Health Information Technology (Hit) Under the Terms

¶ … Health Information Technology (HIT)

Under the terms of the current financial and regulatory environment, it is highly incumbent upon healthcare institutions to operate utilizing the most current and compliant Health Information Technology (HIT). But implementation and maintenance are not sufficient alone to ensure that an adopted strategy is achieving its desired or optimal outcomes, particularly not in an era of such fast-moving change for the healthcare industry. This is why, beyond implementation and maintenance, proper evaluation of implemented systems is an absolute necessity. The dimensions of this evaluation are discussed here below.

Strategies for Evaluation:

Conducting an evaluation of a recently implemented or long-ingrained HIT system can be a distinct challenge. This is because there are many factors to consider when rendering a meaningful assessment. Most comprehensive HIT systems will be designed to integrate a wide range of functionalities relating to one's Electronic Health Record, the ability to engage in a state or federal Health Information Exchange, the privacy and security capabilities of the system and the accessibility provided to end-users such as healthcare providers and patients. This is why most the research available on the subject urges the use of multiple systems of measurement when conducting evaluation. According to the text by Nahm et al. (2007), the best strategy is to combine a number of evaluative measurements in order to deliver a definable performance index. To this end, Nahm et al. The outcomes in their study "have been assessed employing various methods, including randomized controlled trials, pre- and post-test studies, time and motion studies, surveys, and user testing." (p. 282)

This directly informs the strategy for evaluation that will be taken going forward with the present implementation. That is, we would intend to employ a combination of quantitative evaluation where pre and post testing would be used to determine positive or negative changes in system efficiency, accountability and completeness. This would be supplemented by field evaluation through oversight of equipment in usage and through consultation with end users. Qualitative survey methods would be used to incorporate feedback from those with the most intimate experience with the implemented technology. Factors such as accessibility, workflow compatibility and integrative seamlessness would be considered here.

Judging System Effectiveness:

In order to judge the effectiveness of the implemented HIT system, it is necessary to select appropriate outcomes for measurement. This requires a determination of the key functions of the Health Information Technology in question. Informed by both legislative and technological advances, the effectiveness of a chosen IT system is largely centered on its performance with certain deliverables. The article by Nahm et al. (2007) identifies these deliverables, indicating that "based on in-depth literature reviews and their empirical experiences, the authors identified 3 frequently used outcomes: user satisfaction, clinical outcomes, and financial impact." (p. 282)

These are the features both that hospitals and other healthcare facilities will seek out in implementation as well as those which are monitored by third-party, governmental and external agencies. The process of evaluation should center on consideration of these three deliverables and how they are achieved under the auspices of a new HIT implementation.

Main Evaluation Design Challenges:

Perhaps the most significant challenge faced by those assigned the task of evaluation is the construction of a framework for interpreting the impact of a system on its adopting facility. In other words, there is a need to establish clear, meaningful and flexible qualifications for evaluating the effects and outputs of a system. As the research by Rahimi & Vimarlund (2007) indicate, "there is no standard framework for evaluation effects and outputs of implementation and use of IT in the healthcare setting and that until today no studies explore the impact of IT on the healthcare system' productivity and effectiveness." (p. 397)