Quote Of The Year

Quotes Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Wednesday, January 09, 2008

Nurses Often Left Out of Health IT Initiatives.

This article is quite a nice follow up to the point I made about nursing involvement recently.

See the following for details of that blog.


Nurses Often Left Out of Health IT Initiatives

by Bryn Lansdowne

For years, health IT has been touted as a means to improve documentation, ease the administration of medication and generally boost patient care delivery and coordination. Yet for many nurses, the adoption of health IT in hospitals is not a smooth road to improved efficiency.

Federal incentives for IT adoption have mostly been aimed at hospitals and physicians, not nurses. Also, most health care facilities direct their IT adoption efforts toward physicians because nurses are almost always employed by the institution where they practice, whereas most physicians are not. Many hospital administrators fear that if they force IT adoption on physicians, those physicians may take their business elsewhere.

But however slowly, the health care industry is shifting its focus to assisting nurses in the implementation of health IT. Of 150 CIOs surveyed by Health Data Management this year, 55% agreed and 29% strongly agreed that providing nurses with IT is an increasing focus of their IT initiatives. Further, the Joint Commission, the Institute for Healthcare Improvement and the Institute of Medicine all have issued patient safety mandates that call for enhanced nurse involvement with IT.

Working With Vendors

Experts have suggested that health IT vendors solicit feedback directly from nurses and work with them during the initial design process.

Pam Cipriano, chief clinical officer of the University of Virginia Health System and chair of the American Academy of Nurses Workforce Commission's Workforce Commission, has said that involving nurses in the IT development process can reduce the potential for error and ensure that vendors' products are user friendly.

Many vendors already consider real-world implications during the design phase of IT development, according to Reed Gelzer, COO of Advocates for Documentation Integrity and Compliance. According to Gelzer, "Vendors often make a valiant effort to improve their" products by soliciting input from the users themselves, "but then they discover that the message was coming from only a subset of users," leaving the vendor to ask, "'Who do I listen to?'"

Gelzer recommended that vendors make a more concerted effort to incorporate nurses' suggestions into their offerings, but only after they first develop an input plan that will ensure the recommendations are valid and transparent to designers. Further, Gelzer said that suggestions can't come from just one component of users; instead, they have to represent all potential operators of the technology: physicians, administrators and ambulatory care workers, among others.



  • AAN Commission on Workforce
  • CDW, "Nurses Tech Talk 2007" (.pdf)
  • Rebillot, "Nurses Push for Input Into Clinical Health IT Design To Boost Hospital Workflow," iHealthBeat, 12/3
  • "Hospitals Work To Make Health IT More Nurse Friendly," iHealthBeat, 12/5

Read the full article below:


I can do little better than refer the interested reader to the links above for more information and ideas on how the manage this critical issue.


1 comment:

Jon Hilton said...

Very good article, and very good point. It is not only nurses that are often left out. Providers of home based care are also left out.

Consumers would benefit greatly if their home based care, such as meals and home help, were better coordinated with the rest of the health care system. For example, I believe it would be beneficial if these services were routinely notified when their clients are admitted to or discharged from hospital.

These providers should be treated as part of the health care continuum and they should be included in the scope of provider identification strategies.

According to the NEHTA "High Level Business Requirements
Unique Healthcare Identification
Version 2.0 - 03/09/2007"
, Section Healthcare Providers Individuals, on p. 10:

• Only Healthcare Provider Individuals registered with a professional registration board, professional body or policy approved (e.g. through qualifications) by the Governance Authority are able to participate in the UHI Services.

• Medical Practitioners (e.g. General Practitioners, Specialists)
• Pharmacists
• Dentists
• Nurses
• Allied Health Professionals

While this possibly includes some allied health professionals in scope, it completely leaves out home care providers.

I have spent a great deal of time (off and on since 1997) working with these services on design, development and implementation of information systems. They are keen to be involved, appreciate the potential benefits of information systems and many are not at all happy that the NEHTA strategy has passed them over.

I appreciate the need to manage the scope of the healthcare provider identification initiative. At the same time, I am concerned that the current approach is completely ignoring a large and growing group of health care providers. My view of current trends in healthcare is that this group will continue to grow in importance over time as we face the challenge of an ageing population.

Most (if not all) these providers work within a management structure, many within local government (at least in Victoria.) Perhaps we should consider including these managers in the healthcare provider identification strategy?