Exploring Strategies for Successful Implementation of Electronic Health Records

Adoption of electronic health records (EHR) systems in nonfederal acute care hospitals has increased, with adoption rates across the United States reaching as high as 94%. Of the 330 plus acute care hospital EHR implementations in Texas, only 31% have completed attestation to Stage 2 of the meaningful use (MU) criteria. The purpose of this multiple case study was to explore strategies that hospital chief information officers (CIOs) used for the successful implementation of EHR. The target population consists of 3 hospitals CIOs from a multi-county region in North Central Texas who successfully implemented EHRs meeting Stage 2 MU criteria. The conceptual framework, for this research, was the technology acceptance model theory. The data were collected through semistructured interviews, member checking, review of the literature on the topic, and publicly available documents on the respective hospital websites. Using methodological triangulation of the data, 4 themes emerged from data analysis: EHR implementation strategies, overcoming resistance to technology acceptance, strategic alignment, and patient wellbeing. Participants identified implementation teams and informatics teams as a primary strategy for obtaining user engagement, ownership, and establishing a culture of acceptance to the technological changes. The application of the findings may contribute to social change by identifying the strategies hospital CIOs used for successful implementation of EHRs. Successful EHR implementation might provide positive social change by improving the quality of patient care, patient safety, security of personal health information, lowering health care cost, and improvements in the overall health of the general population

The Advent of Digital Productivity Assistants: The Case of Microsoft MyAnalytics

Modern digital work environments allow for great flexibility, but can also contribute to a blurring of work/life boundaries and technostress. An emerging class of intelligent tools, that we term Digital Productivity Assistant (DPA), helps knowledge workers to improve their productivity by creating awareness of their collaboration behaviour and by suggesting improvements. In this revelatory case study, we combine auto-ethnographic insights with interview data from three organisations to explore how one such tool works to influence collaboration and productivity management behaviours, using the lens of persuasive IS design. We also identify barriers to DPAs’ effective use as a partner in personal productivity management

Telehealth Case Management Nursing Process and Technology Enhancements: Reflecting Practice and Outcomes

Accurate reflection of care practices in telehealth care management is the fore runner to the delivery of reportable beneficiary outcomes. Success in delivering Geriatric Care Services (GCS) resides in a partnership between clinician practice and technology tools utilized in telehealth practice. Through in home technologies, telehealth can provide ongoing care needs to underserved populations, and it can support independent aging of beneficiaries who live with chronic care conditions. Tele-health care management, performed through a health plan, presents a unique opportunity to capitalize on the abundance of health data collected on a patient, and maximize the use of that information for clinical decision support. Nursing informatics is the facilitator of telenursing. It is the specialty that integrates and applies nursing science, and respective theoretical models, in identifying, collecting, processing, and managing data. It furthers seeks to process that data to formulate knowledge based decisions and informed care plan actions. Maximizing technology and available data are primary tools a telehealth clinician uses in care management practice. It is imperative that the technology system utilized in practice supports the telehealth interaction by accurately and effectively reflecting the clinician’s practice through data inputs, collection methods, and interpretation logic. This Doctorate of Nursing Practice (DNP) systems change project examined existing telehealth care practice and available technology tools. The project explored options for practice and process improvements in identification and formulation of cases and the development of new clinical technology tools to support the practice. Further, this project implemented practice change to support the organization’s strategic plan to provide efficient and effective GCS case management to our client. In summary, this project produced new clinical technology tools to reflect telehealth practice, gave a voice to telehealth case managers in the technology development cycle, and established a measurement framework for organizational reporting on case management outcomes

