The document outlines an evaluation project focusing on health information technology (HIT) systems that enhance nursing effectiveness. Three specific scenarios for implementing HIT systems are presented, involving electronic health records, computerized provider order entry, and electronic medication administration systems. Each scenario requires the selection of a research goal and viewpoint to guide the evaluation process, alongside published research on similar systems.

1. Application: Evaluation Project Part 1: Evaluation Plan Focus
Technology increases human effectiveness. Using a lever, you
can move an object several times your size. In an airplane, you
can move exponentially faster than on foot. Using the Internet,
you can access information much more quickly than at a library.
What possibilities like this exist in the nursing field? What
health information technologies can amplify your impact as a
nurse far more than ever before? In this Evaluation Project, you
will have the opportunity to answer these questions.
Because of the great differences between HIT systems and
different goals of an evaluation, there is no one-size-fits-all
evaluation plan. Different technologies require different
evaluation methods. Consequently, in this part of your
Evaluation Project, you will conduct research on how system
implementations similar to the one you select have been
previously evaluated. After exploring similar system
implementations, you will select one research goal and
viewpoint to use in the evaluation.
Read the following three scenarios, and select the one that is of
most interest to you:
Scenario 1:
Your hospital is implementing a new unified acute and
ambulatory Electronic Health Record (EHR) system through
which patient care documentation will occur. Interdisciplinary
assessment forms (including nursing), clinical decision support,
and medical notes will be documented in this system. The
implementation of the system is anticipated to improve the
hospital’s performance in a multitude of areas. In particular, it
is hoped that the use of the EHR system will reduce the rate of
patient safety events, improve the quality of care, deter sentinel
events, reduce patient readmissions, and impact spending. The
implementation of the EHR system is also intended to fulfill the
“Meaningful Use” requirements stipulated in the Health
Information Technology for Economic and Clinical Health

2. (HITECH) Act. As the hospital’s lead nurse informaticist, you
have been tasked with planning the evaluation of the EHR
implementation.
Scenario 2:
As the lead nurse informaticist in your hospital, you have been
given the task of planning an evaluation for a soon-to-be
launched computerized provider order entry (CPOE) system.
The CPOE system is designed to replace conventional methods
of placing medication, laboratory, admission, referral, and
radiology orders. CPOE systems enable health care providers to
electronically specify orders, rather than rely on paper
prescriptions, telephone calls, and faxes. The intended goal of a
CPOE system is to improve safety by ensuring that orders are
easily comprehensible through the use of evidence-based order
sets. In addition, the CPOE system has the potential for
improving workflow by avoiding duplicate orders and reducing
the steps between those who place medical orders and their
recipients.
Scenario 3:
You are the lead nurse informaticist in a large urban hospital
that has recently implemented a new Electronic Medication
Administration Record (eMAR) and Bar Code Medication
Administration (BCMA) system. The BCMA system uses bar
coding technology to facilitate the correct identification of
patients at the point of administration of medications. BCMA
will be used for all medications—tables, injections, and
intravenous treatment. You have been selected to conduct an
evaluation of the new system. The eMAR is designed to utilize
the medication order entry process in order to expedite the
creation of the 24-hour medication administration record,
whereas the BCMA will automate administration
documentation. In addition, the system is intended to reduce
medication administration errors by tracking and alerting health
care providers about dosages, proper administration times,
medication allergies, or medication incompatibilities.
To prepare

3. :
Select one scenario to use for the Evaluation Project.
Consider what viewpoint and research goal you would use to
guide your evaluation plan. Although many potential research
goals or viewpoints could be selected for each scenario, you are
only required to choose one goal and one viewpoint. The
scenario you select will be used for the Evaluation Project
throughout this course. To maximize your benefit from this
project, consider selecting a scenario that is relevant to a health
care organization with which you are involved.
Research published evaluations that have been conducted on
HIT system implementations similar to the one in the scenario
you selected.
To complete
Part 1 of this Evaluation Project:
By Friday 12/23/2016
1)
In a
3-page paper, identify which of the three hypothetical health
information technology systems you will be evaluating in this
project, and explain why you selected this system.
2)
Summarize your research findings on similar HIT
implementations.
3)
Describe the evaluation goal and viewpoint that will guide your
own evaluation plan. Provide your rationale.
Required Readings

