Use of Health Information Technology in Patient Care Management: a Mixed Method Study in Iran
Introduction: New computerized system, including health information technologies (HITs), plays an important role in the efficacy of management and nursing care services. Objective: This study was aimed to determine the use of HIT in patient care management, in a case study in Iran. Methods: This mixed method study was conducted in 2018 at the Kowsar Hospital of Semnan, Iran. Data collection was performed, using an observational checklist, and a questionnaire, including two main parts, one demographic and other assessment of information technology (IT) application in the care management of inpatients. The researcher prepared the questionnaire and its validity was verified. The data were organized and analyzed in the form of a descriptive analytic report. In the process of data collection 10 participants, including nurses, head nurses, physicians, radiology experts and IT managers were interviewed, and data analysis was performed, using conventional content analysis. Results: Nurses were satisfied with the computerized system and believed it can expedite the job. From the nurse’s viewpoint, the most common use of the HIT was to have access (observation) to patient admission and discharge information (100%), providing medicine and equipment, and transfer of patients (92.3%). The least use of IT was the retrieval of evidence in the care process (0%), and judgment and analysis related to radiological diagnostic procedures (0%). The potential of electronic record is still not applicable. Conclusion: Use of modern information and communication technology in hospitals facilitates access and transfer of information, and also accelerates patient’s admission and discharge process, relation between hospital units, simplifying the administration of current affairs and providing the necessary medical supplies and diagnostic procedures. However, modifying organizational policies improves the infrastructure, and enhances nurses' motivation in documentation of nursing reports, which can be effective in increasing the impact of IT in care management processes, especially in electronic record and nurse’s clinical judgment and evidence-based care.
2. Scholes M, Tallberg M, Pluyter-Wenting E. International Nursing Informatics: a history of the first forty years: 1960-2000. Br Comput Soc. 2000;9(1):191-2.
3. Kulikowski CA, Shortliffe EH, Currie LM, Elkin PL, Hunter LE, Johnson TR, et al. AMIA Board white paper: definition of biomedical informatics and specification of core competencies for graduate education in the discipline. J Am Med Inform Assoc. 2012;19(6):931-8.
4. Watcharasriroj B, Tang JC. The effects of size and information technology on hospital efficiency. J High Tech Manag Res. 2004;15(1):1-16.
5. Ball MJ, JA EM. Introduction to nursing informatics: Springer; 2006.
6. Saba V, Hovenga E, Coenen A, McCormick K, Bakken S. Nursing language–terminology models for nurses. ISO Bull. 2003;34:16-8.
7. Travis L, Brennan PF. Information science for the future: an innovative nursing informatics curriculum. J Nurs Educ. 1998;37(4):162-8.
8. Garde S, Harrison D, Hovenga E. Skill needs for nurses in their role as health informatics professionals: a survey in the context of global health informatics education. Int J Med Inform. 2005;74(11-12):899-907.
9. Honey M, Procter P. The shifting sands of nursing informatics education: from content to connectivity. Stud Health Technol Inform. 2017;232:31-40.
10. Chaudhry B, Wang J, Wu S, Maglione M, Mojica W, Roth E, et al. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann Intern Med. 2006;144(10):742-52.
11. Kaushal R, Shojania KG, Bates DW. Effects of computerized physician order entry and clinical decision support systems on medication safety: a systematic review. Arch Intern Med. 2003;163(12):1409-16.
12. Waneka R, Spetz J. Hospital information technology systems' impact on nurses and nursing care. J Nurs Adm. 2010;40(12):509-14.
13. Mennemeyer ST, Menachemi N, Rahurkar S, Ford EW. Impact of the HITECH act on physicians’ adoption of electronic health records. J Am Med Inform Assoc. 2016;23(2):375-9.
14. Persell SD, Kaiser D, Dolan NC, Andrews B, Levi S, Khandekar J, et al. Changes in performance after implementation of a multifaceted electronic-health-record-based quality improvement system. Med Care. 2011;49(2):117-25.
15. Sood HS, McNeil K. How is health information technology changing the way we deliver NHS hospital care? Future Healthc J. 2017;4(2):117-20.
16. Gephart S, Carrington JM, Finley B. A systematic review of nurses' experiences with unintended consequences when using the electronic health record. Nurs Adm Q. 2015;39(4):345-56.
17. Buntin MB, Burke MF, Hoaglin MC, Blumenthal D. The benefits of health information technology: a review of the recent literature shows predominantly positive results. Health Aff. 2011;30(3):464-71.
18. Kruse CS, Kristof C, Jones B, Mitchell E, Martinez A. Barriers to electronic health record adoption: a systematic literature review. J Med Syst. 2016;40(12):252.
19. Police RL, Foster T, Wong KS. Adoption and use of health information technology in physician practice organisations: systematic review. Inform Prim Care. 2010;18(4):245-58.
20. Kaplan B. Culture counts: how institutional values affect computer use. MD Comput. 2000;17(1):23-6.
21. Sadeghei R, Yaghmayi F. Informatics applying in nursing education, research and care. Educ Strategy Med Sci. 2012;5(3):199-206.
22. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105-12.
23. Piscotty RJ, Kalisch B, Gracey‐Thomas A. Impact of healthcare information technology on nursing practice. J Nurs Scholarsh. 2015;47(4):287-93.
24. Imani E, Khademi Z, Yusefi P, Bahrami Z, Naghizadeh F. Experiences of nursing managers about hospital information system: a qualitative study. Med J Hormozgan Uni. 2012;16(3):223-32.
25. Cohen JF, Coleman E, Kangethe MJ. An importance-performance analysis of hospital information system attributes: A nurses' perspective. Int J Med Inform. 2016;86:82-90.
26. Pittman P, Salmon ME. Advancing nursing enterprises: A cross-country comparison. Nurs Outlook. 2016;64(1):24-32.
27. Forkner-Dunn J. Internet-based patient self-care: the next generation of health care delivery. J Med Internet Res. 2003;5(2):e8.
28. Gjevjon ER, Hellesø R. The quality of home care nurses’ documentation in new electronic patient records. J Clin Nurs. 2010 Jan;19(1-2):100-8.
29. Ang S, Ayoob S, Hussain N, Uthaman T, Adenan H, Chiang P, et al. Challenges faced by older nurses in Singapore: a mixed methods study. Int Nurs Rev. 2017;64(4):502-10.
30. Moody LE, Slocumb E, Berg B, Jackson D. Electronic health records documentation in nursing: nurses' perceptions, attitudes, and preferences. Comput Inform Nurs. 2004;22(6):337-44.
31. Sadoughi F, Kimiafar K, Ahmadi M, Shakeri MT. Determining of factors influencing the success and failure of hospital information system and their evaluation methods: a systematic review. Iran Red Crescent Med J. 2013;15(12):e11716.
32. Poon EG, Jha AK, Christino M, Honour MM, Fernandopulle R, Middleton B, et al. Assessing the level of healthcare information technology adoption in the United States: a snapshot. BMC Med Inform Decis Mak. 2006;6(1):1.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.