Successful Implementation of Electronic Health Information Technology

Successful Implementation of Electronic Health Information Technology
The Systems Development Life Cycle (SDLC) refers to the five stages of information technology design and development. They include the analysis, design, implementation, evaluation and maintenance stages. Successful implementation of electronic health information technology (EHIT) depends on the extent to which nurses, as majority end-users, are engaged throughout the systems development life cycle (McLean, Frisch & Roudsari, 2015). The purpose of this paper is to describe the potential implications of the exclusion of nurses in the processes of HIT systems development.

Systems analysis

This stage evaluates existing technologies to see what works and what doesn’t. The role of nurses as end users of the HITs is to provide information on the challenges and benefits they have experienced in using existing systems. Given the position they occupy and nature of their work in a health care facility, they are best placed to identify the critical system’s challenges in collecting, assessing, storing, retrieving and using the information within the existing information system. Therefore, a failure to involve nurses at this stage would mean that the new HITs will not respond to the immediate IT needs of nurses.

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Systems design

In this stage, the HIT expert develops a plan to improve the existing system based on the results of systems analysis. This stage identifies the most relevant user interface, databases, hardware, software and how all the parts of the HIT system can integrate into an effective and efficient whole. The nurses also play a crucial role in proposing specific operational mechanisms that should be incorporated into the new systems to enhance performance. At this stage, system designers should engage the nurses in ongoing testing and refining of the system. Failure to involve the nurses in systems design would mean that the new technology will not be responsive to the nurses’ data input and output requirements. Nurses help to verify whether or not the designed system is useful or not.

Systems implementation

In this phase, the nurses, with the help of the systems design expert, put the new HIT into the application. Nurses are the major implementing team of EHITs. The most important step in systems implementation is training for nurses to be able to optimize the HIT in providing safe and quality care services for patients. Lack of training on the use of technologies will hinder implementation as it leads to low acceptance and poor motivation among the nurses. Training enhances end-user competence, confidence and willingness to use the new EHIT (McLeod, Hweitt, Gibbs & Kristof, 2017). During implementation, nurses contribute insights into the necessary changes in procedures, policies, workflow, and coordination in the application of HITs. Without their input, the new systems might not function well within the existing organizational culture and practice.

Systems evaluation

Once implemented, the systems experts, trainers, and nurse executives evaluate the functionality of the system as well as the abilities of nurses to use it. The real and perceived usefulness of technology influences its application (Yen & Bakken, 2012). In this stage, nurses should be engaged in assessing the usability of the implemented systems. An evaluation that excludes the role of nurses will engender invalid results. As the end-users of HITs, nurses are best placed to identify technological hitches that could compromise patient safety and quality of care.

Systems maintenance and support

Systems maintenance entails the activities involved in identifying and fixing problems that could compromise the functions of the new HIT. After implementation, the hospital must work closely with the new HIT systems vendor and developer. In the course of their work, nurses will identify and report to the nurse executive the bugs in the system that affect the functionality and applicability of the technology. The nurse executive will then report the matter to the hospital’s IT specialists who will in turn initiate corrective and preventive measures.

Conclusion

At the core of the implementation of electronic healthcare information technology are the nurses. The active engagement of the nurses should form an integral part of the entire systems development life cycle. Nurses are strategically positioned to define the IT needs of their facilities. Their recommendations should guide the design and programming phases in the development of healthcare technologies. Successful implementation of EHITs relies solely on the input and commitment of the nurses.

References

McLean, A., Frisch, N., & Roudsari, A. (2015). Nursing’s Voice in Healthcare IT Acquisition Decisions. Canadian Journal of Nursing Informatics, 10(3), 1-24.

McLeod, A., Hweitt, B., Gibbs, D., & Kristof, C. (2017). Evaluating Motivation for the Use of an Electronic Health Record Simulation Game. Perspect Health Inf Manag., 14(Spring): 1d.

Yen, P. Y., & Bakken, S. (2012). Review of health information technology usability study methodologies. J Am Med inform Assoc., 19(3), 413-422.

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SDLC Sample paper #2
Application of SDLC in Nursing
Systems development cycle (SDLC) is a guiding framework that is primarily used for the deployment of information systems. It involves the five steps of planning, designing, implementation, and post-implementation support. Despite the technical limitations, it is still important for nurses to be involved in the actual implementation process in order to improve the functionality of the system after deployment. Strudwick, Booth, Bjarnadottir, Collins, and Srivastava, (2017) outlined how various healthcare technological systems have failed to achieve their full potential due to poor adoption among healthcare practitioners. Involvement of nurses in the SDLC process is one of the ways through which the use of technology in healthcare can be enhanced. In this regard, this paper presents an overview of the various roles of a graduate nurse in each step of the SDLC process as a prerequisite for improved healthcare systems adoption and success.