4. Friedman, C. P., & Wyatt, J. C. (2010). Evaluation methods in
biomedical informatics (2nd ed.). New York, NY: Springer
Science+Business Media, Inc
.
Chapter 2, “Evaluation as a Field” (pp. 21–47)
This chapter defines evaluation and shows how it differs from
research. The chapter also includes a discussion the philosophy
behind evaluation and the multiple approaches to evaluation.
Board on Health Care Services. (2012). Health IT and patient
safety: Building safer systems for better care. The National
Academies Press: Washington DC. Retrieved from
http://www.nap.edu/catalog.php?record_id=13269
Chapter 2, “Evaluating the Current State of Patient Safety and
Health IT” (pp. 31–58)
This chapter addresses the challenges of evaluation in health
information technology due to the complex nature of technology
and rapid changes in the field. The chapter also identifies
barriers to evaluation and the threats posed to patient safety by
a lack of evaluation.
Nursing Documentation
Hyun, S., Johnson, S. B., Stetson, P. D., & Bakken, S. (2009).
Development and evaluation of nursing user interface screens
using multiple methods. Journal of Biomedical Informatics,
42(6), 1004–1012.
Retrieved from the Walden Library databases.
"The design of nursing documentation systems to support
quality management and research as well as practice is a

5. complicated task as it requires understanding of nursing
practice and informatics" (p. 1010). In an effort to design more
user-friendly interface screens for electronic nursing
documentation systems, the researchers explore the application
of theory and user-centered methods to the design process.
Saranto, K., & Kinnunen. U. M. (2009). Evaluating nursing
documentation—Research designs and methods: A systematic
review. Journal of Advanced Nursing, 65(3), 464–476.
Retrieved from the Walden Library databases.
In this research study, the authors examine the nursing
documentation literature. One significant finding was the
importance of using structured nursing terminology, as this
supports more consistent documentation practices.
Public Health
Honoré, P. A., Wright, D., Berwick, D. M., Clancy, C. M., Lee,
P., Nowinshi, J., & Koh, H. K. (2011). Creating a framework for
getting quality into the public health system. Health Affairs,
30(4), 737–745.
Retrieved from the Walden Library databases.
In this article, the authors explore two Department of Health
and Human Services (DHHS) reports on public health quality.
The authors also posit how a framework of quality concepts can
be applied in various programs to address the quality concerns
presented in the two DHHS reports.
Reeder, B., Hills, R. A., Demiris, G., Revere, D., & Pina, J.
(2011) Reusable design: A proposed approach to public health

6. informatics system design. BMC Public Health, 11, 116–118.
Retrieved from the Walden Library databases.
The authors of this article examine the current state of public
health informatics in terms of design consistency and
interoperability. They suggest a standard design framework be
implemented to guide the development of public health
informatics systems.
Consumer Health Information
Van Gemert-Pijnen, J., Nijland, N., van Limburg, M.,
Ossebarrd, H. C., Kelders, S. M., Eysenbach, G., & Seydel, E.
R. (2011). A holistic framework to improve the uptake and
impact of eHealth technologies. Journal of Medical Internet
Research, 13(4), e111.
Retrieved from the Walden Library databases.
Many factors influence the successful adoption of eHealth
technologies. As such, many integration efforts have not been
successful or sustainable. In this article, the authors propose a
more holistic approach for implementing eHealth technologies
to overcome problems with adoption and sustainability.
Black, A. D., Car, J., Pagliari, C., Anandan, C., Cresswell, K.,
Bokun, T., et al. (2011). The impact of eHealth on the quality
and safety of health care: A systematic overview. PLoS
Medicine, 8(1), e1000387.
Retrieved from
http://www.plosmedicine.org/article/info:doi/10.1371/journal.p
med.1000387
The authors of this article discuss eHealth technologies and
reviews current literature on its impact. The authors argue that
eHealth technologies have yet to demonstrate cost savings,

