HIT Usability and Design Challenges

 

Reflect on your experiences with the integration of new technology. How have these implementations affected the procedures that you perform at work? As the end user, it can be easy to overlook all of the important decisions that went into the finished product that you see before you. In looking at the final data management screens, you may find yourself at the crossroads of two options. You may either 1) be ecstatic about the needed change that this system brought, or 2) frustrated because you feel the system brings new hurdles into your already busy day. If you have ever experienced the latter option, the comment “I could have implemented a better system than this” may resonate strongly with you. Though research agrees that user input assists HIT designers, the development and implementation of new systems is not as straightforward as it may appear. HIT development teams find themselves in constant phases of trial and error as they strive to meet the needs of all users within the proposed development timeline. Failure to achieve promised usability benefits can lead to increased costs and job complications. Applying effective strategies to overcome usability challenges is essential.
In this week’s Discussion, you move from the standpoint of the “outsider looking in” (end user) and place yourself into a real-world implementation example. To complete this Discussion, you evaluate a case study to determine where the implementation process took a wrong turn. Use this week’s Learning Resources to propose changes that could have put this operation on the road to success.

 

To prepare:

• Review      the Learning Resources, focusing on the TIGER Usability and Clinical      Application Design Collaborative.
• Consider      the “Best Practice Exemplars” provided in the course text Nursing      Informatics: Where Technology and Caring Meet.
• Review      “Case Study 1: A Usability and Clinical Application Design Challenge”      presented on page 238 of the course text Nursing Informatics:      Where Technology and Caring Meet. (see bottom of this page for the      case study)
• Determine      the causes of the noted usability challenges (i.e., human factors,      ergonomics, human-computer interaction), as well as potential usability      concerns experienced by staff during implementation. Consider the possible      design failures that lead to the usability challenges.
• What      strategies might you employ to overcome these HIT usability challenges and      concerns?

By tomorrow Tuesday 10/03/17, 5 pm, write a minimum of 550 words essay in APA format with a minimum of 3 references from the list of Required Readings below. Include all level one headings as numbered below:

 

post a cohesive response to the following:

• Place      yourself in the role of the clinical administrator tasked with      implementing the case study’s new health information technology system.

1) Evaluate the usability challenges that you faced during implementation as well as the factors that caused these challenges.

2) Determine whether these challenges were a result of implementation or design.

3) Formulate strategies for overcoming these usability challenges.

Required Readings

Course Text: Ball, M. J., Douglas, J. V., Hinton Walker, P., DuLong, D., Gugerty, B., Hannah, K. J., . . . Troseth, M. R. (Eds.) (2011). Nursing informatics: Where technology and caring meet (4th ed.). London, England: Springer-Verlag.

• Chapter      14, “Usability and Clinical Application Design”

This chapter begins by defining the terms usability and application design as they are used in the field of nursing informatics. The authors then describe the literature review and analytic process that the TIGER Collaborative group underwent to positively transform the development of HIT systems.

Gruber, D., Cummings, G. G., LeBlanc, L., & Smith, D. L. (2009). Factors influencing outcomes of clinical information systems implementation: A systematic review. CIN: Computers, Informatics, Nursing, 27(3), 151–163.

The authors analyze the outcomes of prior IT implementations to determine if certain strategies can guarantee success when launching new clinical information systems.

Kaufman, D., Roberts, W. D., Merrill, J., Lai, T., & Bakken, S. (2006). Applying an evaluation framework for health information system design, development, and implementation. Nursing Research, 55(2, Suppl. 1), S37–S42.

This article emphasizes the indispensable role of continuous evaluation throughout the development and real-time application of new information systems into the workplace.

Schlotzer, A., & Madsen, M. (2010). Health information systems: Requirements and characteristics. Studies in Health Technology and Informatics, 151, 156–166.

Use this article to examine the importance of focusing on sound design, interoperability of systems, and fulfillment of user needs when developing an effective database.

