Health Information Technology and the Nursing Workforce

Information technology has become a priority in health systems around the country and will be an important resource in any national healthcare overhaul. Healthforce staff have completed evaluations of electronic medical systems in the Veterans Health Administration, the largest health system in the nation, as well as a small rural hospital in California’s Central Valley.

The Effect of Information Technology on Nurses and Patients in the Veterans Health Administration

The Veterans Health Administration’s (VA) late 1990’s implementation of a Computerized Patient Record System (CPRS) and Bar Code Medication Administration (BCMA) offered a unique opportunity to study the effects of information technologies on hospital staff and patients in the largest health care system in the United States. Healthforce faculty and staff collaborated with researchers at the Boston VA and the VA Health Economics Research Center in Palo Alto to evaluate the VA’s information technology investments.

Implementation and Evaluation of IT in a Rural Hospital

A small rural hospital in central California implemented a fully integrated electronic medical records system to improve overall patient safety. This hospital is in a rural community and serves a large share of Medi-Cal and uninsured patients. The hospital is also affiliated with a community health center. Healthforce staff evaluated the effects of the information system on medication errors, patient safety, hospital finances, and hospital staff, including factors that might affect staff acceptance of computerization in the workplace.

In the hospital setting, new information technologies have an important relationship with nursing staff. Nurses are responsible for the majority of inpatient bedside care, recordkeeping, and administration of medications. Accordingly, this study focused on the effect of CPRS and BCMA on nursing staff — in particular, the effects of CPRS and BCMA on hours worked by nursing staff and adverse events experienced by patients. The experience of a large diverse system like the VA, with a wide mix of rural, urban, teaching, and community hospitals has provided valuable information about the issues surrounding new information systems for hospitals in the private sector.

Funding: 

The Implementation and Evaluation of IT in a Rural Hospital project was funded by grant from the Agency for Healthcare Research and Quality

The Effect of Information Technology on Nurses and Patients in the Veterans Health Administration project was funded by the Robert Wood Johnson Foundation and the Gordon and Betty Moore Foundation.

For more information, please contact Joanne Spetz.