The Effects of Health Information Technology Change Over Time: A Study of Tele-ICU Functions

SummaryObjective: Longitudinal studies exploring the evolution of health information technology functions provide valuable information about how technology systems are integrated and exploited in situ. This study reports changes in the distribution of functions for a specific health information technology, the tele-ICU, over time. The studied tele-ICU provided care to six remote ICUs within a local geographic region in the same state and had nursing staff around the clock.Methods: The intervention logs of tele-ICU nurses were collected during two discrete times and coded into nine emergent functional categories, who initiated the intervention and, if required, subsequent escalation. All coded functional categories were investigated for significant changes over time in the nursing logged interventions.Results: A total of 1927 interventions were coded into the nine emergent functional categories. Seven of the nine categories (78%) were significantly different between 2005 and 2007. The functions of the tele-ICU system continue to change and develop over time.Conclusion: These findings suggest that the tele-ICU increased support when ICU nurses were off the unit, inter-hospital coordinating and adherence to best practices, while simultaneously decreasing real-time support for ICU nurses. This research suggests that sustaining safety features in a new technology over time have post-conditions after implementation.

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Nurses� Experience With Health Information Technology: Longitudinal Qualitative Study (Preprint)

10.2196/preprints.8734 ◽

2017 ◽

Author(s):

Inga M Zadvinskis ◽

Jessica Garvey Smith ◽

Po-Yin Yen

Keyword(s):

Information Technology ◽

Qualitative Study ◽

Health Information Technology ◽

Health Information ◽

Organizational Level ◽

Future Research ◽

Bar Code ◽

Time Points ◽

Nurses Perceptions ◽

Over Time

BACKGROUND Nurses are the largest group of health information technology (HIT) users. As such, nurses’ adaptations are critical for HIT implementation success. However, longitudinal approaches to understanding nurses’ perceptions of HIT remain underexplored. Previous studies of nurses’ perceptions demonstrate that the progress and timing for acceptance of and adaptation to HIT varies. OBJECTIVE This study aimed to explore nurses’ experience regarding implementation of HIT over time. METHODS A phenomenological approach was used for this longitudinal qualitative study to explore nurses’ perceptions of HIT implementation over time, focusing on three time points (rounds) at 3, 9, and 18 months after implementation of electronic health records and bar code medication administration. The purposive sample was comprised of clinical nurses who worked on a medical-surgical unit in an academic center. RESULTS Major findings were categorized into 7 main themes with 54 subthemes. Nurses reported personal-level and organizational-level factors that facilitated HIT adaptation. We also generated network graphs to illustrate the occurrence of themes. Thematic interconnectivity differed due to nurses’ concerns and satisfaction at different time points. Equipment and workflow were the most frequent themes across all three rounds. Nurses were the most dissatisfied approximately 9 months after HIT implementation. Eighteen months after HIT implementation, nurses’ perceptions appeared more balanced. CONCLUSIONS It is recommended that organizations invest in equipment (ie, wireless barcode scanners), refine policies to reflect nursing practice, and improve systems to focus on patient safety. Future research is necessary to confirm patterns of nurses’ adaptation to HIT in other samples.

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