NURS FPX 6426 Assessment 2 Needs Assessment Meeting with Stakeholders

Needs Assessment Meeting with Stakeholders

Hi, my name is _______, and I work as the Nursing Informatics Specialist at Mercy Medical Center, where I am spearheading the implementation of an integrated telemonitoring-enhanced electronic health record (EHR) system for the 15,000-patient population. The project serves a patient population of 50-65-year-olds receiving acute care services by combining advanced telemonitoring capabilities with the existing electronic health record infrastructure to improve clinical outcomes and operational efficiency.

The 18-month implementation timeline includes stakeholder evaluation, system integration, comprehensive staff training, and full system implementation, which will be completed by December 2026. The organizational vision behind the initiative is to shift the model of care delivery from reactive to proactive patient management, with the goal of reducing average hospital length of stay and hospitalization costs through evidence-based telemonitoring interventions (Siddique et al., 2021).

The strategic information system change aligns with the institution’s commitment to providing patient-centered, cost-effective healthcare through innovative nursing informatics solutions to improve clinical outcomes and financial sustainability.

Connection Between Organizational Vision and Information System Change

Mercy Medical Center’s organizational vision of providing patient-centered, cost-effective healthcare through innovative technology aligns directly with the telemonitoring-enhanced EHR implementation scope and strategic direction. The project’s potential to shorten hospital stays and cut costs by 30% supports the institution’s commitment to value-based care delivery and financial sustainability (Kokshagina & Keranen, 2021).

The information system change moves the project forward by creating measurable benchmarks that link technology investment to improved patient outcomes and operational efficiency. Stakeholders benefit from the vision-project alignment through increased job satisfaction among clinical staff, no financial burden on administration, improved patient safety outcomes, and competitive positioning in the healthcare market (Depla et al., 2023).

The institutional integration of telemonitoring capabilities into current workflow processes helps ensure that technological improvements are used toward the broader organizational goal of excellence in patient care.

Current Situation and Desired State Assessment

Stakeholders identified critical issues with the current EHR system, including fragmented patient data across departments, limited real-time monitoring capabilities, and extended hospital stays, resulting in costs of $15,799 per patient admission. The projected fiscal impact analysis shows significant cost-reduction potential with the implementation of telemonitoring, estimated to reduce hospitalization costs to $11,039 per patient, yielding savings of $4,760 per admission while reducing length of stay to 9.13 days.

Current system strengths include well-documented workflows, rudimentary clinical decision support capabilities, and high staff familiarity with existing interfaces that support routine care coordination activities. With unlimited resources, stakeholders envision a fully integrated telemonitoring platform with predictive analytics, automatic patient alerts, cross-platform interoperability with all healthcare networks, mobile accessibility for real-time monitoring, and comprehensive patient engagement tools (Liu et al., 2024).

The desired state transformation would facilitate proactive, evidence-based patient management, ensure compliance with the Health Insurance Portability and Accountability Act (HIPAA), and support all-inclusive nursing informatics standards throughout the organization.

Risk Assessment and Mitigation

Stakeholders identified significant patient safety risks with the current system, including delayed clinical decision-making due to fragmented data access, failure to receive critical patient alerts with deteriorating patients, and potential medication errors due to incomplete real-time monitoring system capabilities. HIPAA compliance issues with existing data storage techniques, patient autonomy issues regarding incomplete access to health information, and liability issues arising from delayed interventions due to system limitations are among the ethical and legal issues that come to light (Blessing, 2024).

The projected training timeframe is 6 months, with a budget allocation of $450,000 for extensive staff education across all stakeholder groups, including clinical staff, information technology (IT) personnel, and administrative teams. A one-month implementation is not fiscally feasible due to the complexity of telemonitoring integration, the need for extensive workflow redesign, and the requirement for a phased rollout to ensure patient safety and system stability (Auener et al., 2023).

Risk mitigation strategies, such as robust backup systems, comprehensive audit trails, and parallel systems, should be in place during the transition period to ensure the continuity of patient care and regulatory compliance.

Evidence-Based Practice Standards

Best practices for telemonitoring systems include continuous vital sign monitoring, automated alert protocols for critical values, and integration with clinical decision support tools that follow evidence-based guidelines for patient management. The use of electronic health, mobile health, and telehealth systems helps facilitate quality, ethical, and efficient patient care by enabling real-time data transmission, remote patient monitoring, and improved care coordination among interprofessional teams.

