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The use of a nursing informatics system as an exemplar to investigate business value of IT in healthcare

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Abstract

Researchers and decision makers in healthcare are taking great interest in clinical practices where there is a high potential to improve healthcare outcomes and reduce costs by incorporating a myriad of technology solutions. However, to date very few, if any of these IS/IT (information systems/information technology) solutions have realised the expected improvements to quality care with the expected cost reductions. This makes the need to evaluate the impact of IT on overall performance of clinical practices i.e. business value of IT a key strategic imperative in healthcare. To address this key need, we propose a comprehensive framework that conceptualises business value of IT in healthcare in different layers. To illustrate the proposed framework, a case study is used, which serves to examine the proposed conceptual model. The exemplar case study is an Australian-made nursing documentation system; an enterprise system that caters for multiple clinical users in acute healthcare contexts and hence provides appropriate richness to validate the proposed model.

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Notes

  1. These results are the summary of a research project to evaluate the fidelity and usability of the NIS system. The reference is available upon request.

References

  1. Berner ES. Implementation challenges for clinical and research information systems: recommendations from the 2007 Winter Symposium of the American College of Medical Informatics. J Am Med Inform Assoc. 2008;15(3):281–2. doi:10.1197/jamia.M2581.

    Article  Google Scholar 

  2. Kilbridge PM, Classen DC. The informatics opportunities at the intersection of patient safety and clinical informatics. J Am Med Inform Assoc. 2008;15(4):397. doi:10.1197/jamia.M2735.

    Article  Google Scholar 

  3. Eysenbach G. What is e-health? J Med Internet Res. 2001;3(2):E20. doi:10.2196/jmir.3.2.e20.

    Article  Google Scholar 

  4. Lawler EK, Hedge A, Pavlovic-Veselinovic S. Cognitive ergonomics, socio-technical systems, and the impact of healthcare information technologies. Int J Ind Ergon. 2011;41(4):336–44. doi:10.1016/j.ergon.2011.02.006.

    Article  Google Scholar 

  5. Wickramasinghe N, Schaffer J. Realizing value driven e-health solutions. Washington DC: IBM Center for the Business of Government; 2010.

    Google Scholar 

  6. De Veer AJE, Francke AL. Attitudes of nursing staff towards electronic patient records: a questionnaire survey. Int J Nurs Stud. 2010;47(7):846–54. doi:10.1016/j.ijnurstu.2009.11.016.

    Article  Google Scholar 

  7. von Krogh G, Naden D, Aasland OG. Testing a Nursing-Specific Model of Electronic Patient Record documentation with regard to information completeness, comprehensiveness and consistency. J Clin Nurs. 2012;21(19–20):2930–9. doi:10.1111/j.1365-2702.2012.04185.x.

    Article  Google Scholar 

  8. Weill P. The relationship between investment in information technology and firm performance: a study of the valve manufacturing sector. Inf Syst Res. 1992;3(4):307–33.

    Article  Google Scholar 

  9. Silvius AG. The Business Value of IT: A Conceptual Model for Understanding. Enterprise IT Governance, Business Value and Performance Measurement; 2010: p. 102.

  10. Masli A, Richardson VJ, Sanchez JM, Smith RE. The business value of IT: a synthesis and framework of archival research. J Inf Syst. 2011;25(2):81–116. doi:10.2308/isys-10117.

    Google Scholar 

  11. von Lubitz D, Patricelli F. Network-centric healthcare operations: data warehousing and the associated telecommunications platforms. Int J Ser Stand. 2007;3(1):97–119. doi:10.1504/IJSS.2007.011830.

    Google Scholar 

  12. Weill P, Broadbent M. Leveraging the new infrastructure : how market leaders capitalize on information technology. Boston: Harvard Business School Press; 1998.

    Google Scholar 

  13. Rouse WB, Cortese DA. Engineering the system of healthcare delivery. Amsterdam: IOS Press; 2010.

    Google Scholar 

  14. Gagnon MP, Godin G, Gagne C, Fortin JP, Lamothe L, Reinharz D, et al. An adaptation of the theory of interpersonal behaviour to the study of telemedicine adoption by physicians. Int J Med Inform. 2003;71(2–3):103–15. doi:10.1016/S1386-5056(03)00094-7.

    Article  Google Scholar 

  15. Ryan L. System overhaul. Society of Hospital Medicine. 2009. http://www.the-hospitalist.org/details/article/184492/System_Overhaul.html. Accessed 1 Sept 2014.

  16. Silvia Piai JD. Western Europe, Healthcare Sector, IT spending forecast update, 2007–20112008.

  17. Melville N, Kraemer K, Gurbaxani V. Review: information technology and organizational performance: an integrative model of IT business value. MIS Q. 2004;28(2):283–322.

    Google Scholar 

  18. Kohli R, Grover V. Business value of IT: an essay on expanding research directions to keep up with the times. J Assoc Inf Syst. 2008;9(1):23–39.

    Google Scholar 

  19. Dalrymple PW. Data, information, knowledge: the emerging field of health informatics. Bull Am Soc Inf Sci Technol. 2011;37(5):41.

    Article  Google Scholar 

  20. Burke DE, Menachemi N. Opening the black box: measuring hospital information technology capability. Health Care Manag Rev. 2004;29(3):207–17.

    Article  Google Scholar 

  21. Das S, Yaylacicegi U, Menon NM. The effect of information technology investments in healthcare: a longitudinal study of its lag, duration, and economic value. IEEE Trans Eng Manag. 2010;58(1):124–40. doi:10.1109/TEM.2010.2048906.

