ABSTRACT
This chapter presents a case study of Hospital A and Hospital B. A multihospital health system opened a brand new hospital (Hospital A) with a strong focus on paperless records and use of cutting-edge technology and innovation. An electronic health record (EHR) vendor was selected to assist with this goal. The next hospital (Hospital B) to implement the enterprise EHR hospital-wide was very different from Hospital A. While Hospital A went live from the start with the new EHR, Hospital B had preexisting workflows that covered nursing documentation, physician ordering via paper templates, and the dictation of physician notes. The EHR go-live at Hospital B had an enormously negative impact on emergency department (ED) workflow. System inefficiency in the higher-volume ED at Hospital B required additional nursing and physician staffing, leading to increased costs for the hospital and physician group. Nurses and physicians were also required to complete addenda to correct charting issues identified after charts had been created.
