Week 6 Discussion: Successful Implementation of Electronic Health Information Technology

Since the inception of the HITECH Act, health organizations have faced increased pressure to update their health information technology (HIT) resources. As discussed last week, many believe that the increased use of electronic health records and the quick and efficient communication afforded by HIT can lead to improved quality of patient care. Yet there are significant costs associated with implementing such systems. What can organizations do to ensure that the correct system is selected and that the system will be appropriate for those required to use it? Who should be involved in those decisions?

This week introduces the systems development life cycle and discusses how it can guide an organization through the complexities of adopting a new HIT system. In this Discussion, you are asked to consider the role of nurses in the SDLC process. Week 6 Discussion: Successful Implementation of Electronic Health Information Technology

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Discussion: Successful Implementation of Electronic

Health Information Technology

To prepare for Week 6 Discussion: Successful Implementation of Electronic Health Information Technology:

Review the steps of the systems development life cycle.

Think about your own organization, or one with which you are familiar, and the steps the organization goes through when purchasing and implementing a new HIT system.

Consider what a nurse could contribute to decisions made at each stage when planning for new health information technology. What might be the consequences of not involving nurses?

Reflect on your own experiences with your organization selecting and implementing new technology. As an end user, do you feel you had any input in the selection or and planning of the new HIT system? Week 6 Discussion: Successful Implementation of Electronic Health Information Technology

By Day 3 of Week 6 Discussion: Successful Implementation of Electronic Health Information Technology

Post an analysis of the ramifications of an organization not involving nurses in each stage of the systems development life cycle when purchasing and implementing a new HIT system. Give specific examples of potential issues at each stage and how the inclusion of nurses could help avoid such issues. Week 6 Discussion: Successful Implementation of Electronic Health Information Technology

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

Ask a probing question, substantiated with additional background information, evidence or research.

Share an insight from NURS 6051 Discussion Papers – Transforming Nursing & Healthcare Through IT having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research. Week 6 Discussion: Successful Implementation of Electronic Health Information Technology

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence. Week 6 Discussion: Successful Implementation of Electronic Health Information Technology.

Week 7 Discussion: Understanding Workflow Design

As you explored last week, the implementation of a new technology can dramatically affect the workflow of an organization. Newly implemented technologies can initially limit the productivity of users as they adjust to their new tools. Such implementations tend to be so significant that they often require workflows to be redesigned in order to achieve improvements in safety and patient outcomes. However, before workflows can be redesigned, they must first be analyzed. This analysis includes each step in completing a certain process. Some systems duplicate efforts or contain unnecessary steps that waste time and money and could even jeopardize patient health care. By reviewing and modifying the workflow, you enable greater productivity. This drive to implement new technologies has elevated the demand for nurses who can perform workflow analysis.

In this Discussion you explore resources that have been designed to help guide you through the process of workflow assessment.

To prepare:

Take a few minutes and peruse the information found in the article “Workflow Assessment for Health IT Toolkit” listed in this week’s Learning Resources.

As you check out the information located on the different tabs, identify key concepts that you could use to improve a workflow in your own organization and consider how you could use them.

Go the Research tab and identify and read one article that is of interest to you and relates to your specialty area.

By Day 3

Post a summary of three different concepts you found in “Workflow Assessment for Health IT Toolkit” that would help in redesigning a workflow in the organization in which you work (or one with which you are familiar) and describe how you would apply them. Next, summarize the article you selected and assess how you could use the information to improve workflow within your organization. Finally, evaluate the importance of monitoring the effect of technology on workflow. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

Read a selection of your colleagues’ responses. Focus particularly on questions raised for which you can add comments based on your experiences or situations. Consider how your colleagues’ postings reflect and/or differ from your own perceptions and opinions. Review the Learning Resources for any clarification needed before responding.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches

Ask a probing question, substantiated with additional background information, evidence or research.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence. NURS 6051 Discussion Papers – Transforming Nursing & Healthcare Through IT.

Week 8 Discussion: Using Health Information Technology as a Source of Evidence-Based Practice

Before the digital revolution, health information technology supplied very limited support for evidence-based practice. If nurses wanted to be informed about cutting-edge research, their best bet was to either subscribe to leading journals or make periodic trips to the library. With the establishment of research databases, however, nurses became empowered to learn about and facilitate interdisciplinary and translational research. Databases are just one example of how health information technology supports evidence-based practice.

