EHR System Case Study: Implementation, Challenges & Recommendations

This case study proposes an implementation of an Electronic Health Record (EHR) system using enterprise resource modeling to improve healthcare management. It details the architecture required for the EHR system, including conceptual and logical forms, and illustrates the relationships and communication flow between system components. The study also identifies challenges such as implementation barriers, learning curves, and data integration issues, and suggests strategies for overcoming them. Furthermore, it discusses opportunities for enhancing patient safety, service efficiency, and data management within the healthcare sector, providing recommendations for system improvement and future development. This document is shared on Desklib, a platform offering AI-powered study tools and a wide range of student resources, including past papers and solved assignments.

Case Study-EHR System
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CASE STUDY-EHR SYSTEM
Executive Summary
The main objective of this report is to propose the implementation of the system that will be
beneficial for managing the health care management system. This paper proposed a way for
the implementation of the health care management system using enterprise resource
modeling. The implementation of the system is done by the enterprise resource management.
This architecture is used to formulate the diagrams that represents requirements for the
electronic health record system. In order to develop the proposed system this paper has
described the components of the system and the relationship and the flow of communication
between the systems components. The overview of the relationship between the different
components helps to understand the system clearly. The paper has also discussed about the
challenges and the opportunities those are present in the current system.
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Table of Contents
Executive Summary...........................................................................................................................i
Introduction.....................................................................................................................................1
EIA RA for eHealth...........................................................................................................................1
Conceptual form of architecture.................................................................................................2
Logical form of Architecture........................................................................................................5
Diagram of Component Relationship..........................................................................................7
Management of Information and data Integration.......................................................................10
Operational Structure................................................................................................................10
Challenges in the System...........................................................................................................12
Strategies those can be implemented.......................................................................................12
Conclusion......................................................................................................................................12
Recommendations for the improvisation......................................................................................13
References.....................................................................................................................................14
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Introduction
Electronic health record is the system maintained by the Federal Government of the
United States . The main aim of this health record is to serve the benefits to the common
people of te country along with the healthcare providers. The maintenance of electronic health
record facilitates integration of data and sharing data among health providers (Ahmad and
Brosio2015). In order to develop the health care management system Australian Federal
Government needs a design for the implementation of the system. This study discusses about
the advantages and the challenges associated with the health care record management system.
In order to develop the required architecture for the healthcare record, the enterprise
reference architecture is required. This enterprise reference architecture delivers the design
which includes the design for the different blocks exists in the health care management system.
This designing of the blocks are done through the systematic approach and the logical
implementation described in the enterprise reference architecture. In order to implement the
system this paper focuses on the logical implementation approach which can be achieved by
the application of the enterprise information architecture.
The structure discussed in this paper and the logic of following the structure is based on
the reference of the enterprise reference architecture. This includes logical architecture and
conceptual architecture. The architecture will also reflects the benefits of the reference model.
The next section information management and integration includes component relationship
diagram, component interaction diagram and operational model along with challenges for
management and integration of data.
EIA RA for eHealth
Some of the advantages of following the model of enterprise information architecture and
reference architecture in the implementation of the health care record management system
has been discussed through the impacts of the health record system in the following domain.
 Integration in enterprise- The EIA RA provides benefits to ensure interaction among
enterprise entities to achieve electronic health record system’s objective. The enterprise
integration can be achieved in various ways and in various levels. These approaches are as
follows: physical integration, application integration and business integration (Bussler2013).
The physical integration includes interconnection of connecting machines and devices. The
application integration involves integration of database systems and software applications.
The business integration includes monitoring, managing and controlling of business
processes. The other integration approach is enterprise integration to achieve consistent
decision making for enterprise.
 Enterprise interoperability- The enterprise information architecture allows to store the
relevant information in the various locations of the system indifferent formats such as
database formats and conflicting formats. These provides that two systems are able to
understand and to use each other’s functionality (Chang 2016). The Enterprise
interoperability helps to interact, exchange and provide services between information
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systems. The three levels at the system those get advantages from it are the service process
and the data.
 Data domains- This helps to provide accurate truth from a specific source and correct
information at the right time to central services of eHealth (Charter and Tischner2017). The
main advantage of using the data domain is that it allows the single approach the the data
service related t the master data, metadata along with the unstructured contetnt of the
information and the operational data. The integration provided by the enterprise
information delivers management and integration of the central service.
 Interaction and Information systems- The interaction of the information system delivers
the functionality by managing the internal and external staffs and using the channels and
the services for the presentation of the system.
Conceptual form of architecture
This level of the architecture helps to define the security of the electronic health record
system. The effectiveness of the conceptual part also defines the relevance of the helath record
in delivering its objective. In order to develop the health record system the architecture follows
the concepts provided by the enterprise architecture. The architecture overview diagram is the
architecture through which eHealth can be determined to develop electronic health record
system (Giachetti2016). The building block for the development of the required architecture
has been discussed through the diagram mentioned below. The diagram shows the different
components present in the system and the relationship among those systems. The building
block described in the figure will help to get the overall overview of the architecture requires
for the e-health record.