7. improved patient outcomes, or improved quality of care.
Decision Support Systems
Levy, S., & Heyes, B. (2012). Information systems that support
effective clinical decision making. Nursing Management, 19(7),
20–22.
Retrieved from the Walden Library databases.
The focus of this article is the importance of providing nurses
with HIT tools to support them in using and managing
information effectively to improve patient care. The nurses
should use the clinical decision-making tools to have access to
relevant and timely information that they can then relay to their
patients.
Randell, R., & Dowding, D. (2010). Organisational influences
on nurses’ use of clinical decision support systems.
International Journal of Medical Informatics, 79(6), 412–421.
Retrieved from the Walden Library databases.
The article describes a study that examined nurses’ perceptions
on which organizational features facilitate the introduction and
use of clinical decision support systems. The authors rank the
organizational features according to the findings of their study.
Tele-Medicine and Telehealth
Pelletier, A. C., Jethwani, K., Bello, H., Kvedar, J., & Grant, R.
W. (2011). Implementing a web-based home monitoring system
within an academic health care network: Barriers and
facilitators to innovation diffusion. Journal of Diabetes Science
and Technology, 5(1), 32–38.

8. Retrieved from the Walden Library databases.
In this article, the authors use the framework of the diffusion of
innovation theory to examine the implementation of a new
information communication technology intervention at the
Center for Connected Health. The article provides details on the
intervention in question, which focuses on non-visit-based
diabetes care.
Boulos, M. N. K., Wheeler, S., Tavares, C., & Jones, R. (2011).
How smartphones are changing the face of mobile and
participatory healthcare: An overview, with example from
eCAALYX.Biomedical Engineering Online, 10(1), 24[RAR1].
Retrieved from http://www.biomedical-engineering-
online.com/content/10/1/24
This article explores the use of smartphones in health care by
patients and health care professionals. The authors review a
variety of apps available for smartphones and discuss the
application of these apps in different health care settings. They
also explore barriers to the adoption of this technology and
provide strategies for addressing those barriers.
Unintended Consequences
Sockolow, P., Crawford, P., & Lehmann, H. (2012). Broadening
a general framework for evaluating health information
technology. Methods of Information in Medicine, 51(2), 122–
130.
Copyright 2012 by Verwertungsgesellschaft Wort. Reprinted by
permission of Verwertungsgesellschaft Wort via the Copyright
Clearance Center.
This article describes the authors’ attempts to create an
informatics evaluation framework for health information

9. technology (HIT). In particular, the authors focus on developing
a framework that utilizes portions of pre-existing health
services research evaluation and informatics evaluation to
remedy issues in currently available HIT evaluation
frameworks.
Sockolow, P. S., Weiner, J. P., Bowles, K. H., & Lehmann, H.
P. (2011). A new instrument for measuring clinician satisfaction
with electronic health records. CIN: Computers, Informatics,
Nursing, 29(10), 574–585.
Retrieved from the Walden Library databases.
The authors of this article explore the creation of a new survey
instrument designed to determine nurse satisfaction with an
electronic health record’s impact on clinical processes. The
authors describe the influences that guided the selection of the
survey’s features.
General
Bélanger, E., Bartlett, G., Dawes, M., Rodríguez, G., & Hasson-
Gidoni, I. (2012). Examining the evidence of the impact of
health information technology in primary care: An argument for
participatory research with health professionals and patients.
International Journal of Medical Informatics, 81(10), 654–661.
Retrieved from the Walden Library databases.
This article examines the findings of numerous literature
reviews concerning the impact of information systems on health
outcomes in primary care settings. In particular, the article
focuses on the findings’ implications for developing personal
health records.

