Telehealth System Nursing Informatics Project

Nursing Informatics Project: Telehealth System

Part 1

Introduction

In basic terms, nursing informatics, as the Healthcare Information and Management Systems Society – HIMSS (2021) indicates, could be conceptualized as a “specialty that integrates nursing science with multiple information and analytical sciences to identify, define, manage, and communicate data, information, knowledge and wisdom in nursing practice.” Houston (2017) indicates that nursing informatics is of great relevance in efforts to improve or further enhance care outcomes. The need to develop a small nursing informatics project for my organization is largely founded upon this assertion.

In my institution, the delivery of quality services is in some instances hampered by overstretched facility resources, as will be highlighted elsewhere in this discussion. As a consequence, the need was established to initiate and implement a Telehealth System. It is also important to note that the lessons learnt from the COVID-19 epidemic necessitated a project of this nature. This is more so the case given the need to limit the occurrence and frequency of physical interactions between healthcare providers and patients.

Discussion

Project Description in Brief

In the past, my institution has largely made use of in-person visits, in which case patients interact face-to-face with healthcare providers in the facility. The Telehealth System suggested in this case would complement the in-person visits by connecting patients and healthcare providers at the facility virtually. This is to say that the relevant digital technologies including, but not limited to, smartphones, computers, and apps will be deployed to ease communication and interactions between healthcare providers and patients – with patients in this case being attended to from the comfort of their homes or workplaces (i.e. with no need to travel to the facility for in-person engagements with doctors). In other words, this could be perceived as remote delivery of healthcare services. To a large extent, the Telehealth System will be beneficial in efforts to address overstretched facility resources as it will reduce the number of in-person visits at the facility.

SWOT Analysis

From the onset, it would be prudent to note that as Williamson, Laundon, Stephens and Migliore (1997) indicate, the SWOT analysis comes in handy in the evaluation of health information technologies. Indeed, in the words of the authors, the said analysis “is very useful when beginning an information systems or technology related project to get a big picture of positive and negative factors in an organization and generate ideas for improvement” (215). In the present undertaking, SWOT analysis will be instrumental in efforts to formulate the relevant details for the Scope as well as Charter. SWOT happens to be the condensed version of the terms Strengths, Weaknesses, Opportunities, and Threats (Williamson, Laundon, Stephens and Migliore, 1997). The SWOT items highlighted above will especially be instrumental in situational analysis as well as assessment.

a) Strengths

1. Enhanced care coordination, i.e. between practitioners and patients

2. Enhanced convenience for patients and the institution

3. Cost savings for both patients and the institution

b) Weaknesses

1. High acquisition and implementation cost. Acquiring the relevant software and hardware tools could be a rather costly affair. Staff training would also have to be undertaken in this case so as to ensure that members of staff are familiar with the relevant system protocols.

2. May not be appropriate or efficient in all scenarios, i.e. in relation to blood work as well as imaging tests

3. Prone to technical failures which could end up disrupting the delivery of healthcare services.

c) Opportunities

1. Could be utilized to promote care for persons across a broader spectrum of illnesses, i.e. persons with mobility problems.

2. Could be deployed in the further promotion as well as enhancement of other institutional services and procedures, i.e. in relation to response to emergencies

3. Could be deployed in an attempt to achieve better protection against, and control of, pandemics such as the current COVID-19 pandemic.

d) Threats

1. Loss of personal touch could result in inaccurate assumptions and a suboptimal plan of care.

2. Risk of resistance to change among healthcare workers within the institution

3. Risk of private patient data/information exposure as the said data or information is being transmitted over a network. This could result in filing of lawsuits against the institution.

