Murphy JA et al. 1997 "Nursing process redesign with the implementation of a computer based patient record in the ambulatory setting."
Reference
Murphy JA, Ahlstrom JS. Nursing process redesign with the implementation of a computer based patient record in the ambulatory setting. Stud Health Technol Inform 1997;46:323-329.
Abstract
"Increasingly, health care organizations are considering moving to Computer Based Patient Records (CPR), a trend driven by managed care and capitated payments. Central to the change is recognition of the need for community based and clinically relevant information systems that span the care continuum. Thus, Aurora Health Care chose to start their CPR effort in the ambulatory setting as the focus of health care delivery in the evolving paradigm. This paper describes computerization of the ambulatory record in a 45 physician clinic and associated workflow redesign. Months were spent in the processes of current state documentation and analysis, future state design, detail system design, and workflow reengineering. There was substantial impact on nursing care delivery with computer system interaction at the point of care in the exam room. Access to clinically relevant longitudinal data was found key to the implementation and evaluation of Care Management strategies."
Objective
To describe "computerization of the ambulatory record in a 45 physician clinic and associated workflow redesign."
Type Clinic
Primary care
Size
Large
Geography
Suburban
Type of Health IT
Electronic health records (EHR)
Type of Health IT Functions
Functions included client/server software for data entry and retrieval, and specific software for the data repository.
Workflow-Related Findings
Electronic order communication is facilitating the communication of all of the necessary order details to the ancillary departments.
"The implementation analysts throughout the course of the database build and customization process documented the data flow and the changes to the current state process flows that would occur with implementation of the system ... Because it was not possible to build and implement the ideal system envisioned in the future state process flows, the Reality State process flows" were documented.
Test results are now online and the "clinician now has immediate online access to both hospital and clinic documents."
Study Design
Story
Study Participants
Clinical and administrative staff participated.