10. Coiera, E., Aarts, J., & Kulikowski, C. (2012). The dangerous
decade. Journal of the American Medical Informatics
Association, 19(1), 2–5.
Retrieved from the Walden Library databases.
This article provides an overview of changes resulting from
information and communication technology (ICT) that are
anticipated to occur in the decade following 2012. Specifically,
the article has a large emphasis on how these potential changes
could impact patient safety.
Lanham, H. J., Leykum, L. K., & McDaniel, R. R. Jr. (2012).
Same organization, same electronic health records (EHRs)
system, different use: Exploring the linkage between practice
member communication patterns and EHR use patterns in an
ambulatory care setting. Journal of the American Medical
Informatics Association, 19(3), 382–391.
Retrieved from the Walden Library databases.
The authors of this article describe a study that examines the
link between communication patterns “within-practice” and the
use patterns of practice-level electronic health records (EHR).
The authors explain how the link between these patterns may
provide additional opportunities for standardizing the use of
EHRs.
Looking toward the future: 2012: Industry insiders weigh in on
the year ahead in healthcare technology. (2012). Health
Management Technology, 33(1), 8, 10–12, 14–15.
Retrieved from the Walden Library databases.
This article provides the perspectives of numerous “industry

11. insiders” on how technological changes shape health care. In
particular, the insiders focus on cloud computing, real-time
location systems, business intelligence, patient engagement, the
ICD-10 standard, high-performing health care organizations, the
information technology market, electronic medical record
adoption, and much more.
Looking toward the future: 2012 part II: Industry insiders weigh
in on the year ahead in healthcare technology. Health
Management Technology, 33(2), 30, 32–34.
Retrieved from the Walden Library databases.
This article continues the examination of health care technology
in 2012 begun in Part I. The “insiders” in this article expound
on their predictions for the individual network-exchange model,
revenue cycle management, and health care cuts, as well as on
implementing HIPAA Version 5010 and more.
Wu, I.-L., Li, J.-Y., & Fu, C.-Y. (2011). The adoption of mobile
healthcare by hospital’s professionals: An integrative
perspective. Decision Support Systems, 51(3), 587–596.
Retrieved from the Walden Library databases.
This article explores the integration of technology adoption
frameworks to predict the adoption of mobile technology by
health care providers in a hospital setting: the Technology
Acceptance Model (TAM), the Theory of Planned Behavior
(TPB), the perceived service availability (PSA), and the
personal innovativeness in IT (PIIT).
Jensen, P. B., Jensen, L. J., & Brunak, S. (2012). Mining
electronic health records: Towards better research applications

12. and clinical care. Nature Reviews: Genetics, 13(6), 395–405.
Copyright 2012 by Nature Publishing Group. Reprinted by
permission of Nature Publishing Group via the Copyright
Clearance Center.
In this article, the authors discuss the wealth of information and
data provided by electronic health records (EHR) and how these
data could provide valuable information for medical research.
The authors also address the ethical and legal barriers to using
EHR data in this manner, and they examine methods for
addressing these barriers.
Required Media
Laureate Education (Producer). (n.d.g). Telehealth and public
health. Retrieved from https://class.waldenu.edu
Note:
The approximate length of this media piece is 21 minutes.
This video revolves around a presentation discussing telehealth.
The video also provides a general overview of different
technologies being applied to improve the health of individuals
and populations.
Laureate Education (Producer). (n.d.c).
Interoperability and standards
. Retrieved from https://class.waldenu.edu
Note:
The approximate length of this media piece is 16 minutes.
In this video, presenters discuss the need for standards to
facilitate the availability of health information. In addition, the

13. video elaborates on challenges commonly faced with health
information exchange.
Laureate Education (Producer). (n.d.a).
Clinical and administrative systems
. Retrieved from https://class.waldenu.edu
Note:
The approximate length of this media piece is 19 minutes.
This video provides a general overview on clinical information
systems. The video focuses in particular on clinical and
administrative systems in the United States.