Strengths

1. Enhanced care coordination

2. Enhanced convenience

3. Cost savings

Weaknesses

1. High acquisition and implementation cost

2. Not appropriate/efficient in all scenarios

3. Prone to technical failures

Opportunities

1. Care for persons across a broader spectrum

2. Complement other institutional services and procedures

3. Achieve better control/protection against pandemics

Threats

1. Inaccurate assumptions and a suboptimal plan of care

2. Resistance to change

3. Private patient data/information exposure

SWOT Tabular Representation

GAP Analysis

NURSING INFORMATICS PROJECT

A gap analysis is of great relevance in efforts to compare the target state with the prevailing state so as to establish what ought to be worked on for better outcomes. Thus, the gap analysis conducted will in this context be seeking to assess the current scenario at the facility. This could be distinguished from the risk management highlighted elsewhere in this text which happens to be largely forward-focused. The specific gap analysis tool that will be embraced on this front is the Fishbone Diagram. In essence, a fishbone diagram comes in handy in the identification of what triggers a certain issue, problem, or concern. It is also referred to as the Ishikawa diagram. As Coplan and Masuda (2011) observe, it is often instrumental in the assessment of a certain effect’s root cause. In this case, the effect has been identified as ‘overstretched facility resources’. Four root causes have been indicated.

Size of hospital relative to population being served

Prevailing patient engagement strategies

Nosocomial infection minimization strategies

Need for proper ventilation

Special skills nurse scarcity

Retiring workforce

Increased need for care

Overstretched Facility Resources

Facility Procedures

Onsite Covid-19 Measures

Overcrowding –

Outpatient

Staff Shortage

Social distancing

FISHBONE DIAGRAM

Project Timeline Gantt Chart

Telehealth System

Gantt Chart

My Organization

Project Start:

Mon, 4/4/2022

Display Week:

Apr 4, 2022

Apr 11, 2022

Apr 18, 2022

Apr 25, 2022

May 2, 2022

May 9, 2022

May 16, 2022

May 23, 2022

TASK

ASSIGNED

TO

PROGRESS

START

END

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Roadmap Building

Planning

Robert Strapp

Software/hardware selection

Andrew Clifford

System prep and training

Alex Jung

Implementation

Rob Williams

Evaluation

Joanna Garner

Responsibility for Tasks

The need for teamwork has been established in this undertaking. This is especially the case given that teamwork comes in handy in the promotion of productivity as well as efficiency. As Houston and Bove (2007) point out, teamwork should be seen as crucial for successful running of projects. More specifically, in the words of the authors, “good teamwork can contribute to economizing, more successful project outcomes and ultimately higher efficiency… also adds to the quality and individuality of projects” (Houston and Bove, 2007, 119).

A team comprising of a total of 6 members has been established. The team has been established with the implementation tasks in mind. Team members will be inclusive of: the project manager, application developer, QA test engineer, physician advocate, nurse advocate, and super-users. Below is a RACI Matrix highlighting/indicating responsibility for tasks.

Project Activity

Project manager

Application developer

QA test engineer

Physician advocate

Nurse advocate

Super-users

Planning

R/A

C

C

C

C

I

Software/Hardware selection

A

R

R

I

I

I

System prep and training

A

R

R

I

I

I

Implementation

R/A

C

C

C

C

C/I

Evaluation

R/A

I

I

C

C

C

RACI Matrix

Communication Plan

According to Houston (2017), without ensuring that smaller assignments are derived out of high-level goals, project management cannot be effective. To a large extent, as has been demonstrated elsewhere in this text, deadlines are set around these smaller assignments. However, of equal importance is an effective communication plan. Houston (2017) indicates that a plan of this nature clearly highlights the methodology that will be used to engage stakeholders going forward. As Houston (2017) further point out, a plan of this nature would also come in handy in efforts to make a determination as to whom specific information will be sent, how it will be sent, and the frequency of sending out specific information. To further enhance the chances of success with the present project, a project management communication methodology has been formulated and summarized in the table below. An easy-to-follow format has been embraced. More specifically the table identifies the purpose, medium, as well as frequency of communication. It also identifies those who are targeted at any given point.

Purpose

Medium

Frequency

Audience

Commencement Meeting

-Project introduction

-Highlighting of the project deliverables

In-person

Once

-Project manager

-Physician advocate