RESPONSE ONE

As I inch closer and closer to the end of the course, I can see the value in taking time to consider what additional barriers there are between now and the completion of my research. My topic involves minimizing the financial impact felt by healthcare organizations during the time that workers are reaching full productivity in the use of their electronic health record (EHR) systems. There are a few big issues that could cause barriers. I work at the crossroad of the healthcare industry and information technology – both of these fields have potential to provide barriers.

Healthcare Industry Concerns

First of all, the healthcare industry is highly regulated in the United States. Patient privacy is an absolutely critical concern. So, any work with a computer system which holds patient information presents risk. These risks have the potential to translate into barriers to completing my research. Healthcare organizations protect their patient information closely – obviously it just makes good business sense to protect your customers. However, there are also a number of laws in place such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA) which outlines penalties for data breaches of protected health information (see Seh et al., 2020; U.S. Department of Health & Human Services, 2022). As a result, there will be several steps that I need to take in order to get permission to carry out my research. Although I have no expectation that I need direct access to protected health information (and my research does not require it), I suspect that the healthcare organization employing my participants will still require that I follow a few internal procedures concerning privacy in order to cover them if any patient information was discussed during data collection.

Navigating the healthcare landscape also requires a deep understanding and adherence to ethical standards. I will need to work carefully to develop an appropriate informed consent form to make sure that my participants understand the type of information that I will be trying to get from them and the risks involved. Healthcare providers may feel trepidatious about sharing information with me, even if it does not directly involve identifiable patient information and I must be careful not to make it seem as though I am attempting to gather that type of data. I believe that securing necessary permissions and authorizations, as well as continuing my conversations with compliance personnel at the healthcare organization will help with this. I have started some of these conversations but I am, as of yet, unsure how involved this process will prove to be.

Information Technology Concerns

Additionally, my topic is deep in the world of information technology and this adds another layer of complexity to my research. Electronic health records are intricate systems and their use is extremely complicated. In order to carry out this research I will likely need to consult other experts in the field such as software engineers who specialize in the software itself, or clinical informatics personnel who specialize in how healthcare workflows are carried out within these systems. Although this extra complexity will likely add some required effort my project, I do believe that collaborating with these individuals will help me develop a more full understanding of the topic and offer even more effective solutions. Still, the possibility of needing to involve others could be a barrier to getting my research completed.

Outstanding Questions

Although I feel like I have been researching this topic and thinking about my project at a deep level, I am still at the beginning stages of development. Therefore, I feel that it’s understandable to have a few outstanding questions. Even though I am certain that more questions will come along as I continue, I am currently considering the following:

1.
How can I develop my research design to more appropriately fit the requirements of the project?
Working out the specifics will be an ongoing process. For example, I am currently planning on conducting an interview with participants shortly before and shortly after they complete their initial training session. I will also conduct one follow up with each participant. Additionally, I plan on conducting interviews with individuals that have already reached full productivity in the system. I feel as though the plan makes sense and is relatively aligned with my understanding of the current literature on the topic, but I know that there is more for me to read on the subject of EHR training and productivity. I fully expect that my research design will continue to evolve.

2.
Should I focus on a specific type of healthcare worker?
There are physicians, nurses, and ancillary workers such as respiratory therapists and dieticians. Many individuals who work in these clinical roles utilize an EHR system. There are also many non-clinical roles such as individuals working at the front desk of outpatient clinics – these individuals generally use an EHR as well. I am still developing enough of an understanding of the current literature to answer this question.

Fortunately for me, I have access to many potential participants through my current employer. So, I do not believe that getting participants within a short period of time will prove to be difficult. However, I am glad to have taken some time to reflect on these other barriers.

References

Seh, A. H., Zarour, M., Alenezi, M., Sarkar, A. K., Agrawal, A., Kumar, R., & Khan, R. A. (2020). Healthcare data breaches: Insights and implications. 
Healthcare, 
8(2), 133. https://doi.org/10.3390/healthcare8020133

U.S. Department of Health & Human Services. (2022, January 27). 
Health Insurance Portability and Accountability Act of 1996 (HIPAA) | CDC. CDC.gov. Retrieved November 14, 2023, from https://www.cdc.gov/phlp/publications/topic/hipaa.html

Response two

Over the last few weeks, I’ve been thinking about this topic quite a bit, and two things keep coming to mind.  The first is a different version of the question posed in the topic itself:  “Do you have a heavy workload at work that can prevent you from dedicating the time you need to complete your project?”  My workload at work is definitely busy, however, I am finding that more personal things are a blocker, as I haven’t been well recently.  I was diagnosed with Stage 4a cancer three years ago, and I’ve been managing around that ever since.  It tends to go in streaks, but I’ve been feeling weaker and more tired over the last month or so.  I’m working with my care team to try and manage side effects and am trying to schedule breaks and naps into my day, so I don’t get run down. I’m often asked why I am undertaking this program while I’m dealing with a cancer fight, and my response is always that it’s important to me, and I would regret it if I don’t.  So the approach is often one of “one step at a time,” which I generally consider as good advice for most questions.  

The other blocker I face is how my participant pool might respond to the data collection.  My experience has taught me that Indian culture has some very particular approaches with regard to caste, class, gender, and position, and that potentially sets me up as someone who should be handled carefully.  In order to work around it, I have asked my human resources lead to help with organizational communications, requesting participation, and providing reassurance about how data will be collected, stored, and anonymized.  

I still question whether or not my topic is clean enough, but I do know that understanding the cultural implications of recruiting, hiring, training, and performance is overlooked in my organization, and I feel strongly that all information can be useful, if applied in practice.  This research could open the door for process improvement and policy changes, which could benefit everyone;  shareholders, stakeholders, employees, and clients alike.  The article, “Common language doesn’t equal common culture,” calls out how unique a situation this is;  you can be speaking the same words as someone else, but it means something different (Molinksy, 2013). What we can do, however, is try to translate it a bit better.