The Journal of Healthcare Information Management (JHIM). 2006;20(2):36-44.

The article has been excerpted with permission of HIMSS. Full text can be found online (requires subscription to JHIM) at http://www.himss.org/ASP/publications_jhim_issue.asp?issue=3/1/2006.

OVERVIEW

In 2005, the Healthcare Information and Management Systems Society (HIMSS) Nursing Informatics Task Force surveyed acute care providers across the United States to explore the impact of health information technology (HIT) on the role of nurses in acute care settings, including what was gained or lost with the use of HIT, particularly with regard to the nursing roles of collaboration and communication.

This article provides an overview of survey results from four large healthcare delivery systems (N = 498), with a focus on how the results will be used to support an evidence-based approach to improving acute care HIT systems across the following health-care delivery systems in the United States: Partners and Lifespan Health Systems in the northeast, Baptist Health South Florida in the southeast, and Providence Health System in the northwest.

DISCUSSION

Survey responses across the four health systems indicate overall satisfaction with HIT applications and tools, with a clear desire for improvement particularly with regard to communication tools available to indicate action on a message sent. The data also indicate that HIT applications and tools that support interdisciplinary communication and collaboration were perceived to be supportive of the nursing process.

The results of the post hoc analysis suggest that efforts spent developing and improving on HIT applications and tools to facilitate and strengthen interdisciplinary communication, collaboration, and patient-centered care are likely to be associated with improved satisfaction. The post hoc analysis also acknowledged that the use of HIT strategies to improve communication processes is associated with greater overall satisfaction. This suggests the importance of clearly conveying to nurses and other acute care providers that the purpose of using HIT applications and tools is to facilitate communication and to improve access to data and information necessary to provide effective and safe patient care.

There are several limitations to this study. Each healthcare system that participated in this analysis included several hospitals and, in some cases, several systems and inconsistent depth of deployment within and across healthcare systems. Therefore, where improved satisfaction was noted, it was not possible to isolate the source or attribute to a single factor. The survey did not account for methods of training or the degree of ongoing support that may vary within and across healthcare systems. Despite these limitations, this analysis did assist the participating healthcare systems with meeting their original goal of gaining a better understanding of the impact of HIT on the role of nurses and interdisciplinary communication and providing an evidence-based approach to the improvement of HIT systems.

CONCLUSION

Acute care providers included in this analysis reported overall satisfaction with the HIT systems in place; however, the results indicate that a range of strategies may be indicated to promote greater satisfaction with HIT and to assure that applications and tools support the nursing process. Institutional policies and practices that use HIT solutions with the intent to improve com munication are clearly indicated. A focus on the development of HIT applications and tools with features associated with greater satisfaction, including features to facilitate improved acknowledgement of messages acted upon and the ability to support patient-centered care, is needed. Development of HIT applications and tools that support interdisciplinary collaboration and treatment planning and the capacity for data-intensive tasks such as patient transfer may help to improve overall satisfaction with HIT systems and strengthen the degree to which HIT applications in place are perceived as supportive of the nursing process.