Navigating Health Information Technology and Informatics in Healthcare Organizations

Informatics Paper

Health information technology and informatics impacts every aspects of healthcare today (Nelson & Staggers, 2018, p. 2). A critical report by the Institute of Medicine stated health care failed to recognize and reduce avoidable medical errors which harmed patients and many recognized the need for improved health information technology and informatics (National Coordinator for the Health Information Technology [NCHIT], 2013, p. 3). In addition, health information technology when integrated into the healthcare delivery process has shown to enhance health care quality and safety. Healthcare organizational information technology is unique and understanding the health data interface network can be challenging. Therefore, many organizations are recognizing a need for more effective and efficient information systems.

The electronic health record (EHR) stores patients records in electronic format and consolidates a patient’s healthcare information and activities with the intention to exchange information with other systems (Elysee, Herrin, & Horwitz, 2017, p. 2) Designing, developing, and facilitating a well-designed EHR is key to improving quality and safe patient care. Also, proper integration of an electronic health record into a health organization is essential for patient safety (NCHIT, 2013, p. 8). Many larger health organizations implement more than one EHR to meet their specific needs. Supplementary EHRs can include medication, lab, radiology, registration and billing modular using integration between each other utilizing an interface engine within the organization (Nelson & Staggers, 2018, p. 81). Lastly, all systems come with potential hazards including EHRs, therefore, acknowledging these hazards and creating an organizational culture of safety to mitigate those risks is crucial (Carayon et al., 2017, p. 3).

NEEDS ASSESSMENT

Selecting a new healthcare system begins with careful analysis. An initial step to addressing the needs of the organization is conducting a needs assessment. The needs assessment involves gathering pertinent data to identify gaps or needs including specific wants in determining the organization’s goals; this includes the organization’s current state and it’s future goals (Nelson & Staggers, 2018, p. 272). In addition, a successful needs assessment involves developing and implementing a strategic vision and plan which typically aligns with the organization’s strategic vision and plan (Nelson & Staggers, 2018, p. 272). The strategic plan sets the organization’s goals, objectives, and measures on the project (Nelson & Staggers, 2018, p. 272).

The needs assessment provides information on the multiple internal and external stakeholders to include all of the users of the application (Nelson & Staggers, 2018, p. 272). Several tools can be used to elicit information from stakeholders including self-reported questionnaires, interviews, surveys and focus groups. Identifying key stakeholders to ensure each is heard, considered and involved on what system are considered ensures the stakeholders buy in throughout the project process and final plans (Nelson & Staggers, 2018, p. 273).

The needs assessment should also address external and internal measures related to the organization. External measures critical to the organization include developing economic, regulatory and market pressures in the industry (Nelson & Staggers, 2018, p. 272). Internal measures also include economic considerations within the departmental sectors including the operational and clinical objectives of the organization (Nelson & Staggers, 2018, p. 272).

Next, analysis in key areas within the institution necessitates a series of question requirements. Prioritizing these requirements include regulatory and accreditation with financial and increased net revenue requirements are essentials for most organizations (Nelson & Staggers, 2018, p. 273). Many would include mission-critical requirements such as privacy and security as vital. Lastly, end user demands and functionality requirements that are “must have” and “nice to have” can be compared (Nelson & Staggers, 2018, p. 273).

The results of an organization needs assessment will assist in identifying the essential criteria needed during the system identification and selection process. The final analysis is an internal document which provides both strengths and weaknesses of each system and detailed information for each department and the organization should be included (Nelson & Staggers, 2018, p. 273).

An EHR is a complex system with the intention of crossing several health care systems. Many factors can cause a systems error problem leading to a sentinel event in an acute care setting (Carayon et al., 2017, p. 10). Outdated pharmacy medication modules can cause patient safety issues. Therefore, a needs assessment is crucial when an organization is integrating a new pharmacy medication modular EHR into their healthcare delivery process (Nelson & Staggers, 2018, p. 31). Some EHR medication prescribing systems experience problems leading to seriously harmed patient safety issues (Carayon et al., 2017, p. 9). Therefore, researching new and improved EHR medication prescribing systems from qualified vendors is priority.

FRAMEWORK

A systems life cycle model is a framework that allows an organization to develop, implement, maintain and evaluate a new product such as a system or application (Nelson & Staggers, 2018, p. 31). Several variations of the systems life cycle model exist with different specific number of stages an organization can implement. The stages can range from three to seven based on an organization’s specific project (Nelson & Staggers, 2018, p. 31). In order to prioritize and identify the needs of the organization evaluation is part of the process between all stages in the life cycle.

