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Electronic Medical Records: Life Cycle Phases

The Broad Category of HIT Chosen

The type of health information technology (HIT) chosen for this paper is the electronic health records (EHR), also known by the name of electronic medical records (EMR), an innovative type of software for health care institutions. EMR is a software system that allows for storing, processing, maintaining and accessing information related to the medical history of patients.

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EMR, therefore, works as an electronic version of the medical history of a patient. The use of EMR may allow for more efficacious data storage, access and analysis, and optimization of the work of the clinical staff. However, because EMRs were only developed recently and have not yet been refined by practice, they often have several disadvantages such as an inconvenient, non-user-friendly interface, the incapability of the critical assessments of patients’ health to be critically captured by medics, etc. (Simpson, 2015).

The Four Phases of the HIT Systems Life Cycle and the Activities that Would Be Performed in Each Phase

The implementation of such HIT as EMR can be carried out by thoroughly considering the life cycle of EMR (Brokel, Ochylski, & Kramer, 2011). It is possible to break this life cycle into four phases: planning and analysis; design; implementation; review and maintenance.

Planning and Analysis

At this stage, the leadership of a health care institution needs to assess the practicability of implementation of a particular EMR, including the economic (cost-effectiveness), legal (conflicts between the offered system and the legislation), and operational (can the system be utilized if the current work practices are taken into account?) practicability of the EMR. Then, it is needed to analyze the current requirements and such items as the opinion of the staff, the currently existing procedures, and so on. See Appendix 1 for the diagram for this phase.


At this phase, it is needed to specify how the system will function in the institution. In particular, it is important to establish a proper hardware platform, as well as to test the EMR. It is also required to develop a plan for transferring to EMR, and to create the necessary documentation (such as systems documentation and user’s manual). See Appendix 2 for the diagram for this phase.


At this stage, the necessary hardware and software need to be purchased, and the new EMR system needs to be installed and tested. This should also include teaching the users how to utilize the new system. Old records need to be transferred to EMR. The transition from the old system of health records to the EMR should occur. See Appendix 3 for the diagram for this phase.

Review and Maintenance

At this phase, it is required to review the quality of work of the system. This may result in a discovery of the need to carry out certain amendments or modifications in the system or to update it. It should also be maintained to improve the quality, adapt the system to new conditions, or address some errors. In some cases, the review might show that a switch to a different system or significant changes in the current one is advised, which returns the administrator to the first phase (see Appendix 5). See Appendix 4 for the diagram for this phase.

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Key Elements to Be Included in a Needs Assessment and the Effects on Other Systems that May Already Be in Use at an Agency

Before implementing a new EMR system, it is paramount to carry out a needs assessment procedure to evaluate which imperfections in the current record system the EMR is supposed to address, how well it aligns with the current systems, and how it should be implemented. Ajami, Ketabi, Isfahani, and Heidari (2011) state that such an assessment should include estimates of a) electronic readiness (which includes architecture readiness, infrastructure readiness, and process readiness), and b) other important areas of EMR readiness (organizational culture, leadership and management, technical readiness, and operational readiness).

EMR may conflict or align with the systems the assessment of the readiness of which was mentioned in the previous paragraph. For instance, EMR may or may not agree with the currently existing infrastructure (e.g., the system of teams of nurses) or the organizational culture of an institution. Therefore, the full-fledged implementation of EMR may require changing these features of the organization. Also, because the new EMR will be aimed at replacing the currently existing health records system, it is clear that the old records will need to be managed and transferred into the new system.

Key Members of the Steering Committee and Why They Are Important

The steering committee should include the key decision-makers and leaders of the health care institution (chief officers), as well as the leaders who represent the staff of particular departments. The chief officers are important because it is their responsibility to plan and oversee the implementation of the new EMR system and to ensure that its introduction will lead to a more cost-effective service that yields better patient outcomes.

The leaders who represent the staff of particular structural units of the health care institution are needed because they should communicate the opinions and concerns of the staff of the health care organization, to help the staff to switch to the new system, and to facilitate the changes necessary for the successful implementation of the EMR.

A Strategy for Selection of a Product

To select an effective EMR, it is paramount to consider several issues. First, it is needed to evaluate the type and amount of information that the EMR can store, process, and retrieve, and how this information is structured. The currently existing EMRs tend to be cumbersome, and the retrieval and utilization of the data stored there can be time-consuming (Simpson, 2015).

Second, it should allow for convenient and easy entry of the data, so that the health care personnel could input it immediately while examining a patient in their ward. Third, it ought to permit for easy between-staff communication and the prioritization of the tasks. Fourth, it should comply with the current legal requirements and be safe enough to protect the patients’ private information. Fifth, it should be user-friendly and intuitively clear to allow for its effective utilization (Simpson, 2015). Also, there might exist some other features that may need to be considered; some of them might depend on the specifics of a particular health care institution.

Potential Training Needs of End Users

It might be advised to train the end-users of EMR in the further implementation of these systems. In particular, the research by Risko et al. (2014) shows that the implementation of EMR can increase the effectiveness of emergency departments in the long term, but can cause a decrease of efficiency in the long term, which allows for hypothesizing that the utilization of EMR requires some adaptation from the users.

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Simultaneously, Kirwin, DiVall, Guerra, and Brown (2013) demonstrate that simulating at least some hospital settings that use EMR in an educational setting allows for a better adaptation of users to the EMR systems. Therefore, it might be advised to conduct training of the personnel of a health care institution to help them to better and faster adapt to the new EMR system and decrease the magnitude of the adaptation period.


Ajami, S., Ketabi, S., Isfahani, S. S., & Heidari, A. (2011). Readiness assessment of electronic health records implementation. Acta Informatica Medica, 19(4), 224-227. DOI:10.5455/aim.2011.19.224-227

Brokel, J. M., Ochylski, S., & Kramer, J. M. (2011). Re-engineering workflows: Changing the life cycle of an electronic health record system. Journal of Healthcare Engineering, 2(3), 303-320.

Kirwin, J. L., DiVall, M. V., Guerra, C., & Brown, T. (2013). A simulated hospital pharmacy module using an electronic medical record in a pharmaceutical care skills laboratory course. The American Journal of Pharmaceutical Education, 77(3), 1-8.

Risko, N., Anderson, D., Golden, B., Wasil, E., Barrueto, F., Pimentel, L., & Hirshon, J. M. (2014). The impact of electronic health record implementation on emergency physician efficiency and patient throughput. Healthcare, 2, 201-204. DOI:10.1016/j.hjdsi.2014.06.003

Simpson, K. R. (2015). Electronic health records. MCN, The American Journal of Maternal/Child Nursing, 40(1), 68. DOI:10.1097/NMC.0000000000000089

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