The integrated technologies bring significant improvements in healthcare access and help reduce disparities by providing remote monitoring services to underserved populations, eliminating transportation barriers, and enabling continuous care management regardless of geographical location (Alubaie et al., 2024). The evidence shows that implementing telemonitoring across the board can lead to a decrease in hospital readmissions while increasing patient satisfaction scores and strict adherence to nursing informatics ethical standards (Po et al., 2024).

Quality and ethical care are enabled through standardized protocols and automated documentation (reducing the potential for human error), and through increased patient autonomy, improved access to health information, and direct channels of communication with healthcare providers.

Technology Functionality Requirements

Stakeholders expressed their preferences for cloud-based telemonitoring software with real-time analytics capabilities, mobile compatible hardware that includes wearable devices and tablets, and integrated communication platforms that include the capability for secure messaging and video conferencing. Short-term fiscal impact consists of initial software licensing costs of $850,000 and hardware procurement costs of $650,000 for a total of $1.5 million for the first year implementation phase.

Long term investment considerations range from five years with estimated yearly maintenance cost of $200,000, software upgrades at $150,000 every two years and hardware replacement cycles resulting in total ownership costs of $3.2 million.

System capability specifications are automated vital sign monitoring, predictive analytics for early intervention alerts, seamless EHR integration and multi platform accessibility across desktop, mobile and tablet devices (Usha & Bharathi, 2024). The ROI analysis shows cost recovery in 18 months in terms of lower hospitalization costs and higher operational efficiency.

Fiscal Impact of Information and Communication Technologies

The complete fiscal analysis of the telemonitoring-enhanced EHR system shows that it is highly cost-effective compared with the current outdated infrastructure, and the initial implementation costs were $1.5 million, while estimated annual cost savings were $2.3 million, based on reduced hospitalization costs and higher operational efficiency.

A comparison of available EHR systems shows that the chosen cloud-based platform can provide better interoperability with local healthcare networks at 40% lower long-term costs than on-premises alternatives, while offering greater data security and 24/7 technical support. Initial costs are software licensing ($850,000), hardware procurement ($650,000), and training of staff ($450,000), with long-term costs consisting of annual maintenance ($200,000), biennial upgrades ($150,000), and five-year hardware replacement cycles for $3.2 million over the lifetime of the system.

The return on investment analysis shows the cost is recovered within 18 months through measurable reductions in the cost of hospitalizations for patients from $15,799 to $11,039 per admission, which has resulted in organizational savings of $4,760 per patient while improving the quality and safety outcomes (Phillips et al., 2021). Strategic fiscal planning for sustainable technology investment that supports Mercy Medical Center’s financial objectives and advances patient care excellence through evidence-based informatics solutions.

Communication Technology and Health Literacy

Key stakeholders will be able to measure the effectiveness of communication technology through pre- and post-implementation health literacy, patient comprehension surveys, and medication adherence tracking to identify improvements in consumer health information literacy. Stakeholders identified that current patient education materials need to be revised to be appropriate for language and literacy needs.

Multilingual and simplified materials that address sixth-grade reading comprehension standards are required. Decision-making criteria include patient engagement measures such as reduced communication errors, improved appointment compliance rates, and improved patient-provider interaction quality scores (measured quarterly).

The telemonitoring system will incorporate automated delivery of health education, interactive patient portals with visual support, and culturally appropriate support content to address the diverse patient population within the 15,000-patient community (Johnson et al., 2023). Success Measures Include the following results: 80% patient portal usage rate and a 25% increase in health literacy assessment scores during the first year of implementation.

Workflow and Communication Enhancement

The information system change will increase workflow effectiveness through automated documentation, real-time patient data synchronization, and integrated, secure messaging, thereby decreasing communication delays among clinical staff, physicians, and administrative personnel. Internal communication features include instant messaging, automated alerts for critical patient values, notifications for the care team, and collaborative care planning features to facilitate interprofessional coordination across all service lines.

EHR interoperability improvements will ensure seamless data exchange with local provider offices, specialty clinics, and regional healthcare organizations, increasing care continuity, reducing duplicate testing, and improving patient safety outcomes (Ferreira et al., 2024). Emergency back-up protocols such as manual documentation procedures, Phones for communication trees, secure email systems for non-urgent communications, and quarterly training sessions for staff to ensure competency with alternative workflows in the case of system outages.

The comprehensive backup plan will ensure uninterrupted care delivery through established paper-based processes, communication coordinators, and regular drills that ensure care is provided and operations continue until complete system restoration.

• Benefits and Challenges of Health Information System Change

The telemonitoring-enabled EHR system offers numerous benefits, including simplified clinical workflows, real-time access to patient data, and enhanced communication among healthcare disciplines through integrated messaging platforms. The clinical staff will benefit from improved decision-making abilities with automated alerts for patient vital signs and evidence-based care protocols.