A model on factors affecting nurses adoption of health information technology

Healthcare organisations are using Health Information Technology (HIT) to improve efficiency, reduce cost and reduce medical errors. This study focused on the factors that influence the acceptance of HIT among nurses in Saudi hospitals. This research used a 6 stage mixed-methods research approach. Literature was used to search for established models and frameworks of technology acceptance, and the many factors that could play a role. In the field study, the nature of practical HIT issues at the Prince Sultan Military Medical City (PSMMC) and the Heraa Hospital were studied, and combined with literature to create a HIT Implementation Issues Framework. The framework consolidates elements from the Technological, Organisational, Environmental and Human dimensions. The researcher participated in further PSMMC projects in the design and implementation of the new Cardio Pulmonary Resuscitation System and the Nurses and Pharmacists’ Communication System. From the implementation experience, pertinent factors were added to the Technology Acceptance Model and the “Nurses Acceptance Model” was proposed. The proposed model has eleven independent parameters, two dependent parameters, as well as seven moderators of key relationships. A questionnaire with 71 entries was distributed to over 2800 nurses in 52 wards in PSMMC. SPSS was used for data screening and descriptive statistics. The SmartPLS software was used for analysis and testing of the proposed hypotheses. The findings refined the “Nurses Acceptance Model” and highlight the significance of User Involvement and Training. The “Nurses Acceptance Model” enhances the scientific understanding of variables that affect technology acceptance among nurses in Saudi hospitals. The HIT Implementation Issues Framework helps hospital decision makers to plan HIT projects to improve the likelihood of successful adoption

The adoption of healthcare information systems within public hospitals in Kurdistan region of Iraq

In Iraq, government reports stated that the ‎adoption of Healthcare Information Systems ‎‎(HIS) is still low and below the aspirations of the ‎government despite the investments in the system ‎development. For this reason, there was a need to ‎explore and investigate the actual issues that ‎influence the adoption of HIS, and to examine the ‎effect of different dimensions (i.e. the individual, ‎technological, organizational and environmental) ‎on the adoption of HIS in Iraq. The main objective of the study is to explore the ‎factors that affect the adoption of HIS among ‎healthcare practitioners within Kurdistan Region ‎of Iraq (KRI) public hospitals. Furthermore, ‎another goal was to examine the influence of ‎different dimensions on the healthcare ‎practitioners’ adoption behavior in order to ‎produce the essential knowledge regarding HIS ‎adoption. The study used a mixed method approach. The ‎data collection started with a qualitative study ‎using semi-structured interviews with eight ‎healthcare professionals and then followed by a ‎quantitative study that was conducted among 551 ‎respondents using self-administered ‎questionnaires. The qualitative study resulted in 26 themes that ‎were elicited from the interviews. Moreover, the ‎findings of the quantitative study indicated that ‎the adoption of HIS was significantly influenced ‎by different individual, technological, ‎organizational and the environmental dimensions ‎collectively. The study revealed the actual issues (i.e. the ‎individual, technological, organizational and ‎environmental) facing the adoption of HIS within ‎the study’s new context through the qualitative ‎investigation. Moreover, a comprehensive and ‎holistic model based on the Unified Theory of ‎Acceptance and Use of Technology (UTAUT) ‎was presented. The study presented the essential ‎knowledge and information to the literature, ‎healthcare practitioners and researchers in Iraq ‎regarding the issue of HIS adoptio

The Successful Implementation of Electronic Health Records at Small Rural Hospitals

Electronic health records (EHRs) have been in use since the 1960s. U.S. rural hospital leaders and administrators face significant pressure to implement health information technology because of the American Recovery and Reinvestment Act of 2009. However, some leaders and managers of small rural hospital lack strategies to develop and implement EHRs. The focus of this descriptive phenomenological study was to explore lived experiences of hospital leaders and administrators who have used successful strategies to implement EHRs in small rural hospitals. Diffusion of innovation theory shaped the theoretical framework of this study. Data were collected through telephone interviews conducted with participants who successfully deployed EHRs at 10 hospitals in the Appalachian regions of Maryland, Virginia, and West Virginia. Data analysis occurred using a modified Husserlian approach in search of common themes from interview transcripts. The main themes were strategies to address standards and incentives, implementation, and challenges. The exploration of these strategies provides insight that small rural hospital leaders and administrators could consider for implementing EHRs. The study findings might enable small rural hospital leaders and administrators to contribute to positive social change by engaging communities in using EHRs; these findings may also expand information sharing among individuals and organizations and build social relationships with an expectation of future benefits. Results from this study are designed to inform other small rural hospital leaders and administrators to conduct further research on successful strategies for implementation of EHRs

