Methods Inf Med 2003; 42(04): 463-470
DOI: 10.1055/s-0038-1634350
Original article
Schattauer GmbH

Point of Care Technology: A Sociotechnical Approach to Home Health Implementation

M. L. V. Stricklin
1   VNA Healthcare Partners of Ohio, Cleveland, Ohio, USA
,
C. M. Struk
1   VNA Healthcare Partners of Ohio, Cleveland, Ohio, USA
› Author Affiliations
Further Information

Publication History

Publication Date:
08 February 2018 (online)

Summary

Objectives: This paper describes an ongoing evaluation study of the design and implementation of Point of Care (POC) technology in a home health agency. Methods: During the implementation of POC technology data about user acceptance were collected with the help of surveys and statistically analyzed. The survey also allowed for entering non-structured observations. A time series study was conducted to identify factors associated with technology change and its effect on professional competency.

Results and Conclusions: Healthcare markets and consumers are demanding that providers use sophisticated information technology to document, transmit and access clinical and financial information across all delivery points. Newly adapted Patient Care Information Systems (PCIS) are available for clinical use in home care. The factors associated with home care nurses’ end user acceptance and use of the POC technology in clinical work are described. A sociotechnical approach with selected change management strategies appears to have positively influenced the nurse end users’ POC technology adoption and use in clinical work.