Planning

In this phase, nurses are to be involved in the identification of goals, feasibility analyses and evaluation of the system’s compatibility with the hospital environment (Rojas and Seckman, 2014). Their main role would be to assist the team in foreseeing and incorporating the needs of patients when using the systems. This is because the nurse has the responsibility to ensure that care procedures result in positive outcomes for the patients. Moreover, Daly (2015) outlined that the role of the nurse in implementation of information systems also involves voicing out the concerns of other practitioners in addition to the patients. The graduate nurse will be tasked with highlighting potential issues that may affect the working environment or the quality of care given to the patients.

Analysis

The analysis stage involves a detailed evaluation of the system to be implemented in terms of aspects such as the expected functionality and quality. Nurses role in the analysis phase involves evaluating how the system meets the needs of the end users. Rizvi, et al. (2017) highlighted how the inefficiencies of EHR systems originates from the lack of contribution from healthcare practitioners. One way through which graduate nurses contribute to the analysis phase is during the development of user interfaces that match the cognitive capabilities of the staff and the patients. In this context, nurses have the responsibility to evaluate the quality of services, the error rate, the potential challenges of care coordination and the level of patient safety (Rizvi, et al., 2017). The main objective of such activities is to maximize the efficiency of the end system and reduce potential interruptions after deployment.

Design

The design stage involves the process of determining the specific functionality of a system such as the hardware, software, user interface format, and networking capabilities among other critical features. The nurse should also be involved in the design phase to assist with aspects such as cognitive support and safety considerations (Rojas and Seckman, 2014). The designer of the systems needs the cognitive support of the nurse to accurately determine factors such as the intended purpose of the system and the potential environmental factors. In this regard, the main responsibility of the nurse during the design stage is to ensure that the system is in tune with the capabilities of the end users. The nurse also aids the designers in developing adequate safety measures to cater for unintended eventualities. They will also evaluate design aspects with the aim of determining potential safety hazards while providing suitable solutions.

Implementation

The implementation phase involves the installation, testing and final customization of the information system. The nurse is important in the implementation phase due to the need to debunk the complexities involved in care environments. The nurse has the role of identifing the most suitable installation location with regards to issues such as patient safety and usability of the system (Daly, 2015). The nurse will guide the technical team on where to place the physical location of the main system. Additionally, the nurse is also best placed to aid in the testing process through the ability to identify potential downfalls of the system. The nurse will evaluate the system for critical medical limitations after installation. In this regard, the nurse plays a guiding role in ensuring the best possible healthcare outcomes for the end users of a system.

Conclusion

Healthcare technological systems have failed to achieve their full potential due to poor adoption among healthcare practitioners. The SDLC process is one of the ways through which the use of technology in healthcare can be enhanced. It involves the five steps of planning, designing, implementation and post- implementation support. Nurses are to be involved in each of the steps for improved functionality of the system. For instance, under the planning phase, they are to aid in the identification of goals, feasibility analyses and evaluation of the system’s compatibility with the hospital environment. Nurses role in the analysis phase involves defining the needs of the end users alongside the cognitive evaluation aspects. The nurse should also be involved in the design phase by assisting with aspects such as cognitive support and safety considerations. Lastly, the nurse is important in the implementation phase due to the need to debunk the complexities involved in care environments by recommending best practices to enhance care while reviewing operations for potential safety hazards.

References

Daly, P. (2015). Clinical nurses lead the charge with EHR. Nursing, 45(10), pp.25-26.

Rizvi, R. F., Marquard, J. L., Hultman, G. M., Adam, T. J., Harder, K. A., & Melton, G. B. (2017). Usability Evaluation of Electronic Health Record System around Clinical Notes Usage-An Ethnographic Study. Applied clinical informatics, 8(4), 1095–1105. doi:10.4338/ACI-2017-04-RA-0067

Rojas, C. and Seckman, C. (2014). The Informatics Nurse Specialist Role in Electronic Health Record Usability Evaluation. CIN: Computers, Informatics, Nursing, 32(5), pp.221-222.

Strudwick, G., Booth, R. G., Bjarnadottir, R. I., Collins, S., & Srivastava, R. (2017). Exploring the role of the nurse manager in supporting point-of-care nurses’ adoption of electronic health records: protocol for a qualitative research study. BMJ Open, 7(10), e018129. doi:10.1136/bmjopen-2017-018129

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