Business Case for Investing in Electronic Health Records (EHR)

This report presents a comprehensive business case for investing in Electronic Health Records (EHR) within a doctor's practice. It begins by highlighting the challenges faced by doctors, such as managing chronic illnesses and communication issues, and introduces EHR as a solution. The report details the benefits of EHR, including improved patient care, reduced costs, and better access to patient information. It includes an executive summary, key conclusions, and recommendations, such as personalizing EHR and training medical professionals. A SWOT analysis, cost-benefit analysis, and a balanced scorecard are used to evaluate the investment. The report also addresses the strategic context, organizational change impacts, and risks associated with EHR implementation, emphasizing the need for data security and patient privacy. The financial analysis includes a cash flow projection, while the non-financial benefits are assessed using a balanced scorecard. The report concludes with a stakeholder analysis and recommendations for successful EHR implementation, providing a detailed overview of the investment's potential.

The Business Case for Investing in EHR within a Doctor’s Practice
Presented To: XXXXXXXX
Author Name: XXXX
Date:XXXX

Background information
Doctors have always a tough job, they have always confusion like how to handle the issues
like managing the different shift in the hospitals, shifting of payment model to new
government mandate and the same time they treating the increasing number of patient with
different types of critical diseases and coordinate the caring staff of the patient and
communicating with the vendor suppliers or providers.
Followings are the challenges for patient care organisation in the market place:
1. Caring for the chronically ill.
Doctors always facing difficulties while handling the chronically ill people, due to doctors are
not totally prepared for this type of chronically ill patient.
2. Difficulties in Managing illness.
Doctors are facing the difficulties while they managing the patient illness, Patient illness is
not recorded properly, and doctors are not able to go through the patient old medical history
and it will affect the patient treatment.
3. Lack of communication with patients and other providers.
Only thirty percent doctors accept that they inform the other department about the patient
discharge or any patient related information. Lack of coordination and communication
between different departments can lead to the financial penalties and gap between the patients
cares.
4. Not keeping up with technology.
Not properly using of Information technology in the patient care organisation all other system
like billing, patient training and other related work taking more human resources, and taking
more cost.
5. Patient not engages with technology.
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Using the digital tool patient can measure multiple things like (Blood pressure, Sugar
monitoring, pulse check etc.) patient care staff need to know how to engaged the different
generation patient can use the technology, with the use of technology tools we can improve
the patient health. It is expected that in a survey 120 billion people will use the internet of
things by 2020.
Electronic Health Records (EHR)
The Electronic Health Records (EHR) process is a new established and standard model in
today’s era. The acceptance of Electronic Health Records in the patient care system influence
eHealth issues in an intermediate surroundings like EHR vendor, patient, bio laboratory,
health care organisation etc. the motive of electronic health records is to care and recover of
individual patient under the supervision of doctors or specialist with the patient privacy.
However significant patient information is gathered during the patient care and investigation,
some of the information is precise for some patient and useless for some patient (Mildon, T,
2001).
Using EHR the we can reduce the patient queue from the hospitals or clinic, it reduces the
medical professional work and also help to improve the patient care in the hospital, using
EHR doctors are not worry about the patient medical history, they can get the patient medical
history easily. It also provides the information related to patient routine check-up. It notifies
the patient or doctors for upcoming scheduled check-up.
Using PHR patient health record the EHR will notify the routine check-up for the registered
patient, so they cannot miss the check-up. EHR maintain the patient medical record (PMR) so
if any unconditional situation or any emergency condition the doctors can fetch patient
medical report and start treatment without worrying about any previous medical history of
the patient.
EHR maintain the information in repeatedly in combination through organizational patient
care record, and it provide the great value for other purpose which will support the research
work on the health care area. This type of information is reasonable for other purpose which
we can call as secondary use.
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EHR vendor
Our electronic health record vendor is “Emerging Systems E-Health Solutions”. Emerging
Systems E-Health Solutions is an Australian organisation and it provides the wide variety of
solutions for the patient care organisations. It works with both type of client Public and
Private hospitals, and has the facility like laboratory, centre for medical care to provide the
information technology solution.
It was developed in 2002 and provide services at St Vincent's Private, St Vincent's Public
Hospital, and the Mater Hospital in Sydney however it being progressively rolled out
enterprise wide throughout Government of South Australia - SA Health Hospitals.
It has developed and grown-up in scope and functionality. Clinicians have been, and continue
to be, the primary contributors in the development of the application.
