Running head: CHANGE CHANGE 5 Managing and Leading Change: EHR Selection Purdue Global University HS450-01: Strategic Planning and Organizational Development January 25, 2020 Running head: CHANGE 1 CHANGE Managing and Leading Change: EHR Selection In the healthcare industry, it is essential to adapt and adjust to new ways of thinking to deliver the best outcomes for our patients. Like many industries, technology has made improvements in healthcare that have allowed for increased productivity, better care coordination, and better quality of care. Electronic health records (EHR) is one tool that can be used to help achieve all of those measures and can be an asset to the clinic moving forward into the future. With any change, proper steps must be taken to ensure optimal success is achieved with implementing the new process. A collaborative approach is necessary for exploring priorities, processes, and obstacles that will need to be addressed during implementation. Part 1 The first step with implementing a new EHR system will be to establish two teams to help with planning and decision making. The first team that will be developed will be a clinician based team to give input on the clinical wants and needs from the EHR system. This team will consist of a physician, nurse practitioner, radiologist, pathologist, and pharmacists. These roles are chosen to represent the various departments that will be on the frontline of using the new EHR. Physicians and nurse practitioners provide patient care, and their input will be a valuable resource with ensuring that the system delivers quick and efficient ways to accomplish clinical tasks. The radiologist will represent the imaging department, and the pathologist will represent the laboratory department. Their input will ensure that the EHR provides functionality to improve workflow while allowing quick access to labs, pathology, imaging, and other clinical reports. The pharmacist will represent the pharmacy and will provide input on ways for the EHR to increase productivity and optimize medication delivery. The next team that will be put together will consist of administrative staff that will include a medical biller/ coder, an office manager, an IT specialist, a patient account, and a patient service representative. The representative from billing and coding will help provide input on what is needed from the EHR to help improve workflow, reduce errors, and improve processes involving claims. The IT specialist will provide their expertise suggesting what equipment will need to be updated, security measures put in place, and network requirements for the project. As the office manager, there will be reports, tracking systems, and other managerial tools that will be desired options in the EHR. Finally, the representatives from account services and patient services will also provide input on scheduling, access to patient information, and desired options to improve productivity.  Next, a leade ...

1. Running head: CHANGE
CHANGE
5
Managing and Leading Change: EHR Selection
Purdue Global University
HS450-01: Strategic Planning and Organizational Development
January 25, 2020
Running head: CHANGE
1
CHANGE
Managing and Leading Change: EHR Selection
In the healthcare industry, it is essential to adapt and adjust to
new ways of thinking to deliver the best outcomes for our
patients. Like many industries, technology has made
improvements in healthcare that have allowed for increased
productivity, better care coordination, and better quality of

2. care. Electronic health records (EHR) is one tool that can be
used to help achieve all of those measures and can be an asset to
the clinic moving forward into the future. With any change,
proper steps must be taken to ensure optimal success is
achieved with implementing the new process. A collaborative
approach is necessary for exploring priorities, processes, and
obstacles that will need to be addressed during implementation.
Part 1
The first step with implementing a new EHR system will be to
establish two teams to help with planning and decision making.
The first team that will be developed will be a clinician based
team to give input on the clinical wants and needs from the EHR
system. This team will consist of a physician, nurse
practitioner, radiologist, pathologist, and pharmacists. These
roles are chosen to represent the various departments that will
be on the frontline of using the new EHR. Physicians and nurse
practitioners provide patient care, and their input will be a
valuable resource with ensuring that the system delivers quick
and efficient ways to accomplish clinical tasks. The radiologist
will represent the imaging department, and the pathologist will
represent the laboratory department. Their input will ensure that
the EHR provides functionality to improve workflow while
allowing quick access to labs, pathology, imaging, and other
clinical reports. The pharmacist will represent the pharmacy and
will provide input on ways for the EHR to increase productivity
and optimize medication delivery.
The next team that will be put together will consist of
administrative staff that will include a medical biller/ coder, an
office manager, an IT specialist, a patient account, and a patient
service representative. The representative from billing and
coding will help provide input on what is needed from the EHR
to help improve workflow, reduce errors, and improve processes
involving claims. The IT specialist will provide their expertise
suggesting what equipment will need to be updated, security
measures put in place, and network requirements for the project.
As the office manager, there will be reports, tracking systems,

