Qualitative Assessment of an Electronic Health Record in an Integrated Health Care Delivery System

Publication Date


Type of Culminating Activity


Degree Title

Master of Health Science, General Research

Major Advisor

Gary Shook


James T. Girvan


Rudy Andersen


This study explores the obstacles and solutions involved in developing and implementing an Electronic Health Record system in an Integrated Delivery Network. Saint Alphonsus, the integrated delivery network analyzed, chose a unique approach by developing its entire Electronic Health Record infrastructure using its own information technology staff, and linking multiple source systems to it. The system they created is named Clinician Desktop, or CD Web. Clinician Desktop now links the central medical center campus to numerous outpatient clinics, physician offices, and a freestanding imaging center, and will reach further to connect rural hospitals as part of the continued expansion of the Integrated Delivery Network. Qualitative research methods were employed for this case study, chiefly interviews with various stakeholders in the system, and analysis of meeting minutes from committees involved in planning and implementation of Clinician Desktop. The issues found to be most problematic were related to security and confidentiality, with the corresponding solution being a continuous improvement process bringing concerns to light and working toward resolutions. Regulations from the Health Insurance Portability and Accountability Act (HIPAA) will continue to pose a significant challenge to information technology departments in healthcare across the United States, but Saint Alphonsus will likely be a pioneer in innovative strategies for HIPAA compliance.

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