HLTH 302 Group Assignment 3 1

Group Assignment 3

Jasmine Avalos Barajas, Jaida Dinius, Kateriel Sampang, Viki Lemus

California State University, Channel Islands

HLTH 302: Intro Health Care Informatics

Dr. Berkowsky

Spring 2020
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Abstract

The Ventura County Healthcare Agency (VCHCA) implemented a new Electronic Health

Record (EHR) on July 1st, 2013. After critically evaluating and investigating whether or not this

initial implementation was a success or failure, our group has concluded that VCHCA's EHR

implementation was unsuccessful as it contained several mistakes and received several

complaints from the public.

Keywords: VCHCA, EHR, implementation, unsuccessful

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Group Assignment 3

Ventura County Health Care Agency (VCHCA) implemented a new Electronic Health

Record (EHR) on July 1, 2013. There were numerous complaints received by the Ventura

County Grand Jury in 2014-2015 and they concluded that several mistakes were made- making

this implementation unsuccessful. Implementing an EHR requires multiple steps and cooperation

throughout the way to meet standards and be successful. According to the Ventura County Grand

Jury Final Report: Ventura County Electronic Health Record Implementation Risks on June 11,

2015, “Subsequently VCHCA contracted a full-time project manager who reported to the

VCHCA director and had full authority for all aspects of the project related to VCHCA staff and

resource planning and coordination. He also had full authority to manage the Cerner contract for

VCHCA. The project manager was required to adhere to the Work Plan documented in the

contract with Cerner.” Although it was stated that VCHCA developed a strategy and staff to take

over the planning and coordination of the project, one of the many reasons it fell successful was

due to VCHCA underestimating the number of individuals who would use the EHR system, thus

lacking “a dedicated and experienced project manager to oversee, track and report all tasks"

(Healthcare IT News, 2014).

EHR implementation

The VCHCA unsuccessfully demonstrated many of the requirements in the project of

implementing an EHR; they had insufficient numbers of staff members, inadequate staff training

on the new system, and lacking ordering of hardware (like the appropriate amount of laptop

computers and servers). Another requirement to implementing an EHR includes listing the

features to provide thorough and accurate information, however "VCHCA did not fully
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document its system requirements nor was their evidence of a review of the requirements by an

independent EHR review team or an independent EHR Subject Matter expert (SME) consultant”

(Ventura County Grand Jury, 2015). Furthermore, it was stated “VCHCA did not develop a

comprehensive Risk management plan that would have identified significant project risks and

associated mitigation strategies'' (Ventura County Grand Jury, 2015). Lack of implementation of

a Risk Management Plan had undesirable results such as a significant impact on the quality of

the project and its cost which resulted in ultimately having to invest more money to help improve

the quality of the EHR, all of which turned out to contain several mistakes and complaints

anyways.

Workflow Interruptions

Due to these issues with the initial EHR implementation, the VCHCA experienced

several interruptions in workflow. These disruptions included: repeated staff log-in failures due

to an oversaturation of the number of people using the EHR, pharmacy printing issues where

staff needed to handwrite prescriptions for hours, and periods of instability when staff had to

revert to paper record-keeping until the EHR system was available again (Ventura County Grand

Jury, 2015). Additionally, these issues were not repaired promptly by IT personnel. Pharmacy

staff experienced technical difficulties with printing for approximately nine months after going

live with the EHR system. Although there were no records of these issues causing harm to any

patients, there were instances where potential harm was evaded by diligent clinical staff (Ventura

County Grand Jury, 2015).

Incompatibility
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Additionally, implications of the unsuccessful implementation of the EHR impacted the

VCHCA as reports stated that they were faced with incompatibility issues involving Cerner

software and IV pumps, as well as cardiac monitors. This equipment had to be replaced at an

additional cost, an issue found to be the result of a shortage in time for planning and

development. (Bresnick, 2014) The Ventura County Health Care Agency opted for an ASP

Hosted vendor, also referred to as Software as a Service (SASS), has its strengths and

weaknesses. For instance, a few strengths of ASP hosted EHR's are daily backups through the

EHR provider, higher-level security, remotely internet-accessible, and typically 24/7 tech

support year-round. Adversely, weaknesses include: “the server is not at your location and not in

your control”, Internet connection issues will disrupt workflow, and termination of vendor will

result in issues with ownership of data. (Berkowsky, 2020)

Conclusion

After evaluating, it can be concluded that the initial EHR implementation was a failure

due to several mistakes made by the VCHCA and public complaints received by the Grand Jury.

One of the main reasons that implementation of the EHR was ultimately unsuccessful was since

there was no initial testing or simulation at all whatsoever before going live on July 1, 2013.

Since there was no testing or simulation involved, many complications emerged making it

difficult to reach its utmost potential and meaningful use. Overall, the implementation of EHR

systems by the Ventura County Health Care Agency (VCHCA) was unsuccessful because it

caused disturbances in workflow, was not universally compatible with all equipment (IV pumps

& cardiac monitors) and had inadequate management and planning.

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References

Berkowsky, R. (2020). Electronic Health Records [PowerPoint slide 64]. Retrieved from

https://cilearn.csuci.edu/

Bresnick, J. (2014, June 5). Court dings CA county for mishandled EHR implementation. EHR

Intelligence. Retrieved from https://ehrintelligence.com/news/court-dings-ca-county-for-

mishandled-ehr-implementati on

California Healthline. (2014, June 4). Grand Jury Finds Flaws in Ventura County’s EHR

Implementation. https://californiahealthline.org/morning-breakout/grand-jury

-finds-flaws-in-Ventura-county's-EHR-implementation/.

Monegain, B. (2014, June 5). How one county botched its EHR rollout. Healthcare IT News.

https://www.healthcareitnews.com/news/how-one-county-botched-its-ehr-rollout.

Ventura County Grand Jury 2014-2015 (2015). Final Report-Ventura County Electronic Health

Record Implementation Risk. County of Ventura, California. Retrieved from

https://vcportal.ventura.org/GDJ/docs/reports/2014-15/2014-2015_Ventura_County_Elec

tronic_Health_Record_Implementation_Risks.pdf.