The systems life cycle model is a developmental model in which the life cycle process is constantly evaluating and evolving. The circular process begins with analysis and moves into planning, development, testing, implementing, maintaining, and lastly evaluating (Nelson & Staggers, 2018, p. 33). This developmental model returns to the start of the model after the final evaluating stage ends and returns to the beginning analysis stage. This model is a natural fit with healthcare information technology considering its constantly changing and evolving technology and the developmental model is constantly evaluating and evolving. In addition, the system life cycle model provides tools that can assist an organization in ongoing analysis and upgrading and enhancing systems (Nelson & Staggers, 2018, p. 33). Therefore, it should be no surprise, the system life cycle model is the most common model used by organizations when upgrading to new health information systems (Nelson & Staggers, 2018, p. 31).

ROLE OF THE INFORMATICS NURSE

The role of the nursing informatics is growing exponentially (Collins, Phillips, Yen, & Kennedy, 2017, p. 100). Nursing informatics uses evidence based nursing combined with nursing science, technology and computer science to improve patient outcomes (McGonigle, Hunter, Sipes, & Hebda, 2014, p. 356). Nurses play an essential role in healthcare as the largest group providing care and users of the EHR (Rojas & Seckman, 2014, p. 214).

Nurses are leading changes in the future of healthcare and technology. Mostly due to the fact because nurses use the EHR in every aspect of nursing practice to document and communicate patient data (Rojas & Seckman, 2014, p. 215). Therefore, the increased expansion of the EHR and evolving technology impacts nursing greatly. In addition, nurses are subject matter expert when it comes to using electronic health records (McGonigle, Hunter, Sipes, & Hebda, 2014, p. 326). Even though all nurses use the EHR, not all have the appropriate technical skill to assess, evaluate and guide others in new health information systems (Rojas & Seckman, 2014, p. 215). Therefore, it is essential to employ the expert skills of the informatic nurse specialist as part of the process.

The informatic nurse specialist brings a unique set of skills to the team when implementing a change to a system. As stated above, the nurse is a primary user of the EHR and understands how a system needs to be both usable and friendly to save time in an busy environment (Rojas & Seckman, 2014, p. 215). This information specifically allows the informatic nurse specialist to assist in blending the technical content experts with the clinical end users (Collins, Phillips, Yen, & Kennedy, 2017, p. 1). In assessing any system, the ability to find accurate timely information within the presentation is a priority for which nursing understands in the clinical setting. In addition, consistency within a system is essential and nursing can assist in prioritizing this design and functionality in the assessment (Rojas & Seckman, 2014, p. 215).

Nursing informatics offers a unique experience, in which nursing intuition collects data within the organization (McGonigle et al., 2014, p. 324). This understanding assists the informatic nurse with technology and the naturalness and ease of system in application. Therefore, a system must be efficient and not hinder clinicians in practice (Rojas & Seckman, 2014, p. 219) Lastly, flexibility within a program is a necessity as nursing practice is complex with many specialties and documentation variances. Therefore, the informatics nurse is an essential part of the team when changes are needed in a new health information system including the EHR.

CONCLUSION

Sentinel events are cause for alarm and many organizations look to make changes with their technology. Health information technology and informatics is transforming healthcare. Designing, developing, and facilitating a well-designed EHR is key to improving quality and safe patient care. Selecting a new healthcare system begins with careful analysis. The first step includes a needs assessment which involves gathering pertinent data to identify gaps or needs including specific wants in determining the organization’s goals; this includes the organization’s current state and it’s future goals (Nelson & Staggers, 2018, p. 272). Next, utilizing the systems life cycle model will allow an organization to develop, implement, maintain and evaluate a new product a system or application (Nelson & Staggers, 2018, p. 31). In addition, the informatic nurse uses evidence based nursing combined with nursing science, technology and computer science to improve patient outcomes (McGonigle, Hunter, Sipes, & Hebda, 2014, p. 356). For this reason, the informatics nurse specialist is a valuable leader serving as an expert with project management skills and fundamental nursing skills. As for leaders God speaks in Galatians 6:9 “Let us no become weary in doing good, for at the proper time we will reap a harvest if we do not give up” (New Annotated Oxford Bible).