With the recent change in the role that I have experienced I felt that there was a need to write this blog post regarding the issues encountered by the nurses and other support staff while using informatics solutions to facilitate patient care.
The problem has been understood and highlighted by the health professionals perennially that ‘they’, who are using the electronic solutions must be involved in its development and be part of other important stages of implementation. I ponder that when these solutions are developed, tested or implemented how many health professionals are involved.
For example while entering some important patient parameters in the electronic system one might wonder about some very basic things that could have been done better. These little things can only go right when we involve the end user periodically, seek their feedback actively about what makes their life easier and what deters them from entering important information in the system. Let’s face it, if the end user is not comfortable there is a possibility he/she might not want to take all the effort and try to fit ‘in the system’.
So how do we rectify/ improve?
Keep up your training game
As a clinical practitioner I would be happy if I was explained every now and then what is new in the system and how I can use it to my advantage. It is often challenging to have one on one training but periodic updates will make clinical staff to be more oriented and help them to be more confident about the EHR/EMR use.
Direction for Clinical Documentation
It can be often confusing what electronic documentation needs to be done by whom and under what circumstances. It would be good if informaticists could get under the skin of clinical staff and understand what they think. Best possible solution for this could be more involvement of clinical staff. For example in an emergency department a new nurse might get confused about what all documentation she needs to do when she is triaging a patient. There can be MAR charts that she needs to fill, a triage form and then moving on to vitals sign chart or may be a care plan. What happens if she forget any one of them?
While designing a system you have done a good job, you have created the forms which are easy to fill but did you give a thought what could happen if someone ‘new’ forgets to fill information as they were to stressed as they were trying to learn everything. So a clear direction or listing would help. This step remains the same when you expect clinical staff to fill printed
copies. Or maybe take advantage of electronic system and have a step wise process created that automates the electronic documentation one needs to do and save both time and effort. For example emergency nurse begins the documentation by triaging and she is prompted to click on the next set of documentation she needs to be complete with some flexibility as she might have to come back later as she looks after the patient.
Interact with Front Line
It is best to seek support from the clinical nurses and other staff who are using the solution. Learning from the horse’s mouth would give you adequate feedback where you went wrong. In fact, it would serve as a two way process to learn things and clarify things in terms of system usability and utility.
Easy Feedback policy
It would be wonderful idea to be able to express the concerns in the system by the end users without identifying the person as such. It might add to the load of the informaticist but some genuine feedback might come your way to make your life easy as well for the users.
System designers/ Informaticist can try to provide flexibility in data entry for the health professionals to explain things that might go wrong during electronic health/medical system use for example if care was not provided to the patient what is the possible explanation to it or if an intervention was missed what went wrong. As informaticist, there is a responsibility that remains with you that you provide continuous support, understand the needs of end users by visiting the site where the solution will be used and explain the need to change your course of action whenever it happens. A simple example is, if you decide to revoke a system feature without
explaining there is chance of misinterpretation by the clinical staff who might be using it and were quite happy about it.
With this short blog the only thing that I want to emphasize is that firstly you cannot replace a healthcare informaticist/nurse informaticist by a non- clinical informaticist. And finally, if you claim to be a good informaticist professional, you are someone who is in constant touch with your target audience. So, chin up, healthcare informaticist are here to stay to ensure
the life is easier for the fellow health professionals.