Two-stage evaluation of the impact of a nursing information system in Taiwan

Lee, Ting-Ting; Mills, Mary Etta; Bausell, Barker; Lu, Ming-Hui

doi:10.1016/j.ijmedinf.2008.03.004

Cited by 56 publications

(48 citation statements)

References 31 publications

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“…In the hospital sector, several theoretically based models of HIS success (with success defined from the user's perspective) provide empirical support that specific elements can predict successful systems. 7,[28][29][30][31][32] In a recent study, 33 reviews the electronic health information system (EHIS) models, identifying 21 health and 5 nonhealth models.…”

Section: Conceptual Frameworkmentioning

confidence: 99%

Hospital Information System Satisfaction in Brazil: Background and Moderating Effects

Nunes¹,

Javier²

2014

International Journal of Research Foundation of Hospital and Healthcare Administration

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In the last years, hospitals in Brazil have made significant investments in adopting and implementing new hospital information system (HIS). Whether these investments will prove beneficial for these organizations depends on the support that will be provided to ensure the effective use of the information systems (IS) implemented and also on the satisfaction of its users.The purpose of this study is to propose a conceptual model, appropriate for the intention to use HIS, by adopting the system, service, and information qualities covered in the Information System Success Model proposed by DeLone and Mclean.In the present study, structural analysis applied to data from a sample of 393 HIS users showed the variables service quality, information quality, system quality and satisfaction to act as antecedents of HIS success. A novel finding of the study was the importance of the user's aptitude with respect to computer moderating the relationships of the model.Managerial implications are provided accordingly. Suggestions for introducing healthcare information system are then provided as well.

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Section: Conceptual Frameworkmentioning

confidence: 99%

Hospital Information System Satisfaction in Brazil: Background and Moderating Effects

Nunes¹,

Javier²

2014

International Journal of Research Foundation of Hospital and Healthcare Administration

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“…Adoption studies at typical inpatient settings indicate nurses were satisfied with EHR functionality (33)(34)(35)(36) and were dissatisfied with access to (33,37) and quality of (38,39) patient information in the EHR, and the EHR's impact on their efficiency (33). Our results show clinicians were dissatisfied with EHR functionality, and EHR impact on accessibility and quality of patient information and their efficiency, providing an alternative perspective.…”

Section: Ehr Implementation Considerations For Pace Decision Makersmentioning

confidence: 74%

Advice for Decision Makers Based on an Electronic Health Record Evaluation at a Program for All-inclusive Care for Elders Site

et al. 2011

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SummaryObjective: Provide evidence-based advise to "Program of All-inclusive Care for the Elderly" (PACE) decision makers considering implementing an electronic health record (EHR) system, drawing on the results of a mixed methods study to examine: (1) the diffusion of an EHR among clinicians documenting direct patient care in a PACE day care site, (2) the impact of the use of the EHR on the satisfaction levels of clinicians, and (3) the impact of the use of the EHR on patient functional outcomes. Methods: Embedded mixed methods design with a post-test design quantitative experiment and concurrent qualitative component. Quantitative methods included: (1) the EHR audit log used to determine the frequency and timing during the week of clinicians' usage of the system; (2) a 22-item clinician satisfaction survey; and (3) a 16-item patient functional outcome questionnaire related to locomotion, mobility, personal hygiene, dressing, feeding as well the use of adaptive devices. Qualitative methods included observations and open-ended, semi-structured follow-up interviews. Qualitative data was merged with the quantitative data by comparing the findings along themes. The setting was a PACE utilizing an EHR in Philadelphia: PACE manages the care of nursing-home eligible members to enable them to avoid nursing home admission and reside in their homes. Participants were 39 clinicians on the multi-disciplinary teams caring for the elders and 338 PACE members. Results: Clinicians did not use the system as intended, which may help to explain why the benefits related to clinical processes and patient outcomes as expected for an EHR were not reflected in the results. Clinicians were satisfied with the EHR, although there was a non-significant decline between 11 and 17 months post implementation of the EHR. There was no significant difference in patient functional outcome the two time periods. However, the sample size of 48 was too small to allow any conclusive statements to be made. Interpretation of findings underscores the importance of the interaction of workflow and EHR functionality and usability to impact clinician satisfaction, efficiency, and clinician use of the EHR. Conclusion: This research provides insights into EHR use in the care of the older people in community-based health care settings. This study assessed the adoption of an EHR outside the acute hospital setting and in the community setting to provide evidence-based recommendations to PACE decision makers considering implementing an EHR. There is a lack of evidence that shows the effect that patient outcomes improve when clinicians use an EHR in primary care, [7,8] specialty care, [9] or long-term care [10]. The yet to be documented promise of EHRs, combined with concerns with unintended consequences, underscores the continued need for evaluation studies.This situation is notable in the geriatric setting, where informatics evaluation studies are rare. The lack of informatics studies may be due to two possible trends: 1. university-based informaticians tend to ...