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Executive summary
The motive of this research paper is to discover the all type of issues (legal and regulatory)
Electronic Health Records (EHRs) is beneficial for primary purpose which support and
increase the patient care for patient care system. Electronic health record is very important for
because it provide a way to balance the patient privacy as well as the optimal use of EHR.
In today’s patient care system brings the many stakeholders together (for example:- medical
personal, medical insurances company, researchers, infrastructure vendor, pharmaceutical
companies and patients) and they only understand each other’s need and this type of lack of
indulgent is mainly the evident of EHR,
It is often seen far more as a technological solution or gadget, than as a key tool of healthcare
contributing significantly to common values of equitable, efficient and safe healthcare.
For using the EHR in broader terms we need to understand the potential use of EHR it’s not
only the technology aspect but for the social, legal and ethical issues which is elevated by
EHRs. The main emphasis on research on electronic health record was to inspect the
behaviours in which the broader aspect of electronic health record can gives the valuable tool
to deliver and maintain the quality of clinics and hospital so they can give the high grade
services to their patient.
Key conclusions:
 It provide a clear and reliable description or explanation of the electronic health
record and it also explain the benefits of from requiring the EHR in the medical
profession(Hospital)
 Nurturing the clarity and collaboration across the Australia to support the
coordination on clarifications of data security in the legislation in respect of EHR
implementations
 Recognizing the profits of cross-border consumption of info which is maintained in
the EHR for the exact purposes
 Launching the dedicated techniques for the medical professional to meet ‘professional
secrecy obligations’ consistently across the Australia.
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Key Recommendations
Followings are the key recommendation:
1. First need to personalise the EHR
Health care organisation needs to personalise the electronic health record, here the
health care organisation needs to fill or decorate the interface (input the information).
2. Train the medical professional for EHR.
To use the EHR, the medical professional first need to take some training to operate
the electronic health record, so they cannot faces difficulties when they use this
system for patient use.
3. Bring into line EHR workflows with clinical workflows.
The clinical workflow needs to line up with the Electronic health record
4. Listen what the medical professional wants.
When we installing the EHR in the medical professional work space first we need to
understand what they want in their workplace, what type of difficulties they currently
faces in the work place, what are their suggestion for installing the electronic health
record in the clinic or hospital.
Followings are the Secondary key recommendations:
1. Collection of digital health record of patient
2. Digital access of record(only for authorised users)
3. Providing the training so the medical staff can provide the enrich quality, safety, and
efficiency of patient care
4. The record of patient is maintained by the clinic, nurses, and other staff member.
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Strategic Context
EHR is transforming the patient care service and it has very efficiency, various EHR is based
on the communication and technology. When the EHR adoption is not expressed with the
strategic planning the result is inadequate, EHR should pursue to reach the users and meet the
desired goals. It should start from the current situation and consider the all potential resources
which is based on its plan and goals. Information technology environment, network
infrastructure, and IT market(Dearne, 2019).
Following are the strategies seeking to optimize use of electronic health record at the point of
care.
Measure the work and procedure we performed. And compare this with the improved
electronic health care and map the intended to be performed. Openly detect how the medical
person and patient are using the EHR. And observe what will cause the issues, many of which
can be easily corrected with additional training or some slight modification of the system,
Evaluate: Evaluate the processing of electronic health record in the hospital organisation, and
after successful evaluation we implement it on our own electronic health record.
Re-evaluate: Re-evaluate the strategies if we observe anything is not working correctly,
Business Context:
When a patient admitted in the patient care system the process is started, followings are the
steps of business process:
 search the data in the repository
 select the relevant data for decision-making
 save the data
SWOT analysis:
Strength:
Expertise,
cost,
advantage of technology use.
Weaknesses:
Limited service,
Staff member is not well trained.
Opportunities:
Using new technology,
New market place,
Threats:
Competition in market,
Changes in medical insurances,
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Lack of competition. Economic slowdown in Australia.
Analysis of the investment
At the evaluation analysis for EHR we used multi-criteria approach, we take 20 to25 medical
staff depends upon the size of our organisation, we will develop the semi structure
questionnaires, it will be directed in to two important data for the organisation. The
compound assumption result of EHR adoption and it will be developed on Delphi process and
it is used for outcome variable. After one or more than one year of first contact the medical
staff is again contacted to monitor the EHR adoption, the key information is collected again.
A multilevel model applied to identify the organisational and individual determinants of EHR
adoption in patient care system settings (Pifer, Smith, Keever, 2001).
