Bentley Thomas, Rizer Milisa, McAlearney Ann Scheck, Mekhjian Hagop, Siedler Monica, Sharp Karen, Teater Phyllis, Huerta Timothy
Thomas Bentley, RN, MS, is Deputy CIO, Applications, The Ohio State University Wexner Medical Center, Columbus. Milisa Rizer, MD, MPH, is Chief Medical Information Officer, and Associate Professor of Family Medicine, The Ohio State University Wexner Medical Center, Columbus. Ann Scheck McAlearney, ScD, MS, is Professor of Family Medicine and Vice Chair for Research, Department of Family Medicine, The Ohio State University, Columbus. Hagop Mekhjian, MD, is Senior Associate Vice President, Health Sciences, The Ohio State University Wexner Medical Center, Columbus. Monica Siedler, MHA, is Administrative Associate, The Ohio State University Wexner Medical Center, Columbus. Karen Sharp, MS, is Director of Information Technology, The Ohio State University Wexner Medical Center, Columbus. Phyllis Teater, MS, is Associate Vice President, Health Services, The Ohio State University Wexner Medical Center, Columbus. Timothy Huerta, PhD, MS, is Associate Professor of Family Medicine and Biomedical Informatics, The Ohio State University, Columbus. Email:
Health Care Manage Rev. 2016 Jan-Mar;41(1):22-31. doi: 10.1097/HMR.0000000000000041.
Health care organizations, in response to federal programs, have sought to identify electronic medical record (EMR) strategies that align well with their visions for success. Little exists in the literature discussing the transition from one EMR strategy to another.
The analysis and planning process used by a major academic medical center in its journey to adopt a new strategy was described in this study. We use the transtheoretical model of change to frame the five phases through which the organization transitioned from a best-of-breed system to an enterprise system.
METHODOLOGY/APPROACH: We explore the five phases of change from the perspective of a maturing approach to new technology adoption. Data collection included archival retrieval and review as well as interviews with key stakeholders.
Although there was always a focus on some enterprise capabilities such as computerized physician order entry, the emphasis on EMR selection tended to be driven by specialty requirements. Focusing on the patient across the continuum of care, as opposed to focusing on excessive requirements by clinical specialties, was essential in forming and deploying a vision for the new EMR.
This research outlines a successful pathway used by an organization that had invested heavily in EMR technology and was faced with evaluating whether to continue that investment or start with a new platform. Rather than focusing on the technology alone, efforts to reframe the discussion to one that focused on the patient resulted in less resistance to change.
医疗保健机构为响应联邦项目，一直在寻求确定与成功愿景相契合的电子病历（EMR）策略。文献中很少有讨论从一种EMR策略向另一种策略转变的内容。
本研究描述了一家大型学术医疗中心在采用新策略过程中所使用的分析和规划过程。我们运用变革的跨理论模型来界定该组织从最佳-of-breed系统向企业系统转变所经历的五个阶段。
方法/途径：我们从采用新技术的成熟方法的角度探讨变革的五个阶段。数据收集包括档案检索和审查以及与关键利益相关者的访谈。
尽管始终关注一些企业功能，如计算机化医嘱录入，但对EMR选择的重视往往由专业需求驱动。在形成和部署新EMR的愿景时，关注整个连续护理过程中的患者，而非关注临床专业的过度需求至关重要。
本研究概述了一个在EMR技术上投入巨大且面临评估是继续该投资还是启用新平台的组织所采用的成功路径。将讨论从仅关注技术重新聚焦到关注患者，减少了变革阻力。
