No free lunch: institutional preparations for computer-based patient records

Area of Science:

• Health Informatics
• Healthcare Management
• Information Systems in Medicine

Background:

• The Veterans Administration (VA) is transitioning to a new electronic health record system.
• The Computerized Patient Record System (CPRS) represents a shift from older, department-centered systems to a patient-centered model.
• This transition impacts numerous VA facilities nationwide.

Purpose of the Study:

• To detail the preparations and associated costs for implementing the Computerized Patient Record System (CPRS) at a single VA Medical Center.
• To identify and summarize lessons learned during the CPRS implementation process.
• To provide insights into the financial and organizational requirements for adopting electronic health records in a large healthcare system.

Main Methods:

• The study details the specific preparations undertaken at one VA Medical Center for CPRS deployment.
• Costs associated with these preparations were meticulously recorded and analyzed.
• Lessons learned were systematically summarized from the implementation experience.

Main Results:

• Implementing CPRS requires significant institutional investment beyond the software itself.
• Preparations involve substantial organizational changes, human resource development, hardware and infrastructure upgrades, and rigorous software testing.
• The costs associated with achieving institutional readiness are considerable, even though the CPRS software is free.

Conclusions:

• Successful deployment of electronic health records like CPRS necessitates comprehensive planning and investment in institutional readiness.
• The transition to a patient-centered electronic record system involves multifaceted challenges and costs.
• Lessons learned from this implementation can inform future large-scale health informatics projects within the VA and other healthcare organizations.