3. and other managerial tools that will be desired options in the
EHR. Finally, the representatives from account services and
patient services will also provide input on scheduling, access to
patient information, and desired options to improve
productivity.
Next, a leader must be established to help guide and steer the
group in productive discussion. As the administrator tasked with
this project, the leadership role will be my responsibility to
develop an environment of creativity and collaboration.
Disagreements are to be expected when bringing in different
representatives from multiple departments with varying
expectations on processes and what should take priority. Team
building activities can be beneficial to help establish a cohesive
team and demonstrate a functional way to achieve conflict
resolution. These activities can help teams establish positive
communication, self-development, encourage problem-solving,
and foster teamwork, encouraging teams to work together
(Fapohunda, 2013).
The first team building activity that will be employed is called
two truths one lie. This is performed by each person in the
team, making two truthful statements about themselves and one
lie. Each member of the group can ask two questions to each
person to try and discover which statement is the lie. This is an
ice breaker activity and encourages the team to get to know
something about other members of the group. Ice breakers help
spark conversation, increases the comfort level between group
members, and helps to relieve inhibitions and tension (Chlup &
Collins, 2010).
The second team building activity that will be done is called
sneak a peak. To perform this, the leader will create a sculpture
using building blocks or legos and hide it from plain sight. One
person from the two groups will get a short time to view the
sculpture and then go back and have a timed period to
communicate with the team how to replicate it. Once someone
has seen the sculpture, they are not allowed to provide any
hands-on assistance on communicating verbally. Once the round

4. is up, the person who viewed the sculpture will sit down and
give no more aid to the team. This will continue until there are
no more group members to build the sculpture, and in the end,
their work will be compared to the original sculpture. This
activity will encourage communication and problem solving
amongst the teams.
The last activity will consist of a simulated scenario. This will
consist of a situation that doesn’t have any right or wrong
answers but multiple options to choose from. This can be as
simple as a medical dilemma such as a kidney being available
for transplant, but the group must decide on which patient
receives it. The patients will have different ages, backgrounds,
and issues that will complicate the process for deciding. Each
group must come up with a consensus pick that is agreed upon
by each person in the group. This will encourage discussion,
collaboration, conflict resolution, problem-solving, and will
require that the team come up with a resolution supported by
everyone. This will be key in future disagreements involving
the implementation of the EHR.
Part 2
Implementing a new EHR will come with challenges that must
be overcome to achieve success. Two of the most common
barriers seen with EHR systems are buy-in from the staff and
frustrations over decreased efficiency while the new system is
being learned (Palabindala, Pamarthy, & Jonnalagadda, 2016).
Buy-in from the staff can best be described as resistance to
change. It is human nature to resist change, and when adding in
new technology, the resistance can be even higher. Staff
frustrations due to decreased efficiency will be caused by
learning the new systems. Any time a new system is introduced,
it will take time for the staff to be proficient with using it to
improve workflow. To tackle these two issues change
management theories will be applied to overcomes these
barriers and help produce the best outcomes.
Exploring the first issue, buy-in from the staff, the ADKAR
model of change management will be applied. ADKAR stands

