1. Copyright © 2016 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 18: Design Considerations for Healthcare Information Systems Chapter 18: Design Considerations for Healthcare Information Systems

2. Copyright © 2016 Wolters Kluwer All Rights Reserved 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. Copyright © 2016 Wolters Kluwer All Rights Reserved 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. Copyright © 2016 Wolters Kluwer All Rights Reserved 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. Copyright © 2016 Wolters Kluwer All Rights Reserved Question Is the following statement true or false? A key aspect of electronic records is the ability to share data.

6. Copyright © 2016 Wolters Kluwer All Rights Reserved Answer True Rationale: Interoperability, or the ability to share data, is an essential characteristic of electronic records.

7. Copyright © 2016 Wolters Kluwer All Rights Reserved 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. Copyright © 2016 Wolters Kluwer All Rights Reserved 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. Copyright © 2016 Wolters Kluwer All Rights Reserved 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. Copyright © 2016 Wolters Kluwer All Rights Reserved 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. Copyright © 2016 Wolters Kluwer All Rights Reserved Systems Life Cycle (cont.) Implementation –“Go-live” –Roll-back –Contingency plan –Pilot conversion –Phased conversion –Parallel conversion –Big-bang conversion

12. Copyright © 2016 Wolters Kluwer All Rights Reserved 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. Copyright © 2016 Wolters Kluwer All Rights Reserved Question Is the following statement true or false? Debugging of the system occurs during implementation.

14. Copyright © 2016 Wolters Kluwer All Rights Reserved Answer False Rationale: Debugging occurs during the planning step.

15. Copyright © 2016 Wolters Kluwer All Rights Reserved 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. Copyright © 2016 Wolters Kluwer All Rights Reserved 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. Copyright © 2016 Wolters Kluwer All Rights Reserved 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