To prepare:

Read the following scenario from the text (McGonigle & Mastrian, 2011, p. 482):

Twelve-hour shifts are problematic for patient and nurse safety, and yet hospitals continue to keep the 12-hour shift schedule. In 2004, the Institute of Medicine (Board on Health Care Services & Institute of Medicine, 2004) published a report that referred to studies as early as 1988 that discussed the negative effects of rotating shifts on intervention accuracy. Workers with 12-hour shifts realized more fatigue than workers on 8-hour shifts. In another study done in Turkey by Ilhan, Durukan, Aras, Turkcuoglu, and Aygun (2006), factors relating to increased risk for injury were age of 24 or less, less than 4 years of nursing experience, working in the surgical intensive care units, and working for more than 8 hours.

Consider how the resources identified in the scenario above could influence an organization’s practice.

Select an issue in your practice that is of concern to you. Using health information technology, locate at least three evidence-based practice resources that address your concern and that could possibly inform further action.

By Day 3

Post a description of your practice concern. Outline how you used health information technology to locate evidence-based practices that address this concern. Cite and include insights from the resources. Analyze how health information technology supports evidence-based practice. NURS 6051 Transforming Nursing & Healthcare Through Information Technology Discussion Papers

Read a selection of your colleagues’ responses. Focus particularly on those questions raised to which you can add comments based on shared experiences or situations. Consider how your colleagues’ postings reflect and/or differ from your own perceptions and opinions. Review the Learning Resources for any clarification needed before responding.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

Ask a probing question, substantiated with additional background information, evidence or research.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

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Week 9 Discussion: HITECH Legislation

In order for organizations to receive the incentives offered through the HITECH legislation, they must be able to demonstrate that they are using the technology in meaningful ways. The following criteria for meaningful use must be evident to qualify for EHR incentives (U.S. Department of Health & Human Services, 2012). The technology must:

Improve quality, safety, and efficiency, and reduce health disparities

Engage patients and families

Improve care coordination

Improve population and public health

Ensure adequate privacy and security protections for personal health information

For this Discussion you consider the impact of the meaningful use criteria of the HITECH legislation on the adoption of health information technology.

To prepare:

Review the Learning Resources on the HITECH legislation and its primary goals.

Reflect on the positive and negative impact this legislation has had on your organization or one with which you are familiar.

Consider the incentives to encourage the use of EHRs. Focus on the definition of meaningful use and how it is measured.

Reflect on how the incentives and meaningful use impact the quality of patient care.

Find an article in the Walden Library dealing with one of the criteria to qualify for meaningful use and how it has been successfully met.

By Day 3

Post a description of how HITECH legislation has positively or negatively impacted your organization. Address how its related incentives influence the adoption of health information technology in health care and impact the quality of patient care. Provide a summary of the article you identified and explain how it demonstrates the ability of health information technology to meet the requirements of meaningful use.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

Ask a probing question, substantiated with additional background information, evidence or research.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Week 10 Discussion: Security of Health Care Records

With the increase of health information technology used to store and access patient information, the likelihood of security breaches has also risen. In fact, according to the Canadian Medical Association Journal (CMAJ):

In the United States, there was a whopping 97% increase in the number of health records breached from 2010 to 2011… The number of patient records accessed in each breach has also increased substantially, from 26,968 (in 2010) to 49,394 (in 2011). Since August 2009, when the US government regulated that any breach affecting more than 500 patients be publicly disclosed, a total of 385 breaches, involving more than 19 million records, have been reported to the Department of Health and Human Services.

A large portion of those breaches, 39%, occurred because of a lost, stolen, or otherwise compromised portable electronic device—a problem that will likely only get worse as iPads, smartphones, and other gadgets become more common in hospitals. (CMAJ, 2012, p. E215).

Consider your own experiences. Does your organization use portable electronic devices? What safeguards are in place to ensure the security of data and patient information? For this Discussion you consider ethical and security issues surrounding the protection of digital health information.

To prepare:

Review the Learning Resources dealing with the security of digital health care information. Reflect on your own organization or one with which you are familiar, and think about how health information stored electronically is protected.

Consider the nurse’s responsibility to ensure the protection of patient information. What strategies can you use?

Reflect on ethical issues that are likely to arise with the increased access to newer, smaller, and more powerful technology tools.

Consider strategies that can be implemented to ensure that the use of HIT contributes to an overall culture of safety.

