“Don’t design an information system and then say, ‘OK, now let’s change our workflow to make the system work.’ First, design the most effective workflow that delivers safe, efficient, high-quality patient care. Then ask ‘How will this system enable me to do that?”‘ —Linda Burnes Bolton, vice president and chief nursing officer at Cedars-Sinai Medical Center in Los Angeles
Health information technology (HIT): it’s a hugely complicated topic and, with $19 billion in federal stimulus funds accelerating its adoption by medical offices and hospitals, it’s going to have an increasing impact on the way nurses do their jobs over the next few years.
In the print and online editions of AJN—and here on the blog—we’re planning to keep readers informed about HIT as the new system takes shape. This month’s issue has an article that covers some of the concerns of nursing leaders who are trying to ensure that the voices of nurses are heard at the design and testing phases, before new systems are put into place.
If you’ve been hearing a lot about HIT but haven’t been using it in your workplace—or aren’t even completely sure what it is—you’re not alone. A study published in a recent issue of the New England Journal of Medicine found that only about 1.5% of hospitals nationwide have a comprehensive electronic health record (EHR) system .
Electronic health records are a big part of HIT, but they’re only one piece of the puzzle. HIT also comprises computers, software, network infrastructure, and all kinds of digital medical devices that can—or should be able to—communicate with each other.
HIT is a complex subject that’s difficult to summarize, but one of the best short articles explaining the full scope and impact of HIT is here. The author is David Blumenthal, President Obama’s national coordinator for HIT.
Blumenthal recently told AJN: “Nurses are critical to the health care system, so any office-based or hospital-based information systems have to be usable by nurses, and NPs have to be able to use them the way physicians do.”
But he also said, “One of the reasons vendors haven’t been more attentive to nursing perspectives may be that nurses haven’t been prominent in purchasing decisions. Vendors respond to the market, and the market tends to be dominated by physicians and hospitals.”
Does your workplace employ electronic health records? If so, what other devices do you use and how smoothly do they integrate with the electronic health record system you have in place? Have you received adequate training in how to use the technology? And what’s your overall assessment of its impact on patient outcomes and your workflow?