By Suzi Birz, principal, HiQ Analytics
Earlier this year, GE Healthcare and Intermountain Health Care
(IHC), in Salt Lake City, Utah, announced a collaboration to create an
electronic patient record accessible to patients’ entire care team. This month,
Technology Report takes a look at the ambitious project, the roles nurses are
playing and the impact on nurses’ day-to-day activities as the project comes to
life. Playing a key role is Laura Heermann Langford, RN, Ph.D., clinical manager
of the project (GE IHC ECIS), who discussed these topics.
“The GE IHC ECIS (electronic clinical information system)
project is designed around clinical business drivers,” Heermann explained.
In February 2005, GE and IHC announced a $100 million, 10-year
collaboration to enhance the patient care process in hospitals and clinics and
accelerate the adoption of electronic health records among health systems in the
United States. According to both companies, the project will incorporate
computer software programs GE has created with IHC's standards of patient care,
as well as leverage IHC's clinical outcomes research and GE's clinical software
applications and market depth.
Clinicians will not be waiting 10 years to see new systems.
Heermann explained that IHC has developed systems before. This project will use
a similar strategy to allow the systems to be put to use as soon as they become
ready. The electronic medication administration record (eMAR) is the starting
Physicians, nurses and engineers from GE and IHC will work
side by side to create the new eMAR at a joint clinical research center. The
clinical information technology will incorporate handheld devices and bar-coding
technologies, and will leverage in-depth clinical patient information to
automatically validate and document prescribed medications.
The Role of Nurses
Heermann is overseeing the activities for the clinical
applications. With one of the driving goals being to promote and enhance best
practices, clinical representatives from all clinical specialties are gathering
requirements and documenting the current and optimal workflows that will best
support clinicians. There are many and varied opportunities for nurses to get
First, full-time clinical analysts own topic areas. They lead
both small and large group discovery efforts. They determine what the software
needs to do, including data elements, data presentation, data mapping, and
requirements. They work side by side with human-factors experts on screen design
and with developers on translating requirements.
Heermann outlined the topics that might be discussed at a data
gathering meeting on allergies:
- What has to be documented?
- How is allergy information used?
- Where and when is allergy information needed?
- Does allergy information have to be printed?
- How does allergy information help in decision making?
Bedside nurses are tapped as well. Nurses on the units are
being asked to go to the development center and spend time directly with the
developers. The discussions center on use cases—scenarios based on how the
system will work, how the screens will flow and what data will be presented.
Nurses are also being asked to contribute to the testing
process. For a clinical application to be tested, a script has to be created
that will document the sequence in which buttons are clicked and data are
entered along with the expected result or action. The successful execution of
these scripts helps ensure a working system before it hits the units.
Nurses that participate in the project will become ECIS
clinical experts. Their expertise will be drawn on as the system is implemented.
These nurses will be the “super users,” available on the units to provide
detailed, hands-on assistance.
There is also a role for nurse managers. When the workflow for
the new system is created, it may highlight a policy or standard that has to be
reviewed or created. Nurse managers are defining these business rules through
policies, standards and clinical practice guidelines. These resources will
support the workflow through the collection and use of the data.
Heermann summed up the impact to nursing, stating that the
system allows for “access to the right data at the right time in the right
The project’s aim is for clinicians to use the data to take
care of the patient. This happens when nurses can stop searching for data,
become fully informed and be alerted when the data is available for decision
Heermann encouraged nurses not to fear the new technology.
“Embrace change as a new tool that can make you a better
clinician,” she said. “Be involved and don’t ignore the coming changes. Know
that these kinds of projects are not about the computer, but about data and
knowledge and knowing how to manage the data to help you do your job.”
Intermountain Health Care
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