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“…Complex user-interface and navigation mechanism, slow response, poor content design (Darbyshire, 2004;Kossman, 2006;Lee et al, 2008;Stevenson et al, 2010;Vatnøy et al, 2014;Weinhara et al, 2009;Whittaker et al, 2009). Moderate ease of use (Weinhara et al, 2009;Whittaker et al, 2009).…”

Section: Themes Summary Of Findings Usability Ease Of Use / Efficiencymentioning

confidence: 99%

“…Low satisfactory / dissatisfaction (Darbyshire, 2004;Laerum et al, 2004;Mills et al, 2013;Stevenson et al, 2010;Tilahun & Fritz, 2015). Dynamics of nurses' experience: During the period of implementation, nurses' attitude and satisfaction increased overtime as they experienced more with the system (Ammenwerth et al, 2011;Carayon et al, 2011;Lee et al, 2008). Fidelity HIS functionality did not meet the nurses' needs nor support their workflows and practice (Novak et al, 2013;Stevenson et al, 2010); workflow interruptions, additional work (Eley et al, 2009;Lee et al, 2008), unintended consequences (Dowding et al, 2009;Koppel et al, 2005).…”

Section: Usefulness / Effectivenessmentioning

confidence: 99%

“…Dynamics of nurses' experience: During the period of implementation, nurses' attitude and satisfaction increased overtime as they experienced more with the system (Ammenwerth et al, 2011;Carayon et al, 2011;Lee et al, 2008). Fidelity HIS functionality did not meet the nurses' needs nor support their workflows and practice (Novak et al, 2013;Stevenson et al, 2010); workflow interruptions, additional work (Eley et al, 2009;Lee et al, 2008), unintended consequences (Dowding et al, 2009;Koppel et al, 2005). A particular HIS may fit one context but not others (Ackerman et al, 2012;Gough et al, 2014;Jeskey et al, 2011) Firstly, in regard to usability, Stevenson et al (2010) reviewed five empirical studies published from 2000 to 2009 and reported on nurses' experiences with HIS systems.…”

Section: Usefulness / Effectivenessmentioning

confidence: 99%

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An Examination of the Mediating Role for a Nursing Information System

Nguyen

Wickramasinghe

2017

AJIS

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This paper reports on findings from an examination of a nursing information system through the lens of Activity Theory. The information system was designed to support real-time nursing documentation in acute care hospital contexts. The objective was to enable superior nursing care to ensue by providing nurses with the opportunity to document patient care data into a tablet computer located at the patient bedside. The system was evaluated in a not-for-profit acute care hospital's wards during its implementation. Nurses' interactions with the system and their perceptions were collected and analysed through the lens of Activity Theory. The analysis highlighted nurses' positive attitude towards the system and identified potential mediation capabilities as well as areas for improvements. Activity Theory was found to be useful to examine the positive and potentially problematic aspects of this new nursing information system.

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Two-stage evaluation of the impact of a nursing information system in Taiwan

Cited by 56 publications

References 31 publications

Hospital Information System Satisfaction in Brazil: Background and Moderating Effects

Hospital Information System Satisfaction in Brazil: Background and Moderating Effects

Advice for Decision Makers Based on an Electronic Health Record Evaluation at a Program for All-inclusive Care for Elders Site

An Examination of the Mediating Role for a Nursing Information System

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