Case Study 1: A Usability and Clinical Application Design Challenge 

A medical center implemented an EMR with orders, clinical documentation, and results retrieval to improve efficiencies and enhance patient safety in the perinatal units of a small medical center, including Labor and Delivery (L& D), NICU, and Newborn Nursery Selection process The system was installed elsewhere in this integrated delivery network The executives wanted a fast 6-month installation at the maximum Usability challenges Existing order sets and documents from other sites were not uploaded and tailored to this site. Clinicians were asked to input individual orders (not acceptable). Needed computer terminals were ordered late and arrived the day of go-live. Clinicians competed for working terminals at the nurses’ stations Workflow among units was not considered or tested. Shared information such as mother’s blood type and L& D information was not available to NICU or Newborn Nursery, causing confusion about potential patient safety issues Generic training was given because the site tailoring was not done. On go-live, users did not know where to locate information before it had changed in the lag between training and go-live Outcomes The clinicians had to endure an unnecessarily painful implementation and its potential patient safety impacts Working out usability issues took months after go-live

The system was tested/ validated for usability, design, and practice needs Education included practice changes along with how to use the system Developed a methodology to respond rapidly to end users Outcomes Standardized practice in three different acute care hospitals in 15 months Significant improvement in core measures and nurse-sensitive outcomes.

When we approach discussions about diversity, we each come to conclusions with our own perspectives that have been shaped by our experiences. As we begin our first discussion, take a moment to consider what has influenced your ideas of diversity and compare those ideas with what you read in this module’s readings. Then, address the following:

Introduce your major and profession – NURSING.
In your own words, define the term diversity and discuss how it is used or impacts your daily life. How does your definition compare and contrast with those that were presented in the readings?
What is the influence of diversity on your chosen field of study or future profession? How can you use your understanding of diversity in your professional career?
In response to your peers, provide feedback about their definition of diversity. Compare and contrast your answers and consider the following:

What are the similarities and differences between your peer’s response and yours?
How do the two definitions of diversity help to illustrate how diversity and society are intertwined? How can a perspective through the four lenses help to provide a greater understanding of diversity?
Make sure you support your response with the readings from this module, and any additional resources if needed.

Attached below are readings from the module to use to answer the questions above.

Field of study and current profession is NURSING and should be based in that subject.

Purpose
This week’s graded topics relate to the following Course Outcomes (COs).

CO 1 – Utilize prior knowledge of theories and principles of nursing and related disciplines to explain expected client behaviors, while differentiating between normal findings, variations, and abnormalities. (PO 1)
CO 4 – Identify teaching/learning needs from the health history of an individual. (PO 2)
The Assignment
In Week 6 you demonstrated a head to toe assessment of an adult participant. This week you and your classmates will reflect on physical assessment in your own nursing practice, and on the assessment you performed for your video assignment.

Please consider the following in your initial post:

Please share how physical assessment is performed in your practice area. How do you determine what type of physical assessment is appropriate in caring for your patients? Do you perform complete head to toe assessments, or are they typically more focused exams? (If you do not currently work in a patient care setting, you may reflect on observations from a clinical experience or prior work setting.)
Based on your observations, do you feel that patient assessments performed in practice are as thorough as they should be? Explain your answer.
Reflect on the assessment you performed for the video assignment. Perhaps you might compare your performance now, to how it might have been different when you were a brand new nurse? Or share something you learned (or were reminded of) by participating in this activity?

Abdominal Assessment Article

1. What six (6) factors independently predicted GI complications?

2. What were the nine (9) variables that independently predicted major GI complications?

3. Name three (3) ways in which mechanical ventilation affects splanchnic perfusion?

4. Name at least twelve (12) reasons given for hypomotility of the gut?

5. Etiologies of diarrhea include these six (6) items.

6. What is the pathophysiology of diarrhea that starts between the 5th and 10th day of treatment?

7. What are the three (3) broad categories of abdominal pain? Give an example of each…

8. What are the three (3) clinical signs that are indicative of active bleeding?

Scenario: You work for the contracting department for a national payer that is working to convert its provider contracts to value-based arrangements. Your team is approaching large physician groups for recontracting. Develop a 12-15-slide presentation with speaker notes to show the value of converting to a value-based arrangement:

1. Explain value-based care.
2. Explain how value-based care differs from a fee-for-service or a capitated approach.
3. Describe why adopting a value-based purchasing arrangement would be financially advantageous for the physician groups and to the health plan.

Include at least three references, including your textbook.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Each slide should have comprehensive speaker notes.  Please do not restate the info on the slide as the speaker notes.