Standards and Guidelines for Electronic Medical Record Systems in ...

It is important to have a pre-defined process for making requests for changes to the EMR
system. Any request for changes to the EMR should then go through this change management
process.
A change management process would include the procedure for:
1. requesting the change, to whom the request is to be made;
2. how requests will be reviewed;
3. criteria for requests to be approved or denied;
4. how the approved requests are prioritized for implementation based on criteria such as
importance, impact, and complexity of the request; and
5. How the request is processed for implementation.
Most change management processes involve the organization of a group that is responsible for
receiving and processing the request. This group can be health facility management, or another
designated group of stakeholders, such as a technical working group (TWG).Once prioritized, an
agreement needs to be in place between the facility or group and the EMR development team for
processing that request, including acknowledgment of request, estimation of development
timeframe, deployment of request, and system documentation updates.
In addition to the development team making the change, training teams also need to be made
aware of the change in order to determine the impact and plan for the training strategy for the
modification to the system (including notifications to users, retraining users, etc).
Acceptance for System Modifications
It is imperative that there is a process for acceptance of any system modifications prior to
deployment of those modifications. Bug fixes and minor changes may be considered an “express
change” and may be decided by the change management group to not require review by anyone
other than the development team. The types of changes that qualify as an express change should be
explicitly decided on by the change management group before the EMR system is implemented in
the facility. Larger feature enhancements that require a change in workflow and user training may
require larger stakeholder acceptance before proceeding with deployment.
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