System Analysis of T Term Paper

Pages: 10 (3124 words)  ·  Bibliography Sources: 3  ·  Level: Master's  ·  Topic: Health - Nursing

SAMPLE EXCERPT:

[. . .] According to Ms. Small, the server for the T-SYSTEM is located in Massachusetts. The go-live date was set for one month in advance while preparations such as training nurses, doctors and all others was performed in two hour sessions arranged by the director of nursing for the emergency room and the medical director for doctors. At the end of the training session, a quiz would follow as a form of evaluation.

During the implementation phase, T-SYSTEM had technicians that came all the way from Texas to assist with any questions or technical problems. They were on site for at least three weeks. Their main purpose also was to maintain the system to ensure a solid performance. Both nurses and doctors were assigned the role of "super user" and were stationed throughout the different areas of the emergency room to provide their peers with needed support. As "super users," they were expected to be cheerleaders and display positive attitudes in order to assist in a smoother transition. They were considered very proactive and had an understanding of how to best address issues that were posed during the adjustment period. There were two doctors and two nurses for both day and night shift.

Growth, Challenges and Drawbacks

The hospital has expansion plans not only for other departments but also for the emergency department beginning in 2014 (G. Jackson, personal interview, November 26, 2012). With the influx of patients, the department seems smaller and smaller each day. There are two different types of COWS now: some have internet access and some do not, so there is always a minor dispute among nurses in the mornings as they try to get the computers with internet access. In terms of ergonomics (always a big issue for both nurses and doctors), the chairs are reported to be uncomfortable (some have a back rest while others do not); some nurses feel that the stools provided with wheels are not safe to be in the department; and doctors tend to commonly complain that their work space now feels cluttered.

The need for more informatics nurses has been raised from time to time. During an interview with some of the nurses, they stated that even though a survey was performed a month after implementation and the system has been updated many times, they feel as though it is still not as nurse-friendly as it should be. Gayle B., RN, stated it is not a good system, "but we were just happy to get something" (G. B., personal interview, December 2, 2012).

From the finance department, Gerald E. stated "the hospital has lost millions due to documentation in the system; this is because the charge capture for the physician is not the same for the nurses -- which has, of course, changed the way we now document. It's a big problem that was not sighted for quite some time, but was picked up last year." One example of this problem is that there is a charge for the vaginal exam performed by the physician but not for the plastic speculum handed by the nurse: "This is because a plastic speculum is not an item available for us in our documentation. In other words, what the doctors have for their billing is readily accessible for them but not for us nurses" (G. E., personal interview, November 19, 2012).

One possible solution to such a problem could be to have these and other items that are not charged encrypted into the Pyxis system.

A problem that has been posed this year by Cecile B., RN, is that when patients are admitted, the emergency physicians are no longer caring for these patients but will do so only if it is an emergency. In fact, it is the admitting team that is now responsible for this patient. However, due to the fact that they did not have access to T-SYSTEM, their orders were on paper and once again these orders needed to be transcribed prior to sending the patients to the floor. "This was a very time consuming because as the primary nurse you're dealing with new patients and admitted patients at the same time which could cause more error and more harm for patients" (C. B., personal interview, November 19, 2012).

The solution to this problem was implemented in May 2012 and is called Health Bridge. Health Bridge integrates the system that nurses on the other units use, which allows the admitting doctors and residents to now access the admitted patients' charts from anywhere in the hospital. These doctors are then able to place orders and print labels down into the emergency room and to have blood work performed on these admitted patients. According to Cheryl Fraser, MS, RN, the benefit to this integration is that it enhances patient continuity of care (C. Fraser, personal interview, November 19, 2012). However, the problem still exists for nurses in the emergency room because it is very difficult to manage new patients on one system, while trying to give care to the admitted patients on another system. This is also because one system shuts you out quicker than the other and running more than one system tends to slow down the computer. The go-live date for this system was set for two weeks and had raised speculations concerning administration's eagerness to start this system.

An ongoing problem that I've seen that exists and one that I keep inquiring about is that when you return to work the day after taking care of a patient and that particular patient, who may still be in the department is on your new list of patients, the system has no prompt to alert you to say, "This is patient MG; is this whom you want to document on?" According to Ms. Small, this is an ongoing problem that we are in the process of amending (V. Small, personal interview, November 26, 2012).

According to Gayle B., RN, doctors can go back and change their charging -- but nurses do not have access to do that. Resources for such access were available for one week, and of course there was a lot of chaos at the time. Some nurses also thought they needed more time to learn the system: "Because they felt they were rushed into learning, they did not find some of their resources to be very helpful" (G. B., personal interview, December 2, 2012).

Meaningful Use and EMR Implementation

For the attestation process, T-SYSTEM Meaningful Use is available to assist nurses in tracking attestation progress. This process is facilitated by the system's ability to locate and transfer patient information from the Emergency Department. Meaningful Use is meant to help departments interact with information previously isolate in one department. With this aspect of T-SYSTEM, patient data is theoretically more accessible to nurses so that they might comply more readily with guidelines.

Because information technology is constantly evolving, electronic medical records (EMR) and EMR implementation must stay abreast of current developments. Staying abreast of the latest developments is helpful in improving hospital efficiency. However, budgetary concerns as well as the practicality of project planning and development play a large part in allowing a hospital staff to keep abreast of all updates within their field of information technology. To this end, it is recommended that project teams work in conjunction with physician heads to make the required decisions concerning the implementation of EMR.

HITECH Act

The Health Information Technology for Economic and Clinical Health (HITECH) Acct, passed in 2009, was enacted in order to address the issues of meaningful use in the healthcare information technology realm. HITECH has several consequences, both economical and practical: for instance, "the nation's employers can expect a 9% jump in medical costs in 2011" as costs for EMR implementation are raised due to HITECH (Monegain, 2010). Hospitals are expected to receive bonuses and/or penalties depending upon their compliance with HITECH regulations. The implementation and usage of IT is now essentially become mandatory in the healthcare field.

HITECH may be seen as a positive piece of legislation for IT firms, but for the nursing and doctor staff at Suny, it appears to be shouldered as one more cross in the evolution of healthcare services. From cluttered works stations to difficult, electronically bureaucratized systems of documentation, Suny staff members feel the effects of HITECH in different ways. Regardless of their overall thoughts and feelings, however, T-SYSTEM is here to stay -- at least for the time being, which is to say for as long as the promise of better quality service is believed to come through information technology enhancements.

Conclusion

Increased spending on EMR implementation is required to meet state standards (HITECH), results in increased productivity, new technology, and is deemed necessary to maintain a competitive edge. EMRs may prove to be an essential tool for the future of healthcare, and they have certainly demonstrated improved patient outcomes and increased patient satisfaction (M. Jackson, personal interview, November 26, 2012). From the American Recovery and… [END OF PREVIEW]

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