    Article  Google Scholar 

  22. Wolper LF. Health care administration: managing organized delivery systems. 5th ed. Sudbury: Jones and Bartlett Publishers; 2011.

    Google Scholar 

  23. Picker Institute, Eye on patients: a report by the Picker Institute for the American Hospital Association. Picker Institute: Boston, Mass; 2000.

  24. Medicine Io. Building a better delivery system: a new engineering/health care partnership: Institute of Medicine; 2005.

  25. Levinson DR. Adverse events in hospitals: national incidence among Medicare beneficiaries. Department of Health and Human Services Office of the Inspector General; 2010.

  26. James JT. A new, evidence-based estimate of patient harms associated with hospital care. J Patient Saf. 2013;9(3):122–128.

  27. Institute of Medicine (US). Committee on Quality of Health Care in America, Crossing the quality chasm: a new health system for the 21st century. 2001: National Academy Press.

  28. Porter ME, Teisberg EO. Redefining health care: creating value-based competition on results. Boston: Harvard Business School Press; 2006.

    Google Scholar 

  29. Bjorvell C, Wredling R, Thorell-Ekstrand I. Improving documentation using a nursing model. J Adv Nurs. 2003;43(4):402–10.

    Article  Google Scholar 

  30. US Department of Health and Human Services, Electronic health records and meaningful use. Retrieved September, 2014. 8: p. 2010.

  31. HIMMS Analytics Database [database on the Internet] 2009. Available from: http://www.himssanalytics.org/hcproider/emradoption.asp. Accessed 5 Mar 2012.

  32. Kelley TF, Brandon DH, Docherty SL. Electronic nursing documentation as a strategy to improve quality of patient care. J Nurs Scholarsh. 2011;43(2):154–62. doi:10.1111/j.1547-5069.2011.01397.x.

    Article  Google Scholar 

  33. Ball MJ. Nursing informatics: where caring and technology meet. 3rd ed. New York: Springer; 2000. [with] forewords by Sue Karen Donaldson and Ulla Gerdin. ed.

    Book  Google Scholar 

  34. Munyisia EN, Yu P, Hailey D. The impact of an electronic nursing documentation system on efficiency of documentation by caregivers in a residential aged care facility. J Clin Nurs. 2012;21(19–20):2940–8. doi:10.1111/j.1365-2702.2012.04157.x.

    Article  Google Scholar 

  35. Moody LE, Slocumb E, Berg B, Jackson D. Electronic health records documentation in nursing—nurses’ perceptions, attitudes, and preferences. CIN Comput Inform Nurs. 2004;22(6):337–44.

    Article  Google Scholar 

  36. Lee TT, Yeh CH, Ho LH. Application of a computerized nursing care plan system in one hospital: experiences of ICU nurses in Taiwan. J Adv Nurs. 2002;39(1):61–7.

    Article  Google Scholar 

  37. Bosman RJ, Rood E, Oudemans-van Straaten HM, Van der Spoel JI, Wester JPJ, Zandstra DF. Intensive care information system reduces documentation time of the nurses after cardiothoracic surgery. Intensive Care Med. 2003;29(1):83–90. doi:10.1007/s00134-002-1542-9.

    Google Scholar 

  38. Wong DH, Gallegos Y, Weinger MB, Clack S, Slagle J, Anderson CT. Changes in intensive care unit nurse task activity after installation of a third-generation intensive care unit information system. Crit Care Med. 2003;31(10):2488–94. doi:10.1097/01.ccm.0000089637.53301.ef.

    Article  Google Scholar 

  39. Hakes B, Whittington J. Assessing the impact of an electronic medical record on nurse documentation time. CIN Comput Inform Nurs. 2008;26(4):234–41.

    Article  Google Scholar 

  40. Menke JA, Broner CW, Campbell DY, McKissick MY, Edwards-Beckett JA. Computerized clinical documentation system in the pediatric intensive care unit. BMC Med Inform Decis Mak. 2001;1:3. doi:10.1186/1472-6947-1-3.

    Article  Google Scholar 

  41. Saarinen K, Aho M. Does the implementation of a clinical information system decrease the time intensive care nurses spend on documentation of care? Acta Anaesthesiol Scand. 2005;49(1):62–5. doi:10.1111/j.1399-6576.2005.00546.x.

    Article  Google Scholar 

  42. Yin RK. Case study research: design and methods. 5 ed. Los Angeles: SAGE Publications; 2014.

  43. Wickramasinghe N, Kent B, Moghimi F, Stien M, Nguyen L, Redley B, et al. Using technology solutions to streamline healthcare processes for nursing: the case of an Intelligent Operational Planning Support Tool (IOPST) solution. In: Wickramasinghe N, Al-Hakim L, Gonzalez C, Tan J, editors. Lean thinking for healthcare. Healthcare delivery in the information age. New York: Springer; 2014. p. 405–30.

    Chapter  Google Scholar 

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The authors declare that they have no conflict of interest.

Ethical Statement

• The manuscript has not been submitted to more than one journal for simultaneous consideration.

• The manuscript represents a continuous research project. Therefore, some parts of it may be found in our other publications (all cited). The findings though are new and have not been published previously.

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Correspondence to Peter Haddad.

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Haddad, P., Wickramasinghe, N. The use of a nursing informatics system as an exemplar to investigate business value of IT in healthcare. Health Technol. 5, 25–33 (2015). https://doi.org/10.1007/s12553-015-0100-8

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