Figures 6.2, 6.3, 6.4, 6.5, 6.6 and 6.7 in the Amatayakul textbook all show the migration path towards an EHR using different formats, e.g. picture, building block, step diagram, flow chart, etc. Assess the migration path formats and evaluate the similarities and differences.

Develop an EHR migration path of a type of your choice for a small, 49-bed, rural hospital. The hospital has no skilled nursing homes, nor is it associated with any physician clinics.
Develop a summary of your evaluation and reasoning for the chosen format.

 POST
Figure 6.2.Skills of change leadersChange leaders have:•People skills: They are able to understand the diversity among all individuals, skill sets, and positions that are affected by EHR and health IT. Effective change leaders are able to listen, restate, reflect, clarify without interrogating, draw out the quiet, quiet the verbose, channel discussion, plant ideas, and develop trust and confidence among users.•Political skills: They need to understand the various viewpoints and counterpoints that may arise during discussions about EHR and other types of health IT.•System skills: They help organize and manage technology while translating this into language that users will understand and respect.•Analytical skills: These skills ensure that members of the organization not only understand and appropriately improve upon workflow and processes but also use workflow and processes to assess and manage the financial impact of change.•Business skills: These skills are needed to understand the underlying way the health care organization works and the underlying clinical processes. Change leaders need be able to “talk the talk and walk the walk” related to their roles.162
Figure 6.4.Sample communication plan structureMessageSenderReceiverMediumWhenDate DoneFollow UpDate Done
Figure 6.2.Skills of change leadersChange leaders have:•People skills: They are able to understand the diversity among all individuals, skill sets, and positions that are affected by EHR and health IT. Effective change leaders are able to listen, restate, reflect, clarify without interrogating, draw out the quiet, quiet the verbose, channel discussion, plant ideas, and develop trust and confidence among users.•Political skills: They need to understand the various viewpoints and counterpoints that may arise during discussions about EHR and other types of health IT.•System skills: They help organize and manage technology while translating this into language that users will understand and respect.•Analytical skills: These skills ensure that members of the organization not only understand and appropriately improve upon workflow and processes but also use workflow and processes to assess and manage the financial impact of change.•Business skills: These skills are needed to understand the underlying way the health care organization works and the underlying clinical processes. Change leaders need be able to “talk the talk and walk the walk” related to their roles.162
Table 6.5.Stages of change modelStage of ChangeTimelinePrecontemplation (people may be told they need to change, but think only about the negative aspects of change)6 monthsContemplation (people recognize the need to change and are weighing the positive and negative aspects)6 monthsPreparation (people are ready to make a change and start to take small steps toward change)30 daysAction (people actually change their behavior and intend to continue to do so)6 monthsMaintenance (people sustain their new behavior and work to prevent a relapse)OngoingSource: Boston University 2013.
able 6.6.Components of clinical transformation•Integration of enabling technology throughout the redesign process to maximize technology’s impact•Untethering of information to make it available at the time and place it is needed•Clinical process improvement and standardization across the health system and sharing knowledge across the system•Evidence-based medicine and clinical care•Sustained organizational and cultural change•Transfer of knowledge and effective communicationSource: King et al. 2003, 40–41.
Table 6.7.Baldridge Excellence Framework core values and concepts•Systems perspective•Visionary leadership•Customer-focused excellence•Valuing people•Organizational learning and agility•Focus on success•Managing for innovation•Management by fact•Societal responsibility•Ethics and transparency•Delivering value and results
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