The below diagram shows eHealth systems as a single entity that mainly concentrates
on customer and health providers aspects. The leadership/governance is the layer in building
blocks which is the primary requirement for the development of electronic health record
system. The final outcome shows that electronic health record system development will help to
improve health sector (Laudon and Laudon 2016). The discussion will be followed by the
overview of the architecture regarding the diagram which is based on the building blocks.
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Figure 1:Building blocks for development of EHR system
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(Source: Created by author)
Figure 2:Diagram of the architecture of HER Development
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(Source: Created by author)
The overview diagram of the architecture of the proposed system shows the different
components and their relationship along with the significance of the structure in order to
deliver the accurate health record system. The architecture overview diagram is essential for
determining the functional capabilities of any sector. The architecture overview diagram is
formulated according to requirement of a sector. The determination of the functionality of the
entities and the components present in the system can be evaluated through the overview of
the diagram. The diagram regarding the overview of the architecture of the system includes the
process of interaction and the presentation of the existing service. The data services for the
development of electronic health record are given and the services integration consists of
security and privacy services. The electronic health record system development for Australian
federal Government describes the following functional capabilities to achieve goals and
objectives of the system. The first goal is to improve patient safety and to provide them a more
secure and safe environment. The second goal is to provide efficient and effective services for
health care to patients. The third goal is to facilitate management of sensitive data of patients,
healthcare provider and doctors. The fourth goal is to facilitate integration of data and sharing
of data securely among the healthcare providers.
Logical form of Architecture
The feasible development can be delivered by the e-health record system can be
presented by the logical architecture and the functionality of the components. The major
attributes and the their functionality helps to develop the logical view of the components
provided in the electronic health record. The intended groups, framework modelers and
engineers, are related with this diagram that helps to develop the entities for this diagram.
The logical presentation of the diagram mentioned in the paper gives the description of
the significance of the requirements in the system. The necessities related with the end
entities/users requirements are given in the diagram to depict the functions and operation
required to develop electronic health record system (Schwalbe 2015). The development of
electronic health record uses enterprise data warehouse to broadcast and input the integral
data for overall operation of electronic health record. This part of the enterprise architecture
defines the requirements, planning and the significance of the data warehousing in the
enterprise architecture. The main target of logical view diagram is to achieve the required goals
for healthcare providers along with Federal Australia Government objectives for developing
electronic health records.
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Figure 3:Logical View Diagramdevelopment of EHR system
(Source: Created by author)
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Diagram of Component Relationship
The component relationship diagram shows the relationships among different
components of requirements that are necessary to develop electronic health record system.
The electronic health record system development requires various components and they are
described through the given diagram (Stein and Morrison 2014). The components presented in
the component relationship diagram can be easily figured out by the system developer, to
understand the required functionality and operation process of the system to develop
electronic health record. The given diagram is the outcome of combining logical view and
architectural overview diagram which presents the connection of different components within
the information system.
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Figure 4: Diagram between the relationship between components in the EHR
(Source: Created by author)
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Diagram of Component Interaction
Figure 5: Diagram of the interaction between the components in the HER Development
(Source: Created by author)
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The diagram that represents the interaction system between the components in the e-
health record system has been provided in this paper. The components and the information
provided in the diagram indicates the necessary steps for achieving the interactions between
the components. These information is helpful for achieving the goals of the e-health record
system.
Management of Information and data Integration
Operational Structure
The presentation of the geographic distribution of the different nodes rae presented in
the operational model. The diagram based on component model discussed in the previous
section and it is formulated after the component model formulation. The operational model
breaks the components into functional and non-featured components that are further used to
convey the development of the system so that it can be appropriate with the requirement of
clients (Whetzel and Wheaton 2016). The main objective off the operational model is to
showcase the different operational functionalities associated with the e-health record system.
It also showcases the possible outcome of this model against the given data. Some of the
factors for the development of the electronic health record system are the head office, disaster
recovery management of the front office and the back office associated with the system.
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Continuous availability pattern
Figure 6: Development of the operational model through HER system
(Source: Created by author)
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Challenges in the System
The challenges that are posed for data integration are given as follows.
 Barriers to implement electronic health record-The barriers to implement electronic
health record system are various ranging from budget to deployment to security. The
high budget to deploy and maintain with uncertainty in outcome poses the primary
challenge. The other barriers are privacy and security where there is a risk of data
breach.
 Barriers to learn the system and services- The understanding and learning factors is
also a challenge where lack of knowledge about the system will hinder its deployment.
The healthcare providers and patients, if lack knowledge of using electronic healthcare
systems, they may see it as a challenge (Arndtet al.2017). The learning challenge will
hinder participation of healthcare providers and patients.