The Information Systems Academic Discipline in Australia

This book represents the second phase of a multi-method, multi-study of the ‘Information Systems Academic Discipline in Australia’. Drawing on Whitley’s Theory of Scientific Change, the study analysed the degree of ‘professionalisation’ of the Information Systems Discipline, the overarching research question being ‘To what extent is Information Systems a distinct and mature discipline in Australia?’ The book chapters are structured around three main sections: a) the context of the study; b) the state case studies; and c) Australia-wide evidence and analysis. The book is crafted to be accessible to IS and non-IS types both within and outside of Australia. It represents a ‘check point’; a snapshot at a point in time. As the first in a hoped for series of such snap-shots, it includes a brief history of IS in Australia, bringing us up to the time of this report. The editorial team comprises Guy Gable, architect and leader; Bob Smyth, project manager; Shirley Gregor, sponsor, host and co-theoretician; Roger Clarke, discipline memory; and Gail Ridley, theoretician. In phase two, the editors undertook to examine each component study, with a view to arriving at an Australia-wide perspective

Data security in European healthcare information systems

This thesis considers the current requirements for data security in European healthcare systems and establishments. Information technology is being increasingly used in all areas of healthcare operation, from administration to direct care delivery, with a resulting dependence upon it by healthcare staff. Systems routinely store and communicate a wide variety of potentially sensitive data, much of which may also be critical to patient safety. There is consequently a significant requirement for protection in many cases. The thesis presents an assessment of healthcare security requirements at the European level, with a critical examination of how the issue has been addressed to date in operational systems. It is recognised that many systems were originally implemented without security needs being properly addressed, with a consequence that protection is often weak and inconsistent between establishments. The overall aim of the research has been to determine appropriate means by which security may be added or enhanced in these cases. The realisation of this objective has included the development of a common baseline standard for security in healthcare systems and environments. The underlying guidelines in this approach cover all of the principal protection issues, from physical and environmental measures to logical system access controls. Further to this, the work has encompassed the development of a new protection methodology by which establishments may determine their additional security requirements (by classifying aspects of their systems, environments and data). Both the guidelines and the methodology represent work submitted to the Commission of European Communities SEISMED (Secure Environment for Information Systems in MEDicine) project, with which the research programme was closely linked. The thesis also establishes that healthcare systems can present significant targets for both internal and external abuse, highlighting a requirement for improved logical controls. However, it is also shown that the issues of easy integration and convenience are of paramount importance if security is to be accepted and viable in practice. Unfortunately, many traditional methods do not offer these advantages, necessitating the need for a different approach. To this end, the conceptual design for a new intrusion monitoring system was developed, combining the key aspects of authentication and auditing into an advanced framework for real-time user supervision. A principal feature of the approach is the use of behaviour profiles, against which user activities may be continuously compared to determine potential system intrusions and anomalous events. The effectiveness of real-time monitoring was evaluated in an experimental study of keystroke analysis -a behavioural biometric technique that allows an assessment of user identity from their typing style. This technique was found to have significant potential for discriminating between impostors and legitimate users and was subsequently incorporated into a fully functional security system, which demonstrated further aspects of the conceptual design and showed how transparent supervision could be realised in practice. The thesis also examines how the intrusion monitoring concept may be integrated into a wider security architecture, allowing more comprehensive protection within both the local healthcare establishment and between remote domains.Commission of European Communities SEISMED proje

Be patient:A longitudinal study on adoption and diffusion of information technology innovation in Dutch healthcare

Three factors played an important role in the IT innovation alignment for the VBVS: economy, policy and technology. IT management played a crucial role in the alignment process of these factors. However, IT management still has an internal focus when it comes to IT innovations. At best, healthcare professionals are treated as customers, instead of the patients. When IT management realizes that the actual adoption and diffusion of IT innovations in healthcare is an expression of the intangible benefit it brings the patients... ... IT management can consider stimulating the adoption and diffusion of IT innovations by aligning the decision making process around the patients’ needs, and literally ‘be patient.’