Technology increases human effectiveness. Using a lever, you can move an object several times your size. In an airplane, you can move exponentially faster than on foot. Using the Internet, you can access information much more quickly than at a library. What possibilities like this exist in the nursing field? What health information technologies can amplify your impact as a nurse far more than ever before? In this Evaluation Project, you will have the opportunity to answer these questions.
Because of the great differences between HIT systems and different goals of an evaluation, there is no one-size-fits-all evaluation plan. Different technologies require different evaluation methods. Consequently, in this part of your Evaluation Project, you will conduct research on how system implementations similar to the one you select have been previously evaluated. After exploring similar system implementations, you will select one research goal and viewpoint to use in the evaluation.
Read the following three scenarios, and select the one that is of most interest to you:
Your hospital is implementing a new unified acute and ambulatory Electronic Health Record (EHR) system through which patient care documentation will occur. Interdisciplinary assessment forms (including nursing), clinical decision support, and medical notes will be documented in this system. The implementation of the system is anticipated to improve the hospital’s performance in a multitude of areas. In particular, it is hoped that the use of the EHR system will reduce the rate of patient safety events, improve the quality of care, deter sentinel events, reduce patient readmissions, and impact spending. The implementation of the EHR system is also intended to fulfill the “Meaningful Use” requirements stipulated in the Health Information Technology for Economic and Clinical Health (HITECH) Act. As the hospital’s lead nurse informaticist, you have been tasked with planning the evaluation of the EHR implementation.
As the lead nurse informaticist in your hospital, you have been given the task of planning an evaluation for a soon-to-be launched computerized provider order entry (CPOE) system. The CPOE system is designed to replace conventional methods of placing medication, laboratory, admission, referral, and radiology orders. CPOE systems enable health care providers to electronically specify orders, rather than rely on paper prescriptions, telephone calls, and faxes. The intended goal of a CPOE system is to improve safety by ensuring that orders are easily comprehensible through the use of evidence-based order sets. In addition, the CPOE system has the potential for improving workflow by avoiding duplicate orders and reducing the steps between those who place medical orders and their recipients.
You are the lead nurse informaticist in a large urban hospital that has recently implemented a new Electronic Medication Administration Record (eMAR) and Bar Code Medication Administration (BCMA) system. The BCMA system uses bar coding technology to facilitate the correct identification of patients at the point of administration of medications. BCMA will be used for all medications—tables, injections, and intravenous treatment. You have been selected to conduct an evaluation of the new system. The eMAR is designed to utilize the medication order entry process in order to expedite the creation of the 24-hour medication administration record, whereas the BCMA will automate administration documentation. In addition, the system is intended to reduce medication administration errors by tracking and alerting health care providers about dosages, proper administration times, medication allergies, or medication incompatibilities.
- Select one scenario to use for the Evaluation Project.
- Consider what viewpoint and research goal you would use to guide your evaluation plan. Although many potential research goals or viewpoints could be selected for each scenario, you are only required to choose one goal and one viewpoint. The scenario you select will be used for the Evaluation Project throughout this course. To maximize your benefit from this project, consider selecting a scenario that is relevant to a health care organization with which you are involved.
- Research published evaluations that have been conducted on HIT system implementations similar to the one in the scenario you selected.
To complete Part 1 of this Evaluation Project:
By Friday 12/23/2016
1) In a 3-page paper, identify which of the three hypothetical health information technology systems you will be evaluating in this project, and explain why you selected this system.
2) Summarize your research findings on similar HIT implementations.
3) Describe the evaluation goal and viewpoint that will guide your own evaluation plan. Provide your rationale.
Friedman, C. P., & Wyatt, J. C. (2010). Evaluation methods in biomedical informatics (2nd ed.). New York, NY: Springer Science+Business Media, Inc.
Chapter 2, “Evaluation as a Field” (pp. 21–47)
This chapter defines evaluation and shows how it differs from research. The chapter also includes a discussion the philosophy behind evaluation and the multiple approaches to evaluation.
Board on Health Care Services. (2012). Health IT and patient safety: Building safer systems for better care. The National Academies Press: Washington DC. Retrieved from http://www.nap.edu/catalog.php?record_id=13269
Chapter 2, “Evaluating the Current State of Patient Safety and Health IT” (pp. 31–58)
This chapter addresses the challenges of evaluation in health information technology due to the complex nature of technology and rapid changes in the field. The chapter also identifies barriers to evaluation and the threats posed to patient safety by a lack of evaluation.