Design Considerations for Healthcare Information Systems

1. Chapter 18: Design Considerations forHealthcare Information Systems

2. Design Considerations • Need for workflow redesign • Consideration of patient, work done by all care providers, organizational needs • Users’ perceptions; barriers to change; strategies to work through barriers • Purpose, goals, outcomes; tremendous work and collaboration between disciplines

3. Technology Competencies • All users of computerized clinical information systems must have effective technology competencies. • Nurses • Leadership • All providers and staff should assist with planning and training for a new system. • Computer competency tests to assess learning needs • Need for interoperability: ability to share data.

4. Cost/Benefits • A research report estimated that health IT adoption could save more than 81 billion annually. • That savings has not yet occurred • A survey conducted by Medical Economics reported that 70% of physicians stated that purchase of the EHR was not worth the costs. • The physicians did not: • Have clear expectations when selecting an HER • Receive appropriate training • Have the knowledge and experience to make purchase choices for computers and equipment

5. Question • Is the following statement true or false? • A key aspect of electronic records is the ability to share data.

6. Answer • True • Rationale: Interoperability, or the ability to share data, is an essential characteristic of electronic records.

7. Project Management • Essential skill of nursing informatics specialist • Management of project from start to finish • Skills • Communication • Team building • Organizational planning • Time and resource management • Systems life cycle as backbone

8. Systems Life Cycle • Conception of system until implementation • Analogous to nursing process • Assessment • Multiple places for iteration • Evaluation • Never ending; changes made based on evaluation • Wording and steps differ by agency or author

9. Systems Life Cycle (cont.) • Initiating • Project goals • Project scope • Scope creep: unanticipated project growth • Project requirements • Risks; needs assessment • Return on investment (ROI); cost–benefit • Request for information (RFI) • Request for proposal (RFP)

10. Systems Life Cycle (cont.) • Planning • Work flow analyses • System selection • Executing • System design and testing (vanilla product) • Bugs and debugging • Regression testing • Integration testing • Training

11. Systems Life Cycle (cont.) • Implementation • “Go-live” • Roll-back • Contingency plan • Pilot conversion • Phased conversion • Parallel conversion • Big-bang conversion

12. Systems Life Cycle (cont.) • Controlling • System maintenance is an ongoing process. • All issues should be documented, prioritized, and tracked by using a database. • Closing • Evaluation should be a part of every phase of the systems life cycle. • Planned at least 6 months after implementation.

13. Question • Is the following statement true or false? • Debugging of the system occurs during implementation.

14. Answer • False • Rationale: Debugging occurs during the planning step.

15. Question • When should an evaluation of the system’s life cycle be done? (Select all that apply.) • A. When the decision is made to begin the process • B. During each phase of the process • C. 6 months after the implementation phase • D. Whenever administration feels it is necessary

16. Answer • B and C • Rationale: Although evaluation should be a part of every phase of the systems life cycle, there should be a planned evaluation at least 6 months after implementation.

17. Business Continuity Plan • Business continuity plan is the term used by IT for disaster recovery. • An essential component for maintaining the integrity of patient data in the event of a disaster • Usually includes redundancy of data in an off-site storage center • Addresses system maintenance in the event of a shortage of personnel