COMMENT: Why staff and patient involvement is vital to successful EPR deployment

Dr Sean Kelly, chief medical officer at Imprivata is a believer in the idea that UK organisations need clinical IT practitioners to make IT implementations economical and efficient

Dr Sean Kelly believes that Rhode Island Hospital’s Sue Whetstone is a great example of director of inpatient surgical services and nursing informatics, and in this comment article, Sue speaks about her role and what the UK can learn from the advancements in IT over the Atlantic. Here, she offers her view on the process and why staff and patient involvement is so vital to success.

Dedicated informatics professionals within hospital departments have become more and more important to help bridge the gap between IT projects and the work that we do as clinicians.

Since joining the nursing division at Rhode Island Hospital 24 years ago, my role has adapted to focus more on information systems and how they support nursing staff.

I work closely with Dr Alper and our IT department to ensure that workflow requirements of nurses here are considered during the deployment and maintenance of any IT systems. This interaction has been extremely important in allowing us to position IT as an enabler of quality care.

It is especially important for clinical IT staff to connect the dots between user requirements and the IT/business needs

Nursing staff face unique IT challenges just as physicians and administrators have their own specific requirements. What’s more, these challenges can vary depending on which department a nurse is working in. This complex web of demands, differences in workflow and terminology used across the hospital environment mean that it’s especially important for clinical IT staff like myself and Dr Alper to connect the dots between user requirements and the IT/business needs.

In the past, nursing staff have primarily documented patient care information on paper notes, but the introduction of electronic health records (EHR) has meant this data is now managed electronically, which allows for more efficient sharing of information between healthcare providers. As nursing staff have a responsibility to document patient notes in EHR systems, I’ve made it a priority to ensure that nursing teams across various departments here have been consulted when deciding which medical terms are to be standardised throughout our EHR system.

Recently, we have started to expand our EHR rollout to increase the level of data sharing between patients and doctors. To help support this process, the nursing informatics team has grown from just me to six dedicated staff. A key priority for this new team is to work with our clinical IT partners to increase the collaboration between various departments by continually feeding back concerns or requests from our user groups.

Nurses now feel more confident in the standard of treatment they are able to provide and acknowledge the role of IT systems in supporting that change

To give an example of how this works in practice, before embarking on a new IT project, we now carry out deep dive sessions that provide us with input from these different user groups including both nurses and physicians. These discussions have proven very successful. We had close to 500 participants at our recent EPIC deep dive. To add to the knowledge we gather from these sessions, I also regularly liaise with the Nursing Informatics Council as these members have first-hand knowledge of the specific issues facing nurses, which is valuable when identifying best practices for the deployment of new systems. Based on all this, I then make recommendations which help to shape our IT project plans.

Although I am no longer a practicing nurse, I spend time each week speaking with frontline nursing staff to learn about the nursing and patient experience. From these discussions I know that our EHR system has already proven vital to improving the delivery of care. Nurses now feel more confident in the standard of treatment they are able to provide and acknowledge the role of IT systems in supporting that change.

As we increase the amount of patient information shared throughout the organisation and with patients, continuing to work with nursing staff and other clinical IT teams will be critical. After all, the level of user engagement is a key indicator of the success with any IT project and that is particularly true for EHRs where the quality of the information contained within the system could be instrumental in changing the way we treat patients in future years. As more healthcare organisations move towards a paperless approach, I feel that a collaborative approach to IT deployments will become increasingly intrinsic to their success.

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