The interfacing problems in the current OPUS system can only be addressed if the hospital implements some recommendations related to how stakeholders share and access information ( Watters, Bergstrom, & Sandefer, 2016) . There is a need for a multi-disciplinary approach to ensure that all the entities understand what they have to do for the success of the improved system ( Bao & Bardhan, 2017). The following is the analysis of the timeline for implementation, the stakeholders, and the best practices to deal with the barriers.
The most affected stakeholders are the nurses, the billing department, and the physicians because they are the main users of the EHR system. The nurses and physicians work together towards the improvement of care provided to the patients. The focus on the information relevant to nurses and physicians is in line with the objective of the hospital to improve on the quality of healthcare. The billing system is also essential as it reduces losses. Therefore, the hospital should comply with the CMS requirements or get a reduction in reimbursement ( Centers for Medicare & Medicaid Services (CMS), 2015).
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The recommendations come from the needs of the hospital and the challenges that the OPUS system is facing. The recommendation to improve the billing segment comes from the need to have the system produce billing statements differently based on the requirements of the insurers. Nurses also have a challenge when it comes to accessing patient information and organizing supplies to the nursing segment ( Teame, Stålhane, & Nytrø, 2017) . Therefore, nurses handle the largest bulk of information ranging from patient care to discharge information. There is also need to improve on the way information is accessed by physicians in terms of getting full reports from departments such as pharmacy and diagnostic units ( Rajbhandari, Auron, Worley, & Marks, 2018) . There is a challenge in that physicians cannot fill information from wireless devices, which raises a challenge.
Missing Information
There are some areas of unclear information in the system that can be used to improve the system in future. These areas include the role that training will play in ensuring that all the stakeholders are able to use the system. There is also lack of information on how the system can be used in the decision making process in the organization. With the modern systems, there is a trend towards using the EHR systems to improve the decision making process. in future, it would be idea, to check on how the system can be used in ensuing stakeholders are able to make the right decisions in everything they do towards patients care.
| Recommendation | Estimated Time | Challenges |
| Improvement of the billing department | Done in the first month and training done in the second month. The training of employees will focus on how to generate reports and maneuver the system with improved efficiency ( Adler‐Milstein, Everson, & Lee, 2015) . | Difficulty in training individuals while on the job |
| Improvement in nurses applications such as supply, access to patient information including discharge | This is to be done within three months and the fourth month is used to provide on the job training for nurses. | Not all the nurses may be able to attend all the sessions depending on the flow of patients. |
| Improvement in physician access to information and integration of patient data with other sub-systems in the hospital such as diagnostic and pharmacy department | This is scheduled for three months after completion of the recommendations above. The training is to be done on the job to ensure the physicians can get hands-on skills on how to use the system. |
There are some barriers to the implementation of the recommendations. One of the barriers is that some of the employees may be resistant to the proposed change ( DiAngi, Longhurst, & Payne, 2016) . To deal with the resistance, it is important for the leadership to share the vision of the hospital and ensure that everyone understands the role they have to play in the attainment of the vision ( Vuppalapati, Ilapakurti, & Kedari, 2016) . The other barrier is the lack of skills in information technology, which may mean that stakeholders may not be able to handle the changes. This calls for training to fill the gaps in skills.
Impact of Recommendations
Implementing the recommendations means that the hospital will increase its efficiency in billing and hence reduces losses. Patients’ outcomes also improve because of improvement in the quality of care provided ( Russo, Sittig, Murphy, & Singh, 2016) . The quality of care increases because of a reduction in medical errors from physicians and nurses. There is also enhanced collaboration between different departments, which enhances resource allocation thereby minimizing any wastage. Physicians would reduce mistakes in prescribing drugs that are not available in the hospital. On the other hand, the nurses would be able to manage the supplies to the hospital and conduct observations on patients as required based on the information provided by the physicians. It would also be easier for physicians to access information about patient tests and not just reports.
Conclusion
The optimization of the information system is an initiative that will improve efficiency and coordination at the facility. Implementation of modifications in the billing and information department will take a maximum of nine months. This step is likely to face obstacles such as resistance to change and lack of technological exposure on the part of the team. However, a successful implementation will place the facility on a different scale, as it will ensure client satisfaction and promotion of facility brand image.
References
Adler‐Milstein, J., Everson, J., & Lee, S. Y. D. (2015). EHR adoption and hospital performance: time‐related effects. Health Services Research , 50 (6): 1751-1771.
Bao, C., & Bardhan, I. (2017). Measuring Relative Performance of Accountable Care Organizations: the role of health information technology. http://aisel.aisnet.org/icis2017/IT-and-Healthcare/Presentations/16/
Centers for Medicare & Medicaid Services (CMS), HHS. (2015). Medicare and Medicaid Programs; Electronic Health Record Incentive Program--Stage 3 and modifications to meaningful use in 2015 through 2017. Final rules with comment period. Federal Register , 80 (200): 62761.
DiAngi, Y. T., Longhurst, C. A., & Payne, T. H. (2016). Taming the EHR (Electronic Health Record)-there is hope. Journal of Family Medicine , 3 (6):
Rajbhandari, P., Auron, M., Worley, S., & Marks, M. (2018). Improving Documentation of Inpatient Problem List in Electronic Health Record: A Quality Improvement Project. Journal of Patient Safety .DOI: 10.1097/PTS.0000000000000490
Russo, E., Sittig, D. F., Murphy, D. R., & Singh, H. (2016, December). Challenges in patient safety improvement research in the era of electronic health records. In Healthcare (Vol. 4, No. 4, pp. 285-290). Elsevier.
Teame, T., Stålhane, T., & Nytrø, Ø. (2017). EHR Improvement Using Incident Reports. Studies in health technology and informatics , 235 : 559-563.
Vuppalapati, C., Ilapakurti, A., & Kedari, S. (2016, March). The role of big data in creating sense EHR, an integrated approach to create a next-generation mobile sensor and wearable data-driven electronic health record (EHR). In 2016 IEEE Second International Conference on Big Data Computing Service and Applications (BigDataService) (pp. 293-296). IEEE.
Watters, A., Bergstrom, A., & Sandefer, R. (2016). Patient engagement and meaningful use: Assessing the impact of the EHR incentive program on cultural competence in healthcare. Journal of cultural diversity , 23 (3):
