AHRQ has an Evidence Based Handbook for Nurses (April, 2008) on their website. The PDF version of the handbook can be downloaded from the site.
While performing a literature review for research on Nurses' working conditions, I came across this handbook that talks about, among other things, the impact of health care information technology on clinical practice workflow. It discussed the benefits of Health IT to improved quality and efficiency of workflows as well as the impact of health IT as an initial disruptive factor to the existing workflow.
This supports my belief that successful adoption of Health IT in the clinical environment will require a change in culture and should begin with a comparison of "how things are done now" - the "AS-IS" to "how we want to do things" - the "TO-BE." It is important to first establish the goal before taking steps to implement any technology solution. Read my discussion of Culture Change for Healthcare EHRs and beyond.
A key concept in the disruption of Health IT is that often the software will "implicitly assume a workflow" in the way that screens and the user interface is organized. The AHRQ report also discusses the need to understand existing workflows of the clinical environment in order to be successful in health IT adoption.
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