Meaningful use of the Omaha System: Planning the transition to an EHR

The nation's public health is in transition due to the creation and use of electronic health records (EHRs). The American Recovery and Reinvestment Act (ARRA) of 2009 requires “meaningful use” of information technology (IT) as a way to improve the health of all citizens, including the most disadvantaged. The decision to adopt a standardized terminology such as the Omaha System and the purchase of new hardware or software do not constitute “meaningful use” of IT alone. The transition to the use of a standardized terminology and computerized documentation system requires careful planning and partnership among administrators, staff, and vendors to ensure that use of the EHR increases quality, safety, and efficiency of care while improving population and public health. Utilization of a computerized means to document and organize clinical data using a standardized well-accepted terminology provides public health nurses and other public health professionals with a powerful tool for the collection, aggregation and analysis of data. It allows accurate measurements of outcomes at the individual, family and community level, facilitating population-based care and evidenced-based research as well as client involvement in care. However, even the most positive proposed changes in agency practices frequently engender resistance and frustration at both the staff and supervisory levels. This presentation will describe several useful strategies to plan the transition to the use of an EHR and a standardized terminology such as the Omaha System in public health agencies, including how to identify optimal team members among IT, administrative, and clinical staff; how to work with vendors to set EHR goals; geographical considerations; the use of training databases and other training tools; the development of guidelines; the setting of reasonable timetables for various stages of implementation; the use of chart audits; and the use of Focus Groups.