: Nolan CK, eds. Electronic health records: A guide for clinicians and administrators. 2th ed. Philadelphia: ACP Press, 2008: 473-81.

Boonstra A, Broekhuis M. Barriers to the acceptance of electronic medical records by physicians from systematic review to taxonomy and interventions. BMC Health Serv Res 2010;10(1):231.

EMR Success Factors. Canada Health Infoway. (Accessed in May 2014, 14, at https://www.infowayinforoute. ca/working-with-ehr/health-careproviders/ emrs/success-factors#collaborative).

Registration Authorities and Smartcards 2012. NHS. (Accessed in Mar 2014, 14, at http://www.connectingforhealth.nhs.uk/systemsandservices/rasmartcards).

Golden BR, Martin RL. Aligning the Stars: Using Systems Thinking to (re)Design Canadian Healthcare. Healthc Q 2004;7(4):34-42.

Ash JS, Fournier L, Stavri PZ, et al. Principles for a successful computerized physician order entry implementation. AMA Annu Symp Proc 2003;2003(1):36-40.

Curtis B, Hefley EW, Miller SA. Overview of the People Capability Maturity Model. (Accessed in Mar 2014, 10, at http://www.sei.cmu.edu/reports/09tr003.pdf).

Kotter JP, Gestion Ccd. Leading change: Why transformation efforts fail. Harv Bus Rev 1995;73(1):59-67.

Heeks R. ICT4D 2.0: the next phase of applying ICT for International Development. Computer 2008;41(6):26-33.

Berg M. Implementing information systems in health care organizations: myths and challenges. Int J Med Inform 2001;64(2-3):143-56.

Overhage JM, Evans L, Marchibroda J. Communities' readiness for health information exchange: the national landscape in 2004. J Am Med Inform Assoc 2005;12(2):107-12.

Gupta U. Global networks: Promises and challenges. Inf Syst Manag 1992;9(4):28-32.

Wickramasinghe NS, Fadlalla AM, Geisler E, et al. A framework for assessing e-health preparedness. Int J Electron Healthc 2005;1(3):316-34.

Jennett P, Yeo M, Pauls M, et al. Organizational readiness for telemedicine: implications for success and failure. J Telemed Telecare 2003;9(Suppl 2):S27-30.

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IssueVol 52, No 7 (2014) QRcode
SectionArticles
Keywords
Electronic Health Record Public-Teaching Hospitals Pre-Implementation Assessment

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How to Cite
1.
Ghazisaeidi M, Ahmadi M, Sadoughi F, Safdari R. An Assessment of Readiness for Pre-Implementation of Electronic Health Record in Iran: a Practical Approach to Implementation in General and Teaching Hospitals. Acta Med Iran. 1;52(7):532-544.