Devices & Technology

Health Care Technology Implementation Needs Nurses' Input

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Factors for Choosing a System

Some factors to consider with the choice of clinical information systems include:

  • The ease of use and intuitiveness;

  • Integration with other systems so data can be shared;

  • Customization of the system to meet the needs of all providers regardless of their area of specialization;

  • Availability and convenience of PCs or other devices for data entry and viewing;

  • Reliability of the software and hardware;

  • Continuous support of the system–at the hospital and from the vendor and

  • Setting realistic expectations and a sound implementation plan.

In addition, staff members participating in the selection, customization, and implementation of the system should be scheduled to work on the project.


By Beth A. Coutts, RN, BSN, NurseZone contributor

OK nurses, ready or not, the information age is upon us and it’s here to stay. So what are you going to do about it?

This is the technological climate of your industry: Hospitals and health care systems are working on getting up to speed, some because they want to and others because they have to. You’ve no doubt seen some of the latest technologies to improve how patient information is captured and managed. Historically, hospitals invested in information systems to manage patients’ financial information such as billing, insurance and admitting, while clinical data–the patient record–has been managed almost completely on paper in most facilities.

But today, health care providers are moving toward electronic management of patient related clinical information. Why? There are many factors influencing this migration, including regulatory agencies, insurance companies, as well as providers and patients who are demanding large quantities of clinical information that is easily accessible and portable. Manual methods of collecting, managing and analyzing this type of information are no longer sufficient to meet these demands.

With the technological monster knocking at the door, the question remains: How will clinical information systems affect your nursing practice and how can you be prepared?

Benefits of Clinical Information Systems

Let’s look at the big picture: Clinical information systems can deliver many benefits to hospitals, providers and patients. Data can be accessed using personal computers (PCs), handheld devices (PDAs), and thin clients (a simplified version of the PC). Data can be entered and viewed from the patients’ bedside or remotely from other locations within a hospital or even outside of the actual care setting. Many systems provide Web-based access so health care providers can access information from virtually anywhere there is an Internet connection.

What’s more, when data are entered into an electronic medical record, that information can be shared automatically among all the appropriate fields throughout the patient record. Patients only have to answer a question once and providers only have to ask it once. Clinical systems also enhance decision-making with programs that can incorporate clinical guidelines into the charting process. Rob Knodle, a manager with Information Systems at Sharp HealthCare is working closely with providers to incorporate their clinical guidelines into software called LastWord created by IDX Systems Corporation. This system provides a module that applies expert rules to automatically analyze orders and other triggers as they are entered into the system. It also has the capability to "make suggestions" about tests, treatments or other indications for the patient before executing an order.

Ideally, clinical information systems should decrease the amount of time that providers spend documenting. According to Linda Gibson, director of Health Informatics for IDX, systems can also "improve revenue cycle management by increasing the efficiency of the clinicians." How is this carried out? The systems would ideally assist facilities in meeting regulatory demands regarding documentation by automating many aspects of the process for functionality and accuracy. Data entered could also be mined for quality initiatives and research.

Acceptance of Clinical Information Systems

There are many factors that influence the acceptance and use of clinical information systems in the hospital setting. According to Knodle, one of the most important variables in gaining end user buy-in comes from involving the end user in the decision making process from the selection process through to the implementation of a system. Involving end users in this process provides them with a sense of ownership and motivates them toward making it a success. All departments who will use the system should be represented and have a voice in the decision making process. Gibson agreed and added that it is imperative to have knowledgeable nurses and other executives involved in the strategic design and vision of the system.

Another key component of success when choosing and implementing clinical information systems is education. A comprehensive training plan should be implemented. According to Knodle, at Sharp Healthcare they will have "over 40 trainers to educate the end users on how to use the system". Creating experts throughout the facility creates a network of users who can assist one another on a daily basis.

As Nurses, You Should Be Prepared

Nurses are an integral part of the entire process of implementing a clinical information system. They should partner with other clinical providers as well as IT experts to select and implement the best system for the hospital as a whole. Nurses providing direct care to patients as well as management could participate.

If asked to participate in such a team, there are several things that a nurse can do to prepare. Knodle suggested that nurses "do some research into what these systems can and cannot do." Often, vendors will provide product demos or you can attend a trade show and review many vendors’ products side-by-side.

Also, analyze your current processes and practices and know what you want the system to do. Be prepared to rethink your processes and improve on them using this new technology. Gibson suggested that nurses "begin to redesign their work processes/flows prior to selection of a system and use them to drive selection. She also suggested that "databases should be standardized" early on in the process.

Let’s face it, nurses are the experts on clinical processes related to their practice. However, they must be willing to compromise, working with other disciplines and groups to decide how to use the system to everyone’s benefit.

Most importantly, be proactive and get involved. Many implementations suffer from the perception that the system was chosen by non-clinical people and implemented without their input. To mitigate that, nursing professionals should get involved early and actively participate in the implementation of the system. Contribute to the success of the system rather than waiting for someone else to make decisions that will affect how you practice. If clinical information systems are chosen wisely and implemented with a solid plan and the involvement of key players, like you, the nurse, the systems will significantly improve how patient care is delivered. Embrace the change, one day you will find yourself wondering how you ever functioned without it.

Beth Coutts has more than eight years of experience in the health care informatics field as an end user, account manager and manager of clinical services.

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