The impact of applying risk management techniques to an electronic patient record project
Date
2002
Authors
Holt, David Jeffrey
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Abstract
Many health care organizations plan to implement an Electronic Patient Record (EPR) in order to obtain the benefits that these applications bring: improved patient information management, improved quality of service and a reduction in of storage costs for patient records. One of the reasons that Canadian organizations have not widely adopted the EPR is that the implementation process is difficult and features a high risk of failure.
The author participated in an Electronic Patient Record (EPR) implementation project in Chile. The goal of this thesis was to determine whether the application of a normative model of risk management techniques to an EPR project would improve the process of project implementation. The author used the part of the continuous risk management (CRM) paradigm that corresponds to identifying the risks described in the literature, communicating their potential impact on the EPR project, and designing an implementation plan that takes recommended responses and strategies into consideration.
The author conducted a literature search to identify the risks that EPR projects have faced in their implementation efforts and the techniques that had been employed to meet them. The author used documents created during the project to demonstrate the extent to which the project had employed the suggestions that had been found in the literature.
The EPR project in Chile was subject to all of the risks that were reported in the literature as well as risks uniquely related to the Chile project such as a multi-cultural and multi-lingual team, and having to tailor clinical software for a different national health care system. The author found that the recommendations in the literature for how to respond to those risks were useful when drawing up the implementation plan. The implementation process included most of the suggestions made in the literature. The project's pilot phase was evaluated by the client using a study comparing the software's compliance with original client requirements, satisfaction surveys of doctors, patients and staff, and reports of usage levels derived from the database. The project was considered a success and the implementation was expanded from its pilot in two medical centres to include 31 centres located all across Chile.
The author concludes that using the medical informatics literature to identify potential risks and recommended responses, and then employing the recommended responses to generate the implementation plan had a positive impact on the implementation processes in the project as a whole.