Epic's implementation of the Willow module and the healthcare workers involving in standardization

Abstract

Background: Implementation of an electronic health record (EHR) that is fully integrated for clinical information, patient scheduling, and billing can effectively be shared by the entire healthcare community, both for the municipality and hospitals in Central Norway. The role and involvement of healthcare workers (HCW) in the implementation process might affect the standardization process.

Purpose: This article focuses on the HCW' involvement in the Willow module's standardization and how they will support the adapted systems from Epic's implementation process of the electronic health record.

Methods: This is a descriptive 6-month follow-up study, based on observations of 35 directions and building sessions from August to January 2019 in the Willow module. Structured interviews of 20 informants in November were used to cross-check and validate the observations. The analytical approach was conducted in four general contexts: a) traditional, b) practical, c) emotional, and d) analytical, obtained from the contextual-content analysis. This is discussed based on the system theory.

Results: A) Traditional: Epic's normative perspective predominates with a tight agenda, questions that should be answered, focuses on standardization of workflow and concepts and had low degree of discussion and involvement, especially in direction sessions. b) Practical: HCW' involvement in standardization provides a high degree of practicality in the sessions, which is also a rational achievement. c) Emotional: The sessions' expressive and affective achievement is guided by the HCW' engagement in standardization, dependent on knowledge and background. d) Analytic: The HCW' intellectual involvement in the standardization of workflows and concepts will be, to some degree, an agreement of objective terms.

Conclusions: HCW' involvement in standardization will have a supportive function. They will be involved in different contexts and be a part of the end product Willow module, even though Epic controls these.

Keywords: Electronic health record; Epic; Hospitals; Implementations; Municipality; Qualitative research.