Impact of health information technology on detection of potential adverse drug events at the ordering stage.

Purpose: The impact of implementing commercially available health care information technologies at hospitals in a large health system on the identification of potential adverse drug events (ADEs) at the medication ordering stage was studied.

Methods: All hospitals in the health system had implemented a clinical decision-support system (CDSS) consisting of a centralized clinical data repository, interfaces for reports, a results reviewer, and a package of ADE alert rules. Additional technology including computerized provider order entry (CPOE), an advanced CDSS, and evidence-based order sets was implemented in nine hospitals.

Transformation of Emergency Department processes of care with EHR, CPOE, and ER event tracking systems.

Mercy Medical Center, North Iowa implemented electronic health records (EHR), computerised provider order entry (CPOE) and event tracking systems in the emergency department (ED) as part of hospital-wide implementation of clinical information systems. This case study examines the changes in outcomes and processes in the ED following implementation. Although the system was designed to enhance efficiency, there was a significant increase in the mean length of stay (about 17 minutes, or 15%) in the ED after implementation.

The relationship between super users' attitudes and employee experiences with clinical information systems.

The purpose of this study is to examine the manner in which Super User attitudes toward clinical information systems (CIS) are associated with employee experiences with CIS implementation. Super Users (N = 82), selected by hospital administration to assist in implementation of the new CIS, completed a survey that assessed time spent in the Super User role as well as attitudes toward the role. These data were matched with hospital employee (N = 325) survey data about attitudes toward CIS and its impact on work processes.

Complexity of medication-related verbal orders.

Verbal orders are a common practice in hospitals but there has been little systematic study about them. Although the potential for harm arising from the miscommunication and misunderstanding of verbal orders has been recognized, there is very little research examining their complexity. This article provides a descriptive analysis of one hospital's medication-related verbal-order events for a 1-week period.

Redesigning care delivery through health IT implementation. Exploring Trinity Health's IT model.

Trinity Health is a large multihospital healthcare system that developed a system-wide information technology strategy and implementation model. This study looks at how that system-wide strategy and implementation model, called Project Genesis, was used at Mercy Medical Center-North Iowa, a Trinity Health rural referral hospital, and how the care delivery system was redesigned using an electronic health record. This study was funded in part by a grant (UC1 HS15196; Rural Iowa Redesign of Care Delivery with EHR Functions) from the Agency for Healthcare Research and Quality to implement an integrated EHR system in the hospital and two clinics and assess its impact on patient safety, quality of care and organizational culture.

Development of a measure of clinical information systems expectations and experiences.

Background/objectives: The purpose of this study is to describe the development and initial psychometric properties of a measure of expectations and experiences regarding the impact of clinical information systems on work process and outcomes.

Research Design: Basic item analysis, confirmatory factor analysis, cross-validation factor analyses, and reliability analysis were used to assess the psychometric properties of the scale.

Subjects: The initial validation sample included registered nurses from a large Midwestern rural referral hospital that implemented electronic medical records and computerized provider order entry systems.