Financial benefits and costs
Cost benefit analysis is widely accepted tool for the financial decision making. Here we can
estimate the project cost and benefit it has four steps:
 Determine the project goal
 Cost estimation and benefits
 Appropriate discount rate
 Complete the analysis with the calculation
Cash flow analysis for the EHR:
The following table shows the five year period, at the early stage the outflow of cash is
positive but from the second year it gives the positive net value.
EHR
Initial Year 1 Year 2 Year 3 Year 4 Year 5
Inflow $4,500 $20,000 $20,000 $35,000 $35,000
outflow $12, 500 $7,000 $3,000 $9,000 $3,000 $3,000
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EHR
Initial Year 1 Year 2 Year 3 Year 4 Year 5
Net
Cash
Flow
($12,500) ($2,500) $17,000 $11,000 $32,000 $32,000
0 1 2 3 4 5
($12,500) ($2,500) $17,000 $11,000 $32,000 $32,000
Non-financial benefits and costs
Followings are the nonfinancial benefits and cost for the EHR:
 It gives the accurate, updated, and complete record
 We can quick access to the patient record
 Share over network with security
For estimating the nonfinancial benefits and cost we are using the balanced scorecard.
Balanced scorecard for EHR:
Balanced
Scorecard
Provide the
medically
ready
member
Maintain
and
develop
operational
Provide
quality
Provide
operational
capability
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workforce response
Customer
perspectiv
e
Willingness
acquiescence
Provide
training
Health care
satisfaction
Patient
oriented
implementation
Internal
process
perspectiv
e
Post health
medical
requirements
Track and
manage
Effectiveness
in care
Maintain the
accomplished
goal
Risks of implementation
For any new system implementation we have always risk in its implementation, for EHR
implementation we have some social and ethical risk of implementation. When we record the
information of patient in the personised EHR the patient always raised ethical concerns.
Because the entire record of patient medical history is very sensitive and can carriage a threat
to the security as well as overstep on patient’s confidentiality.
To overcome of this type of problem we can use the encrypted password with the patient
confidential records.
Organisational change impact
The change in organisation impact on the EHR core process, followings are the stakeholder
analysis for the organisational change:
 What we can enhance from our Current State?
 What is better for Future?
 What can we change NOW?
 Who will take the change initiative?
 What types of team is needed to form a consistent team?
Real options and future digital opportunities supported by this investment
Followings are the future digital opportunities for the EHR:
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1. Precise Medicine
EHR has ability to provide the computer based assistance and decision support.it is
easier to ask the questions and get answer using the digital system.
2. Increased Patient Engagement program
EHR helps the patient to engaged with the integral process, for example patient needs
to answer questions before arriving in the patient care, the patient appointment is also
depend upon the data provided by the patient.
3. Reach for Remote Medicine
It is predicted that In the future the EHR will integrated with the telemedicine. And as
a result EHR provide care anytime, no matter where the patient is.
Benefits Realisation
Project governance and oversight
Project Governance structures are the mechanisms thorough governance can operate the
functional entities:
• Steering Committees
• Project Sponsors Committees
• Business Owners
• Project Management Teams
• Consulting Teams
• Medical Advisory Teams
Risk management
For any system we have always risk in implementing the system, a pre plan to overcome the
upcoming failure of system is called the risk management. Followings are some key risk for
EHR:
 Inappropriate training of medical professional
 Poor system design(unable to serve the patient)
 Inadequate security and policy of EHR
Target measures
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Followings are the target measure for the EHR system:
 Decreases the number of telephone call related to pharmacy prescription
 Improve the patient care facility
 Decrease the waiting line for the patient
Ethical and Social Implications
Identify relevant ethical and social principles
Followings are some ethical and social principle for the EHR:
 EHR should help in the patient care and also support the relationship with patient and
medical professional.
 It should support each patient.
It should provide the privacy and confidentiality which will prevent it from any
unauthorised access(Ozair, Jamshed, Sharma, Aggarwal,2015).
Evaluation of potential risks and threats to patients and staff
The maximum use of mobile device, embedded device, application software and the
consumerization of IT is the now becomes the top potential risk and threats to patient and
staff in electronic health record system. We believe that the followings are the top patient
care organizations risks and its evaluation.
1. Many Devices, Many Risk
Now a days the use of mobile devices are common in all over world, also the doctors,
administrators, other staff member and nurses of the patient care organisation used multiple
types of devices to communicate. And it is essential to access the network. But these types of
devices also require the software upgradation etc. and it crying out for infection.
Recommendation:
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