However, some implementation challenges include initial workflow disruption during the 6-month training period, potential alert fatigue from increased system notifications, and the need for comprehensive staff education on new telemonitoring technologies (Reegu et al., 2023).

A key implementation barrier cited by IT department stakeholders was the technical integration complexity arising from the existing EHR infrastructure and the new telemonitoring hardware. Despite the challenges, the pilot data show measurable improvements in patient outcomes and cost reductions, supporting the organizational commitment to the transformative change.

Data Capture Improvements

The new telemonitoring system will enhance data capture by continuously monitoring vital signs in real time and using automated algorithms for trend analysis and predictive analytics to identify patterns of patient deterioration 24-48 hours earlier than existing approaches to patient assessment, which are currently performed manually. Enhanced system capabilities include machine learning algorithms for pattern recognition, automated data validation processes, and comprehensive dashboards for comparative analysis, demonstrating improved identification of infection trends, medication adherence patterns, and readmission risk factors compared to the current episodic documentation system.

HIPAA compliance measures include enterprise-grade cloud storage with end-to-end encryption, implementing a secure virtual private network (VPN) for all remote access, encrypted internet protocol (IP) addresses for data transmission, and required two-step multi-factor authentication for all system users (Saini, 2021).

HIPAA violation prevention strategies include automated audit trails, role-based access controls, and routine security assessments. In contrast, violation consequences include individual sanctions such as termination or professional license review, potential criminal charges, organizational penalties of $1.5 million or more per incident, and mandatory corrective action plans.

Practice and Outcome Enhancement

The change in the telemonitoring system will improve current practice by allowing proactive patient management through the use of early warning systems, decreasing hospital readmissions by 25%, and improving patient satisfaction scores by providing better communication and engagement tools.

Digital equity initiatives such as introducing tablet devices to underserved patients, multilingual interfaces, technology training programs, and community Wi-Fi partnerships are examples of technologies that could help reduce access barriers and improve information access for vulnerable populations.

Practice improvement metrics include reductions in hospital length of stay, improvements in chronic disease management outcomes, and increases in patient portal utilization across all demographic groups (Carini et al., 2021). The holistic digital access strategies provide equitable access to healthcare and improve clinical outcomes and cost-effectiveness for the community of 15,000 diverse patients.

Change Management Principles for Resistance Mitigation

Kotter’s 8-step change model and the technology acceptance model (TAM) are key models that can be used to address resistance to the telemonitoring EHR implementation, with a focus on early stakeholder involvement, clear communication of system benefits, and comprehensive training programs to address workflow issues. The principles are advantageous to clinical staff because they reduce anxiety through phased approaches, provide sufficient time for skill development, and ensure perceived usefulness and ease of use, thereby increasing the adoption rate of technology (Trawick and Carraher, 2023).

Administrative stakeholders benefit from increased staff buy-in, lower implementation costs, quicker attainment of expected cost-savings goals, and an enhanced organizational reputation from successful change management. Patient stakeholders are helped by change management strategies to ensure smooth care transitions, consistent quality of service during system upgrades, and maintenance of provider-patient relationships throughout the change implementation process (Reegu et al., 2023).

The application of change management frameworks in a systematic manner creates a conducive environment that transforms potential resistance into collaboration, leading to the successful adoption of telemonitoring systems across all stakeholder groups at Mercy Medical Center.

Conclusion

Key takeaways from the stakeholder needs assessment meeting: strong alignment between the telemonitoring-enhanced EHR implementation and Mercy Medical Center’s organizational vision, with projected results of 30% cost reduction, improved patient safety through real-time monitoring, and enhanced care coordination across all service lines. The project scope actually helps guide strategic direction by shifting from reactive care delivery to proactive patient management, supporting evidence-based interventions that will reduce hospital length of stay while maintaining quality outcomes and regulatory compliance.

Change management principles, such as Kotter’s 8-step change model and the technology acceptance model (TAM), will be used to ensure successful implementation through extensive stakeholder engagement, transparent communication of the benefits of system implementation, phased training programs, and ongoing feedback mechanisms to ease resistance and ensure adoption.

Strategic advancement demands long-term leadership commitment, appropriate resource allocation, and thorough monitoring of strategic goal implementation to achieve the organization’s vision of providing patient-centered, cost-effective healthcare through innovative nursing informatics solutions. Success factors include keeping stakeholders on the bus, having the technical infrastructure in place, and implementing powerful change management strategies to build staff confidence and improve system utilization across the 15,000-patient population.

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