5. for awareness, desire, knowledge, ability, and reinforcement
(Warrilow, 2009). The first step, awareness, is where the need
for change will be conveyed to the staff. Talking points for this
stage will include government mandates, improved
reimbursement, increased productivity, and increased patient
outcomes. The second step, desire, will be the stage that must
encourage the staff to want to make the change happen. Talking
points for this step will include explaining how the new EHR
will help reduce errors, improving the overall accuracy of the
medical records, make the information more accessible and
available to the multidisciplinary team, and reduce delays in
patient care between the different departments (CMS, 2012).
The knowledge stage will lay out the timeline, plan for data
migration, processes, and training procedures should be
discussed, giving staff a clear picture of how the change is
going to happen. The ability stage will include the training of
staff, giving staff the skills to make the change. The last stage,
reinforcement, is critical to the success of the change. This
should include a support system for staff and any additional
training or retraining that is needed.
Next, the issue of frustrations being felt by the team due to
decreased efficiency during initial implementation will be
addressed. This will be addressed with Lewin’s change model.
Lewin’s model has three stages, unfreeze, change, and refreeze.
The first stage, unfreeze, is where the right environment will be
created (Warrilow, 2009). The need for change will be
reinforced along with plans for training staff and the ultimate
end result, which will be improved efficiency. The next phase
will be change; this will including the training and setting up a
good support system and mentors. The last stage will be
refreeze; in this stage, additional training and support will be
done to reinforce the competency of the new EHR system.
Taking this approach will decrease frustrations and provide
staff with a layer of support to help them during the transition.
Part 3
In order to ensure the best EHR is chosen that align with the

6. needs of the clinic, a strong procurement plan must be in place.
The procurement plan will help with the selection of a vendor,
establishing which vendor can meet the clinic’s needs, find
options that meet the project budget, contract negotiations, and
ultimately the implementation of the new system. To make the
selection of the vendor as smooth as possible, a request for
information (RFI), request for proposal(RFP), and request for
quotation (RFQ) will be used. The first step that will be done in
the procurement process is RFI. During this step is when the
clinic will gather information from vendors. This will be sent
out to a wide range of potential candidates to gain preliminary
information on the EHRs each vendor has to offer (Mhay &
Coburn, 2019). The information that is received back from the
vendors will help with narrowing down the different vendors.
The next step will be to send out an RFP. This will be a
document that will be sent out to the shortlist of vendors that
were selected after receiving the RFI. The document will
outline the vision and goals of the project. More detailed
information will be included giving specifics to the vendor of
what the options are being sought for the EHR system. This will
also outline any interoperability issues that need to be
considered with any current systems the clinic has in place. The
document will detail all of the needs of the clinic to allow
vendors to respond with their solutions for meeting them. This
should also include specific information on training support and
timelines for implementation (Mhay & Coburn, 2019).
Finally, once all of the detailed information is obtained from
the shortlist of vendors, an RFQ can be sent. The RFQ will
specifically state all finalized options, functions,
customizations, and requirements for the EHR. The purpose of
the RFQ will be to receive quotes from the shortlist of vendors
based on the finalized specifications for the project. This will
allow the vendors to place bids on the project and allow the
clinic to compare prices. This will be the step where the
specific vendor is chosen based on clinic and budget needs.
In healthcare, change is an inevitable part of the industry.

7. Whether it is a change to the policy, regulation, technology, or
reimbursement facilities who embrace change and adapt will set
themselves apart. A new EHR system will help the clinic
improve productivity and reduce errors. The impact on the
patient will be felt by delivering better care coordination while
improving outcomes. With the proper plan in place, the clinic
will achieve the best results with implementing this new
system.
References
Chlup, D. T., & Collins, T. E. (2010). Breaking the ice: using
ice-breakers and re-energizers with adult learners. Sage
Journals, 21(3), 34–39.
http://dx.doi.org/10.1177%2F104515951002100305
CMS. (2012). Electronic health records. Retrieved from
http://www.cms.gov/Medicare/E-Health/EHealthRecords/index
Fapohunda, T. M. (2013). Towards effective team building in
the workplace. International Journal of Education and Research,
1(4), 1–12. Retrieved from http://ijern.com/images/April-
2013/23.pdf
Mhay, S., & Coburn, C. (2019). Meaning of RFQ RFI RFT RFP.
Retrieved from
http://www.negotiations.com/articles/procurement-terms/
Palabindala, V., Pamarthy, A., & Jonnalagadda, N. R. (2016).
Adoption of electronic health records and barriers. J Community
Hosp Intern Med Perspect, 6(5), 32643.
http://dx.doi.org/10.3402%2Fjchimp.v6.32643
Warrilow, S. (2009). Change management theories. Retrieved
from http://www.strategies-for-managing-change.com/change-
management-theories.html