By Day 3

Post an analysis of the nurse’s responsibility to protect patient information and the extent that HIT has made it easier or more difficult to protect patient privacy. Comment on any security or ethical issues related to the use of portable devices to store information. Assess the strategies your organization uses to safeguard patient information and how these promote a culture of safety. Describe an area where improvement is needed and one strategy that could address the situation.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

Ask a probing question, substantiated with additional background information, evidence or research.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

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Week 11 Discussion: Health Literacy

In order to effectively manage their own health, individuals need to have competencies in two areas—basic literacy and basic health literacy. What is the difference? Basic literacy refers to the ability to read, even simple language. Health literacy is defined as, “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (National Coalition for Literacy, 2009). Unfortunately, according to a Department of Education report on health literacy, only 12% of adults aged 16 and older are considered to have a proficient level of health literacy (U.S. Department of Education, 2006). Acquiring health literacy skills has become more complicated with the explosion of online health information, some credible and some misleading.

In this Discussion, you focus on how to help individuals find credible information on the Internet and develop strategies nurses can use to increase the health literacy of their patients.

To prepare:

Think about the nurse’s role in improving the health literacy of patients.

Consider the many ways patients access health information, including blogs, social media, patient portals, websites, etc.

Reflect on experiences you have had with patients who self-diagnose using online medical sources.

Using the Internet, the Walden Library, or other trustworthy sources, identify a resource that you could introduce to patients to help them evaluate the credibility of health information found online.

What are some strategies you could employ to improve the health literacy of patients?

By Day 3

Post your assessment of the nurse’s role in improving the health literacy of patients. Then, identify the resource you would recommend to patients for evaluating online health information and why it would be beneficial. Describe additional strategies for assisting patients in becoming informed consumers of online health information.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

Ask a probing question, substantiated with additional background information, evidence or research.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Week 4 Assignment: Using the Data/Information/Knowledge/Wisdom Continuum

Have you ever gone online to search for a journal article on a specific topic? It is amazing to see the large number of journals that are available in the health care field. When you view the library in its entirety, you are viewing untapped data. Until you actually research for your particular topic, there is little structure. Once you have narrowed it down, you have information and once you apply the information, you have knowledge. Eventually, after thoughtful research and diligent practice, you reach the level of wisdom—knowledge applied in meaningful ways.

Are there areas in your practice that you believe should be more fully explored? The central aims of nursing informatics are to manage and communicate data, information, knowledge, and wisdom. This continuum represents the overarching structure of nursing informatics. In this Assignment, you develop a research question relevant to your practice area and relate how you would work through the progression from data to information, knowledge, and wisdom.

To prepare:

Review the information in Figure 6–2 in Nursing Informatics and the Foundation of Knowledge.

Develop a clinical question related to your area of practice that you would like to explore.

Consider what you currently know about this topic. What additional information would you need to answer the question?

Using the continuum of data, information, knowledge, and wisdom, determine how you would go about researching your question.

Explore the available databases in the Walden Library. Identify which of these databases you would use to find the information or data you need.

Once you have identified useful databases, how would you go about finding the most relevant articles and information?

Consider how you would extract the relevant information from the articles.

How would you take the information and organize it in a way that was useful? How could you take the step from simply having useful knowledge to gaining wisdom?

By Day 7 of Week 4

Write a 3- to 4-page paper that addresses the following:

Summarize the question you developed, and then relate how you would work through the four steps of the data, information, knowledge, wisdom continuum. Be specific.

Identify the databases and search words you would use.

Relate how you would take the information gleaned and turn it into useable knowledge.

Can informatics be used to gain wisdom? Describe how you would progress from simply having useful knowledge to the wisdom to make decisions about the information you have found during your database search.

Your paper must also include a title page, an introduction, a summary, and a reference page. NURS 6051 Discussion Papers – Transforming Nursing & Healthcare Through IT.

Week 6 Assignment: Application: Adoption of New Technology Systems

As a nurse, you can have a great impact on the success or failure of the adoption of EHRs. It is important for nurses to understand their role as change agents and the ways they can influence others when addressing the challenges of changing to a drastically different way of doing things.

Everett Rogers, a pioneer in the field of the diffusion of innovations, identified five qualities that determine individual attitudes towards adopting new technology (2003). He theorized that individuals are concerned with:

Relative advantage: The individual adopting the new innovation must see how it will be an improvement over the old way of doing things.

Compatibility with existing values and practices: The adopter must understand how the new innovation aligns with current practices.

Simplicity: The adopter must believe he or she can easily master the new technology; the more difficult learning the new system appears, the greater the resistance that will occur.

Trialability: The adopter should have the opportunity to “play around’ with the new technology and explore its capabilities.

Observable results: The adopter must have evidence that the proposed innovation has been successful in other situations.

