course material

1. HIT Usability and Design Challenges
HIT Usability and Design Challenges Reflect on your experiences with the integration of
new technology. How have these implementations affected the procedures that you perform
at work? As the end user, it can be easy to overlook all of the important decisions that went
into the finished product that you see before you. In looking at the final data management
screens, you may find yourself at the crossroads of two options. You may either 1) be
ecstatic about the needed change that this system brought, or 2) frustrated because you feel
the system brings new hurdles into your already busy day. If you have ever experienced the
latter option, the comment “I could have implemented a better system than this” may
resonate strongly with you. Though research agrees that user input assists HIT designers,
the development and implementation of new systems is not as straightforward as it may
appear. HIT development teams find themselves in constant phases of trial and error as
they strive to meet the needs of all users within the proposed development timeline. Failure
to achieve promised usability benefits can lead to increased costs and job complications.
Applying effective strategies to overcome usability challenges is essential. In this week’s
Discussion, you move from the standpoint of the “outsider looking in” (end user) and place
yourself into a real-world implementation example. To complete this Discussion, you
evaluate a case study to determine where the implementation process took a wrong turn.
Use this week’s Learning Resources to propose changes that could have put this operation
on the road to success. To prepare:Review the Learning Resources, focusing on the TIGER
Usability and Clinical Application Design Collaborative.Consider the “Best Practice
Exemplars” provided in the course text Nursing Informatics: Where Technology and
Caring Meet.Review “Case Study 1: A Usability and Clinical Application Design
Challenge” presented on page 238 of the course text Nursing Informatics: Where
Technology and Caring Meet. (see bottom of this page for the case
study)Determine the causes of the noted usability challenges (i.e., human
factors, ergonomics, human-computer interaction), as well as potential
usability concerns experienced by staff during implementation. Consider the
possible design failures that lead to the usability challenges. What strategies might you
employ to overcome these HIT usability challenges and concerns?By tomorrow Tuesday
10/03/17, 5 pm, write a minimum of 550 words essay in APA format with a minimum of 3
references from the list of Required Readings below. Include all level one headings as
numbered below: post a cohesive response to the following:Place yourself in the
role of the clinical administrator tasked with implementing the case study’s new health

2. information technology system.1) Evaluate the usability challenges that you faced during
implementation as well as the factors that caused these challenges.2) Determine whether
these challenges were a result of implementation or design.3) Formulate strategies for
overcoming these usability challenges.Required ReadingsCourse Text: Ball, M. J., Douglas, J.
V., Hinton Walker, P., DuLong, D., Gugerty, B., Hannah, K. J., . . . Troseth, M. R. (Eds.) (2011).
Nursing informatics: Where technology and caring meet (4th ed.). London, England:
Springer-Verlag.Chapter 14, “Usability and Clinical Application Design”This chapter
begins by defining the terms usability and application design as they are used in the field of
nursing informatics. The authors then describe the literature review and analytic process
that the TIGER Collaborative group underwent to positively transform the development of
HIT systems.Gruber, D., Cummings, G. G., LeBlanc, L., & Smith, D. L. (2009). Factors
influencing outcomes of clinical information systems implementation: A systematic review.
CIN: Computers, Informatics, Nursing, 27(3), 151–163. The authors analyze the outcomes of
prior IT implementations to determine if certain strategies can guarantee success when
launching new clinical information systems.Kaufman, D., Roberts, W. D., Merrill, J., Lai, T., &
Bakken, S. (2006). Applying an evaluation framework for health information system design,
development, and implementation. Nursing Research, 55(2, Suppl. 1), S37–S42.This article
emphasizes the indispensable role of continuous evaluation throughout the development
and real-time application of new information systems into the workplace.Schlotzer, A., &
Madsen, M. (2010). Health information systems: Requirements and characteristics. Studies
in Health Technology and Informatics, 151, 156–166.Use this article to examine the
importance of focusing on sound design, interoperability of systems, and fulfillment of user
needs when developing an effective database.Case Study 1: A Usability and Clinical
Application Design Challenge A medical center implemented an EMR with orders, clinical
documentation, and results retrieval to improve efficiencies and enhance patient safety in
the perinatal units of a small medical center, including Labor and Delivery (L& D), NICU, and
Newborn Nursery Selection process The system was installed elsewhere in this integrated
delivery network The executives wanted a fast 6-month installation at the maximum
Usability challenges Existing order sets and documents from other sites were not uploaded
and tailored to this site. Clinicians were asked to input individual orders (not acceptable).
Needed computer terminals were ordered late and arrived the day of go-live. Clinicians
competed for working terminals at the nurses’ stations Workflow among units was not
considered or tested. Shared information such as mother’s blood type and L& D information
was not available to NICU or Newborn Nursery, causing confusion about potential patient
safety issues Generic training was given because the site tailoring was not done. On go-live,
users did not know where to locate information before it had changed in the lag between
training and go-live Outcomes The clinicians had to endure an unnecessarily painful
implementation and its potential patient safety impacts Working out usability issues took
months after go-liveThe system was tested/ validated for usability, design, and practice
needs Education included practice changes along with how to use the system Developed a
methodology to respond rapidly to end users Outcomes Standardized practice in three
different acute care hospitals in 15 months Significant improvement in core measures and
nurse-sensitive outcomes.