 Barriers because of easy use- The electronic health record system may or may not
provide expected health information delivery automatically. The stakeholders are
generally unwilling to use the system due to unfamiliarity to the electronic health record
system or some other reasons.
 Electronic health record system interoperability-The patients receiving treatment at
two very different places will pose a challenge (Jamoom, Yang and Hing 2016. ). The
challenge to provide care for patients-centered is the main hindrance in deployment of
electronic health record system.
 Reporting quality- The main challenge of the health care record management is
regarding the interoperability. It also includes the quality measurement and managing
the engagement of the patients. The quality reporting of information from electronic
health record system are issue related to the certain strategies and the challenges
associated with the strategies in the electronic health record system.
Strategies those can be implemented
The below are the strategies for the challenges posed by the electronic health record
system development.
 Involvement of executive management and implementing efficient and effective
controls and measures.
 Assuring of sufficient resources and components devoting to the project for better
development and deployment of electronic health record system.
 Utilizing phased implementation for projects before its beginning and all the phases
must be negotiated.
 Choosing effective vendor and vendor scope to provide help in developing electronic
health record system.
 The changes are necessary and hence, to deal with the changes preparation is required.
The prior planning for managing the changes of work flows due to electronic health
record system is necessary.
Conclusion
The study shows about the implementation of the health record system using enterprise
architecture. The proposes system is developed by the enterprise information architecture. The
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diagrams provided in the paper gives a clear description between the different components of
the system. The main objective of using the enterprise architecture in the development of the
health care record system is to deliver the sustainable outcome. It can be said that the of the
accurate heat care record keeping system will have positive impact on the society. The different
diagrams helps to provide different illustration of components, entities and relationships
among the components and entities.The challenges and strategies to overcome these
challenges are also provided. Therefore, it can be concluded that there are challenges with the
development of electronic health record system and it should be managed with proper
strategies.
Recommendations for the improvisation
Effective suggestions can be provided in order to improve the proposed process for the
development of the health care record system. Some of these suggestions are-
 Leadership- The leadership plays an important role in successful implementation of HER
system where effective leaders should be there to help in deploying the system.
 Identifying a project manager- A project manager should be there to manage the
deployment and implementation of the system because it is the crucial part.
 Raising awareness- The awareness of electronic health record system must be raised
and enthusiasm must be encouraged for the system among the participants.
 Staff training- The training of staff as well as patients should also be incorporated to
make them aware and acknowledged about the system and its uses for better
facilitation.
 Utilizing accurate resources- The accurate resources should be utilized for the
deployment of electronic health record system because it is important to deploy an
efficient and effective system.
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References
Ahmad, E. and Brosio, G. eds., 2015. Handbook of Multilevel Finance. Edward Elgar Publishing.
Andrus, M.R., Forrester, J.B., Germain, K.E. and Eiland, L.S., 2015. Accuracy of pharmacy benefit
manager medication formularies in an electronic health record system and the Epocrates
mobile application. Journal of managed care & specialty pharmacy, 21(4), pp.281-286.
Arndt, B.G., Beasley, J.W., Watkinson, M.D., Temte, J.L., Tuan, W.J., Sinsky, C.A. and Gilchrist,
V.J., 2017. Tethered to the EHR: primary care physician workload assessment using EHR event
log data and time-motion observations. The Annals of Family Medicine, 15(5), pp.419-426.
Buede, D.M. and Miller, W.D., 2016. The engineering design of systems: models and methods.
John Wiley & Sons.
Bussler, C., 2013. B2B integration: Concepts and architecture. Springer Science & Business
Media.
Chang, J.F., 2016. Business process management systems: strategy and implementation. CRC
Press.
Charter, M. and Tischner, U. eds., 2017. Sustainable solutions: developing products and services
for the future. Routledge.
Galliers, R.D. and Leidner, D.E. eds., 2014. Strategic information management: challenges and
strategies in managing information systems. Routledge.
Giachetti, R.E., 2016. Design of enterprise systems: Theory, architecture, and methods. CRC
Press.
Goetsch, D.L. and Davis, S.B., 2014. Quality management for organizational excellence. Upper
Saddle River, NJ: pearson.
Jamoom, E., Yang, N. and Hing, E., 2016. Adoption of certified electronic health record systems
and electronic information sharing in physician offices: United States, 2013 and 2014. US
Department of Health and Human Services, Centers for Disease Control and Prevention,
National Center for Health Statistics.
Laudon, K.C. and Laudon, J.P., 2016. Management information system. Pearson Education India.
Peppard, J. and Ward, J., 2016. The strategic management of information systems: Building a
digital strategy. John Wiley & Sons.
Schwalbe, K., 2015. Information technology project management. Cengage Learning.
Stein, B. and Morrison, A., 2014. The enterprise data lake: Better integration and deeper
analytics. PwC Technology Forecast: Rethinking integration, 1, pp.1-9.
Whetzel, D.L. and Wheaton, G.R. eds., 2016. Applied measurement: industrial psychology in
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