Health care finance /Problem-Solving Analysis Report – Clinician Provider Order Entry System

Healthcare Finance/Problem-Solving Analysis Report – Clinician Provider Order Entry System

Selection

Justification for Selecting an Information System

The information system the Memorial Health System selected to implement was the Clinician Provider Order Entry (CPOE) system. Despite the high implementation costs, the main argument in favor of the CPOE system was that it decreased medical errors at Memorial Health System. Medical error is an umbrella term for the preventable mistakes made by care providers during the delivery of care that threaten patient safety and the quality of care (Clark & Kipperman, 2023). Medical errors can potentially occur at any stage in the delivery of care services. Such errors include medication administration errors (MAEs), surgical errors, equipment errors, documentation errors, and errors in diagnostics and communication. Medical errors can be caused by failures in communication, lack of knowledge among the care providers, and other human errors. According to Abraham et al. (2020), there is a possibility of reducing medication mistakes and adverse drug events (ADEs) by up to 53% and 92%, respectively, when information systems like the CPOE are used for prescription ordering.

How the Organization’s Goals Drive the Selection of an Information System

The Memorial Health System’s goal in the selection of the CPOE system is to improve patient safety by reducing medical errors. Memorial Health System has eight hospitals that have been integrated to create a larger healthcare system. The occurrence of medical errors across the eight hospitals has negatively impacted patient safety. Medical errors and poor patient safety outcomes can negatively impact the reputation of the hospitals and the entire health system. Due to its ability to provide ordering standards, the CPOE system can dramatically reduce and prevent the occurrence of medical errors and improve patient safety. Although the implementation of the CPOE system across the Memorial Health System faced major opposition, the health system’s goal to reduce and eliminate medical errors was a driving force behind the justification of the CPOE system.

Role of the Organization’s Stakeholders in the Selection and Acquisition Process

The organization’s stakeholders include all groups and individuals affected by the selection and acquisition of the CPOE system. Stakeholders are central in the selection and acquisition process by providing various user perspectives that can highlight how the system will impact the system. The input of the stakeholders can help with and contribute to a successful selection and acquisition process. The major stakeholders in the information selection and acquisition process in the case of Memorial Health System include the patients, the management, the professional staff, the support staff, the system supplier, and the insurance company.

The patients are considered key stakeholders as they are directly affected by the cases of medical errors. The management includes the board of directors, the CEO, and other top-ranking administrators who can decide and authorize expenditures. The professional staff includes the nursing staff, physicians, and lab technologists. They use the CPOE systems directly and must be involved in the selection and acquisition process. Others, such as support staff, including the organization’s information systems, need to be consulted as their contribution can help the organization select the best information system, while the insurance partners can assess the related risks and provide possible risk management guidance.

Implementation

The Typical IT Implementation Process

A typical IT implementation process begins with an analysis of the system requirements, developing a request for proposal (RFP), setting up an implementation team, selecting a supplier or vendor, planning for the implementation timeline, user education, implementation, and post-implementation support and evaluation. The main roles and responsibilities in system implementation include the executive sponsor explaining the organization’s needs to the vendor and setting the vision for the system, the implementation team including a system specialist to guide the implementation process, a vendor to supply and provide support for the system, a change management specialist to help manage the change the implementation of the system brings, and the users responsible for using the system and providing essential feedback to help improve the system.

How the Process Described in the Case Study Failed to Include the Fundamental Activities of a Typical IT Implementation Process

The process of implementing the CPOE across the eight hospitals under the Memorial Health System failed to include the fundamental activities of a typical IT implementation process in a number of ways. First, there was insufficient system requirement analysis necessary for efficient integration of the system with the current system. The scope and goals of the project also kept changing. The scope of the project was reduced from the initial enterprise deployment to focus on particular facilities. Further, there was no predefined deadline for the implementation as it is still not fixed and may be doubled. These are the reasons the program remained at one tertiary care facility and is still at the pilot adopter status. Another failure is in the allocation of resources. These include both human resources and capital. Although the project was supported by the health systems CEO and the chief information officer (CIO) (Joe Roberts), the IT team first was inflated from 16 to 32 and later continued to shrink as the budget kept on changing. The entire process also lacked sufficient stakeholder involvement, leading to the opposition it faced and some of the staff complaining about its implementation, noting that they were notified in the later stages.

Evaluation

Indicators of Project Failure: how and When I  Would Evaluate the Effect of each Indicator I Described

            Firstly, there is a lack of infrastructure to support the implementation of the CPOE system at Memorial Health System. This means that underlying issues could be the problems with the implementation process. This indicator will be evaluated by analyzing the current system’s workflow and integration issues. Another indicator of project failure is the lack of stakeholder involvement in the selection and implementation process. It is obvious the CPOE system implementation faced a lot of opposition from the clinicians. This indicator would be evaluated using regular feedback collection from key stakeholders.

The last-minute changes in the scope of the project are also an indicator of project failure. This indicator would be evaluated by continuously evaluating the project’s risks and barriers to ensure their scope aligns with the project’s goals. Another project failure indicator is the Memorial Health System’s resource constraints while implementing the project. This indicator would be evaluated using an in-depth stakeholder analysis. Finally, another indicator is budget constraints. The indicator would be evaluated through a continuous risk assessment.

References

Abraham, J., Kitsiou, S., Meng, A., Burton, S., Vatani, H., & Kannampallil, T. (2020). Effects of CPOE-based medication ordering on outcomes: an overview of systematic reviews. BMJ Quality & Safety, 29(10), 1–2. https://doi.org/10.1136/BMJQS-2019-010436

Clark, J., & Kipperman, B. (2023). Medical Errors. Ethics in Veterinary Practice: Balancing Conflicting Interests, 167–188. https://doi.org/10.1002/9781119791256.ch9

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As an HIS project manager,
you have just received the following email from the CIO: “Review the example I sent you about the implementation process.

I attached a list of questions for you to answer about how the implementation process works and why IT projects sometimes fail.

I’m most interested in your analysis of how organizations like ours can choose an information system and minimize the occurrences and effects of IT failures.”

Completing this task for the CIO allows you the opportunity to analyze the selection, implementation, and evaluation of information systems in a healthcare organization and showcase yourself as a detail-orientated analyst.

Because you have been tasked with creating a report,
consider using headings to organize and present your content.

Assessment Deliverable
Write a 700- to 1,050-word report in which you answer the following questions:

Selection:

What is the justification for selecting an information system? Describe it.

How do the organization’s goals drive the selection of an information system?

What role does each of the organization’s stakeholders play in the selection and acquisition process? Describe them.

Implementation:

What is the typical IT implementation process? What are the roles and responsibilities involved in system implementation?

How did the process described in the case study fail to include the fundamental activities of a typical IT implementation process?

Evaluation:
What are at least 5 indicators of project failure that manifest themselves in the case study?

How and when would you evaluate the effect of each indicator you described?

Cite at least 2 scholarly, peer-reviewed sources to support your report; format
according to APA guidelines.