Note: You are not required to purchase Rogers’ book or pursue further information regarding his list of five qualities. The information provided here is sufficient to complete this Assignment. The full reference for Rogers’ work is provided below the due date on this page.

For this Assignment, you assume the role of a nurse facilitator in a small hospital in upstate New York. You have been part of a team preparing for the implementation of a new electronic health records system. Decisions as to the program that will be used have been finalized, and you are now tasked with preparing the nurses for the new system. There has been an undercurrent of resistance expressed by nurses, and you must respond to their concerns. You have a meeting scheduled with the nurses 1 week prior to the training on the new EHR system. Consider how you can use the five qualities outlined by Rogers (2003) to assist in preparing the nurses for the upcoming implementation.

To prepare

Review the Learning Resources this week about successful implementations of EHRs.

Consider how you would present the new EHR system to the nurses to win their approval.

Reflect on the five qualities outlined by Rogers. How would addressing each of those areas improve the likelihood of success?

By Day 7 of Week 6

Write a 3- to 5-page paper which includes the following:

Using Rogers’ (2003) theory as a foundation, outline how you would approach the meeting with the nurses. Be specific as to the types of information or activities you could provide to address each area and include how you would respond to resistance.

Analyze the role of nurses as change agents in facilitating the adoption of new technology. NURS 6051 Discussion Papers – Transforming Nursing & Healthcare Through IT.

Week 8 Assignment: Creating a Flowchart

Workflow analysis aims to determine workflow patterns that maximize the effective use of resources and minimize activities that do not add value. There are a variety of tools that can be used to analyze the workflow of processes and clarify potential avenues for eliminating waste. Flowcharts are a basic and commonly used workflow analysis method that can help highlight areas in need of streamlining.

In this Assignment, you select a common event that occurs regularly in your organization and create a flowchart representing the workflow. You analyze the process you have diagrammed and propose changes for improvement.

To prepare:

Identify a common, simple event that frequently occurs in your organization that you would like to evaluate.

Consider how you would design a flowchart to represent the current workflow.

Consider what metrics you would use to determine the effectiveness of the current workflow and identify areas of waste.

To complete:

Write a 3- to 5-page paper which includes the following:

Create a simple flowchart of the activity you selected. (Review the Sample Workflow of Answering a Telephone in an Office document found in this week’s Learning Resources for an example.).

Next, in your paper:

Explain the process you have diagrammed.

For each step or decision point in the process, identify the following:

Who does this step? (It can be several people.)

What technology is used?

What policies and rules are involved in determining how, when, why, or where the step is executed?

What information is needed for the execution of this step?

Describe the metric that is currently used to measure the soundness of the workflow. Is it effective?

Describe any areas where improvements could occur and propose changes that could bring about these improvements in the workflow.

Summarize why it is important to be aware of the flow of an activity.

Remember to include a cover page, introduction, and summary for your paper. NURS 6051 Discussion Papers – Transforming Nursing & Healthcare Through IT

Week 11 Assignment: Health Information Patient Handout

One of the pivotal goals of consumer health literacy efforts is to design educational materials that attract as well as educate users. In this Assignment, you design a health information document on a topic that is of interest to you.

To prepare:

Select a health issue of interest to you.

Identify the audience or population that you seek to educate about this issue.

Search the Internet to find credible sites containing information about your selected topic.

Review the two health literacy websites listed in this week’s Learning Resources. Focus on strategies for presenting information.

To complete:

Design an educational handout on the health issue you selected.

Include a cover page.

Include an introduction that provides:

An explanation of your issue and why you selected it

A description of the audience you are addressing

In the handout itself:

Develop your handout in such a way that it attracts the attention of the intended audience.

Include a description of the health issue and additional content that will enhance your message (i.e., key terms and definitions, graphics, illustrations, etc.).

Recommend four or five sites that provide clear, valuable, and reliable information on the topic.

Note: Remember to keep the information in your health handout and its design at the appropriate level for the audience you are seeking to inform. Submit your Assignment as a Word document.

By Day 5

Submit the Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK11Assgn+last name+first initial.(extension)” as the name.

Click the Week 11 Assignment Rubric to review the Grading Criteria for the Assignment.

Click the Week 11 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK11Assgn+last name+first initial.(extension)” and click Open.

If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.

Click on the Submit button to complete your submission. NURS 6051 Discussion Papers – Transforming Nursing & Healthcare Through IT.

Week 6 Discussion: Successful Implementation of Electronic Health Information Technology