Nursing Management January 2009 17 www.nursingmanagement.com Information technology Frustrated with HIT? Get involved! By Marge Benham-Hutchins, RN, PhD I t’s common knowledge that hospitalized patients receive care from multiple healthcare providers. Many different nurses, physicians, respiratory therapists, pharmacists, and other healthcare providers will care for a patient during any given 24-hour period. Healthcare providers may come to a patient’s room, the patient may be transferred to another depart- ment for surgery or diagnostic testing, trans- ferred to another unit to receive the appropriate level of care, or responsibility for care may be transferred between healthcare providers during shift changes. Communication between health- care providers and coordination of patient information in this disjointed environment has been identified as a crucial component in reducing medical error and providing quality care. 1,2 Quality care is dependent on the ability of healthcare providers to build on the care provided by others. Many hospitals have responded by imple- menting health information technology (HIT), such as computerized provider order entry and electronic health records, with the goal of improv- ing care coordination and reducing medical error. 3 Unfortunately, the influence of new HIT on existing healthcare provider workflow, in- cluding information exchange between health- care providers, has often been overlooked or downplayed during the design, selection, and implementation process. 3-5 Organizational deci- sion makers often fail to recognize that informa- tion technology won’t improve poor work flow or care processes. In fact, due to the turbulent and interruptive nature of the healthcare envi- ronment, HIT may actually magnify these issues by interfering with the established, nonlinear strategies used by healthcare providers to complete a task. 6-8 Due to problems integrating new HIT with existing electronic or paper documentation and record systems, nurses and other healthcare providers may find themselves faced with mul- tiple, sometimes conflicting, sources of patient information. 6 Patient information systems that are made up of multiple paper and electronic documentation sources not only influence work- flow and the quality and efficiency of multipro- fessional communication and collaboration, but also have the potential to lead to new types of medical error caused or influenced by HIT. 9 Understanding these issues requires examina- tion of human factors: How do we design tech- nology that will adapt to the way healthcare providers do their job, instead of the other way around? This process starts with an awareness of how nurses and other healthcare providers access the information necessary to provide quality care. It also requires recognizing that new HIT will influence established processes and not always in expected or desired ways. Change management is a critical component of success- ful HIT implementation. Participation by stake- holders, including the healthcare providers who will be using the new system, during the design, selection, implementation, and evalua- tion processes is the first step in working toward an HIT infrastructure that will enhance quality patient care. How to get involved Nurses, important members of the stakeholder group, understand the importance of timely How do we design technology that will adapt to the way healthcare providers do their job, instead of the other way around?