NURSING INFORMATICS LEADERSHIP
Evaluation of Computerized Management Systems
Kathryn Rawson
Western Governors University

Abstract
This paper will demonstrate: A. How using computerized management systems could increase quality of care B. Why active nursing involvement in the planning, choice and implementation of the systems is important C. How handheld devices used by the nursing staff could be integrated into the management system for better quality care D. Security standards of data and patient confidentiality, including the need for data storage integrity and data backup and recovery and the Health Insurance Portability and Accountability Act (HIPPA) requirements impact the use of the systems E. How the new system can affect healthcare cost F. The benefits these new systems can offer to patient care and nursing care delivery with a recommendation and justification of the system the hospital should put in place

In today’s modern healthcare environment it is important to provide a variety of technology based resources to nurses and other providers to ensure productivity and efficiency are maximized. This requires an effective understanding of available computerized management systems and what resources are available to ensure continued effective, efficient, quality care to patients. Keeping that perspective in mind while creating a technologically advanced environment in which to deliver that care is critical and of vital importance to maximize resources while providing a solid technology platform. The utilization of electronic medical records and nursing documentation systems to ease the burden of paper based records, as well as the space required to store those records in a desirable manner is critical for an organization to sustain its capacity to provide high quality health care. This discussion will explore these systems in greater detail, emphasizing key components playing a role in shaping patient outcomes for the forseeable future. The goal of implementing an electronic documentation system is to help nurses, physicians and allied health care members provide quality care that is not compromised. Nurses will most likely be the greatest users of the technology besides physicians and so must be allowed a voice in the decision of which system to put in place. Nurses are able to provide insight into which system will fit in the organization’s current structure along with which tools are required to ensure uncompromised patient care quality. Nurses might use bedside documentation to help prevent medication errors in some by integrating medication bar code scanning into the system. This and other safety measure that helps prevents errors and in turn produces quality outcomes. It is important for nurses to be active contributors in the decision process with regards to implementation of technology systems so as to establish positive outcomes within the areas of safety, quality care delivery and overall outcomes. Hand held devices could help to improve quality patient care. In a study by Greenfield (2007) “incidents of medical errors in health care settings can be decreased by using technologies. Providing real-time access to health care data directly at the bedside should decrease the incidence of medication error, allowing nurses to work with greater accuracy, less time and greater safety” (p.127) Hand held devices have the potential to improve care in other areas also. These areas should be explored and the potential use of handheld devices investigated with regard to integrating into the organization’s system. Privacy, security standards and patient confidentiality are critical to the success of health care practice. Patients must have the guarantee their electronic health record will remain private and secure, being used only by those that need to know. Health care organizations must choose a technology system that will support security and privacy of the health record. The Healthcare Portability and Accountability Act (HIPAA) of 1996 was established to help protect the patient healthcare record and to give patients and providers alike a guideline for how healthcare information may be used. It is critical to the healthcare organizations implementation of any technology platform to ensure patient data security. Sadly almost a decade after HIPAA was introduced, it was found “only 25% of hospitals across the USA were found to comply with the security regulations” (Smith et. al, 2010). If healthcare organizations do not comply and enforce strict security policy as outlined in HIPAA people who seek healthcare will chose to go elsewhere so they may have their health record protected. Because of this, healthcare organizations must choose wisely when implementing a computerized management system. Healthcare organizations may struggle with the cost of implementing a new technology based system. If there are compatibility issues, that will also increase the cost of the new system. Funding is available from Medicare and Medicaid Services through its deployment of meaningful use dollars but those dollars fall far short of what is actually needed. The costs associated with these new technologies may, in the short term, be a challenge for the organization but over time will most likely provide positive results. This is a critical component of developing new technologies and in maintaining these systems through upgrades and other related factors. Even though the costs are substantial the benefits are too great to ignore. Eventually once a system is integrated throughout the organization there should be a rise in productivity, thus a cost savings benefit will be recognized. While evaluating two separate technology systems it is important to recognize the value of each system and how they would integrate into existing practice. As an example a system developed by McKesson know as Horizon Care Alerts, is a “rules based clinical decision support system” that improves healthcare quality by continuously monitoring patient data against specific conditions. The system provides timely, role-based warnings helping clinicians “connect the dots” and ensure efficient responses to changing patient conditions (McKesson 2012). This system enables nurses to be more efficient in conducting their practice at a consistent level. But on the other hand McKesson also offers a system known as Practice Partner. This is an electronic medical record (EMR) and medical billing software solution that “empowers physicians to enhance the quality of care and increase bottom-line productivity” (McKesson 2012). A successful electronic health record system will allow nurses and physicians to provide cost effective high quality health care. It is important to make decisions regarding these systems that will have the greatest far-reaching impact, and that will protect patients from unnecessary risk and harm in these settings. It is important to make a system decision that is based upon successful results and viability on a long-term basis. The implementation of an EMR system is most important to create new opportunities for growth and feasible outcomes to improve the quality of care that is provided within an organization. It is necessary to select an electronic health records system above all others because it reflects a means of improving the overall direction of the organization, as well as expanding the type and quality of care provided to all patients. Efficiency and growth are maximized along with other factors that encourage positive and meaningful results for all patients. These alternatives provide healthcare organizations with emerging technologies to utilize into the future and capitalize on efficiency and productivity makers to ensure that patient care is not compromised. Having an effective nurse leader to represent the nurse perspective throughout all phases of adopting HIT allows for nursing-related concerns to be addressed regarding patient care, nursing workflow, and nurse job satisfaction, thus improving the effective use of HIT among nurses (Waneka, R., and Spetz, J. 2010). This enables nurses to perform their roles to the best of their ability under all circumstances.