Discussion: Successful Implementation of Electronic Health Information Technology
Since the inception of the HITECH Act, health organizations have faced increased pressure to update their health information technology (HIT) resources. As discussed last week, many believe that the increased use of electronic health records and the quick and efficient communication afforded by HIT can lead to improved quality of patient care. Yet there are significant costs associated with implementing such systems. What can organizations do to ensure that the correct system is selected and that the system will be appropriate for those required to use it? Who should be involved in those decisions?
This week introduces the systems development life cycle and discusses how it can guide an organization through the complexities of adopting a new HIT system. In this Discussion, you are asked to consider the role of nurses in the SDLC process.
- Review the steps of the systems development life cycle.
- Think about your own organization, or one with which you are familiar, and the steps the organization goes through when purchasing and implementing a new HIT system.
- Consider what a nurse could contribute to decisions made at each stage when planning for new health information technology. What might be the consequences of not involving nurses?
- Reflect on your own experiences with your organization selecting and implementing new technology. As an end user, do you feel you had any input in the selection or and planning of the new HIT system?
By Day 3
Post an analysis of the ramifications of an organization not involving nurses in each stage of the systems development life cycle when purchasing and implementing a new HIT system. Give specific examples of potential issues at each stage and how the inclusion of nurses could help avoid such issues.
By Day 6
Respond to at least two of your colleagues on two different days using one or more of the following approaches:
- Ask a probing question, substantiated with additional background information, evidence or research.
- Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
- Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
- Validate an idea with your own experience and additional research.
- Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
- Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
Systems development life cycle (SDLC) is a process that is utilized to deliverinformation systems with effectively with efficiency in a way that
works with the business planof a specific organization (McGonigle et al, 2018 ). When assessing the need to implement a newSDLC, it is common
to use the waterfall model. I will explore the steps of this model and thenecessity of input from nurses and other hospital personnel during the
In the beginning, the organization must initiate an analysis of what is needed. Everyfacility is different. It must be determined what is necessary
on an individual business level. Todetermine this, it is necessary to evaluate the nurses’ needs and gather their input into the newsystem. If
employees are not committed to working with a new system, due to the need for it notbeing legitimate, time and money can be wasted. This is a
loss to the business overall.
During the design stage, it is imperative to collect data from the nursing staff as to what they feel will work on their individual units. A design
must be configured that will work for each specialized setting, and that will flow seamlessly into a generalized system in its completion. Using the
information that nurses have provided for their specific needs can eliminate the need for drastic changes once the system is operational.
Implementation of the program is the next step. When nurses are involved in a process from the ground up, it will be reflected in their ease of
actively using a system to assist them in providing quality care to patients. Nursing involvement at this level will also lead to less frustration on
their part with them being familiar with the workings of the program.
There are five phases to the testing level and what better group to test a program than the one that will be using it. Within a short time frame,
nurses will be able to recognize if this is an SDLC that will work in their facility. If a program needs adjusting or information needs to be added, this
is where that will be discovered. Nurses will be the primary users of a new system and it won’t take them long to see if this new implementation
will work with them or against them. A nurse’s interest in SDLC technologies are influenced by patient safety, health promotion, and quality
patient outcomes (Virginia Nurse Today, 2010.) When the nurse can see that these needs are met with ease while using the system they are better
equipped to provided quality care.
As the SDLC is used it must be maintained. This process could include user support when software changes are necessitated (McGonigle et al,
2018). This is an ongoing stage as needs for facilities can change. When these changes need to occur and the appropriate technical support is
made available, nurses are reassured. We rely heavily on technology at this time in healthcare. When our systems are down it is not just an
inconvenience, it is a safety issue to nurse and patients alike. Nurses utilize their clinical expertise, prior knowledge, and critical thinking skills
(Alfaro-LeFevre, 2009), these processes are hampered when we do not have access to our patient data due to SDLC issues. Knowing that problems
will be dealt with promptly gives us the confidence to trust in our technology.
Alfaro-LeFevre, R. (2009). Critical thinking and clinical judgment. St. Louis, MO: Saunders.
McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of
knowledge (4th ed.). Pp 175, 180. Burlington, MA: Jones and Bartlett Learning
Nurse leaders discuss the nurse’s role in driving technology decisions. (2010). Virginia Nurses Today, 18(1), 8-9.
RE: Discussion – Week 6
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There are multiple approaches to the systems development life cycle (SDLC) that can be utilized. The methods generally involve identifying needs and feasibility, understanding how to address those needs, developing and implementing a plan, evaluation of the system, and maintenance (McGonigle and Mastrian, 2018, p. 175). Through every stage, a strong team from multiple disciplines is crucial to a systems success. Nurses are at the “front lines” of patient care and need to be part of the SDLC.
Identifying organizational needs and finding solutions to them is the first step in choosing and designing new technology systems. The team will need to examine issues and determine the goals of the project. While every discipline on the team will bring forth issues, it is important to include nursing leaders and nursing staff to identify them; nurses can raise awareness on the issues that are directly related to patient care. An example may be that there is an issue with discharge times or processes. Nursing staff can elaborate on those issues and the team can collaborate on solutions and goals that a new system should accomplish.
During the design phase of the project, the team will determine which programs will be needed, how they will interact, what data are essential, and how the interfaces will look (McGonigle and Mastrian, 2018, p. 179). Nursing is especially important in this phase as they will be the end users that will determine if the process is beneficial to themselves and the patient. If, for example, there are too many navigators for an inpatient assessment, this can be identified and simplified during the design phase.
Implementing the new system starts with staff education. In the article by Douglas Page, he discusses the importance of the team providing training with a clear vision of the project and making sure that staff understand how this will change the delivery of health care (Page, 2011, p. 27). Staff support and understanding during training and implementation will increase motivation and ultimately the effectiveness of the program. Staff who can completely utilize the system will lead to improved nursing care and patient outcomes.
Evaluating a new system is largely observed by the nurses who provide patient care. Nurses can identify what is working well and areas that may need improvement. They are also able to bring new ideas to the table for future revisions, which contributes to the maintenance and revision stages of SDLC.
In conclusion, open communication, collaboration with multiple disciplines, team support, and a clear vision for the project are essential in the SDLC. Nurses play a vital role in all aspects of the SDLC and must be included from the beginning of the project. In the article featured in Virginia Nurses Today (2010), the roundtable participants discussed the importance of nurses during the development of new systems stating that “nothing is more powerful than frontline staff being on the inside track in a technology decision.”
McGonigle, D., & Mastrian, K. G. (2018). Nursing Informatics and the Foundation of
Knowledge (4th ed.). Burlington, MA. Jones and Bartlett Learning.
Nurse leaders discuss the nurse’s role in driving technology decisions. (2010). Virginia
Nurses Today, 18(1), 8-9. Retrieved from the Walden Library Database
Page, D. (2011). Turning nurses into health IT superusers. Hospitals & Health Networks, 85(4),
27-28. Retrieved from the Walden Library Database.
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