 
  • References

  • 1 Hoehn B, Perreault L. Care delivery and care management. In: Ball M, Douglas JV. editors. Performance improvement through information management. New York: Springer-Verlag; 1999: 48-109.
  • 2 Brennan PF. Health informatics and community health: support for patients as collaborators in care. Methods Inf Med 1999; 38: 274-8.
  • 3 Williams TD. Home care industry ponders POC automation. Health Manag Technol 1999; 21: 31-5.
  • 4 Amatayakul M. Critical success factors. Health Manag Technol 2000; 21: 14-6.
  • 5 Dowling JR. Do hospital staff interfere with computer system implementation?. Hlth Care Mgmt Rev 1980; 5 Fall: 23-32.
  • 6 Gogold A. Joint hospital/vendor project brings CQI and point of care technology to home care. Comput Nurs 1995; 13: 143-56.
  • 7 Krampf S, Robinson S. Managing nurses’ attitudes towards computers. Nurs Manage 1984; 15 (Suppl. 07) 31-4.
  • 8 Sultana N. Nurses’ attitudes towards computerization in clinical practice. J Adv Nurs 1990; 15: 696-702.
  • 9 Strong J, Brodt A. Assessment of nurses’ attitudes toward computerization. Comput Nurs 1985; 3: 154-8.
  • 10 Jayasuria R, Caputi P. Computer attitude and computer anxiety in nursing. Comput Nurs 1996; 14: 340-5.
  • 11 Chang B. Adoption of innovations. Comput Nurs 1984; 2: 229-35.
  • 12 Brett J. Organizational integrative mechanisms and adoption of innovations by nurses. Nurs Res 1989; 38: 105-10.
  • 13 Nahm R, Poston I. Measurement of the effects of an integrated, point-of-care computer system on quality of nursing documentation and patient satisfaction. Comput Nurs 2000; 18: 220-9.
  • 14 Ngin P, Simms L. Erbin-Roesemann work excitement among computer users in nursing. Comput Nurs 1993; 11: 127-50.
  • 15 Burkes M. Identifying and relating nurses’ attitudes toward computer use. Comput Nurs 1991; 9: 190-201.
  • 16 Scarpa R, Smeltzer S, Jaison B. Attitudes of nurses toward computerization: a replication. Comput Nurs 1992; 10: 72-80.
  • 17 Minda S, Brundage D. Time differences with handwritten and computer documentation of nursing assessment. Comput Nurs 1994; 12: 277-9.
  • 18 Kim I, Kim MI. The effects of individual and nursing unit characteristics on willingness to adopt an innovation. Comput Nurs 1996; 14: 183-7.
  • 19 Dennis K, Sweeney P, MacDonald S, Morse N. Point of care technology: impact on people and paperwork. Nurs Econ 1993; 11: 229-48.
  • 20 Drazen EL. Physicians and nurses acceptance of computers. In: Drazen EL, Metzger JB, Ritter JL, Schneider JK. editors. Patient Care Information Systems: Successful Design and Implementation. New York: Springer-Verlag; 1999: 31-50.
  • 21 Staggers N, Mills ME. Nurse-computer interactings: staff performance outcomes. Nurs Res 1994; 43 (Suppl. 03) 144-50.
  • 22 Hockenjas G, Warton A. Point of care strategies: training for success. Home Healthc Nurs 2001 Dec; in print.
  • 23 Mallard Mitchell. Two approaches to developing a computer-based patient record for home health care. Home Health Care Manage Pract 1988; 10 (Suppl. 06) 19-37.
  • 24 Wilson R, Fulmer T. Introduction of wireless, pen-based computing among visiting nurses in the inner-city: a qualitative study. J Community Health Nurs 1997; 14 (Suppl. 01) 23-37.
  • 25 Larrabee S. Benner’s novice to expert nursing theory applied to the implementation of lap-tops in the home care setting. Home Health Care Manage Pract 1999; Aug 11 (Suppl. 05) 41-7.
  • 26 Lorenzi N, Riley R, Mantel M. Preparing your organization for technological change. Healthc Inform 1990; Dec 33-6.
  • 27 Draft proceedings of the International Medical Informatics Association Working Conference on the Organizational Impact of Informatics. Cincinnati: Riley Associates; 1993
  • 28 Lorenzi NM, Riley RT. Organizational Aspects of Health Informatics: Managing Technological Change. New York: Springer-Verlag; 1995
  • 29 Lorenzi NM, Riley RT. Informatics and organizational change. In: Ball MS, Hannah KJ, Newbold SK, Douglas JV. editors. Nursing Informatics Where Caring and Technology Meet. New York: Springer-Verlag; 1995: 2-25.
  • 30 Watzlawick D, Weakland P, Fisch R. Change. New York: W.W. Norton & Co.; 1974
  • 31 Lewin K. Field Theory in Social Science. New York: Harper & Bros.; 1951
  • 32 Atkinson E, Peel VJ. Growing, not building, the electronic patient record system. Methods Info Med 1998; 37: 206-310.
  • 33 Mumgord E, Weir M. Computer Systems in Work Design: The Ethics Method. New York: Wiley; 1979
  • 34 Friedman M, Comford DS. Computer Systems Development, History, Organization and Implementation. New York: Wiley; 1989
  • 35 Hirscheim R, Klein HK. Lyytinen. Information Systems Development and Data Modeling Conceptual and Philosophical Foundations. Cambridge: Cambridge University Press; 1995
  • 36 Berg M. Patient care information systems and health care work: a socio-technical approach. Int J Med Inf 1999; 55: 87-101.
  • 37 Berg M, Goorman E. The contextual nature of medical information. Int J Med Inf 1999; 56: 51-60.
  • 38 Berg M, Langenberg C, Ignas v.d. Berg Kwakkernaat J. Considerations for sociotechnical design: experiences with an electronic patient record in a clinical context. Int J Med Inf 1998; 52: 243-51.
  • 39 Berg M. Rationalizing Medical Work: Decision Support Techniques and Medical Practices. Cambridge: MIT Press; 1997
  • 40 Stricklin ML, Jones S, Niles S, Struk C. What nurses and managers expect from point of care technology. Home Healthc Nurs 2000; 9 (Suppl. 18) 3-11.
  • 41 Stricklin ML, Lowe-Phelps K. Home care patient satisfaction with POC technology. Home Healthc Nurs 2001 Dec; in print.
  • 42 Thoman J, Struk C, Spero M, Stricklin ML. Reflections from a point of care pilot nurse group experience. Home Healthc Nurs 2001 in press.
  • 43 Darbyshire P. User friendliness of computerized information systems. Comput Nurs 2000; 18 (Suppl. 02) 93-9.
  • 44 Struk C. Critical steps for integrating information technology in home care. Home Healthc Nurs 2001 Dec; in print.
  • 45 Stoop AP, Berg M. Evaluation of patient care information systems: on integrating response methods conference proceedings in healthcare sociotechnical approaches. Erasmus University Rotterdam; The Netherlands: September 2001
  • 46 Swanson EB. Management information systems: appreciation and involvement. Health Care Manag Sci 1974; 21: 178-88.
  • 47 Tait P, Vessey I. The effect of user involvement on system success: a contingency approach. MIS Qtrly 1988; Mar 232-8.
  • 48 Ives B, Olson MH, Baroudi JJ. The measurement of user information satisfaction. Comm ACM 1983; 10: 785-93.
  • 49 Goorman L, Berg H. Modeling nursing activities: electronic patient records and their discontents. Nurs Inq 1999; 7 (Suppl. 01) 3-9.