Discussion: Using Health Information Technology as a Source of Evidence-Based Practice
Before the digital revolution, health information technology supplied very limited support
for evidence-based practice. If nurses wanted to be informed about cutting-edge research,
their best bet was to either subscribe to leading journals or make periodic trips to the
library. With the establishment of research databases, however, nurses became empowered
to learn about and facilitate interdisciplinary and translational research. Databases are just
one example of how health information technology supports evidence-based practice.
To prepare:
�Read the following scenario from the text (McGonigle & Mastrian, 2015, p. 445):
Twelve-hour shifts are problematic for patient and nurse safety, and yet hospitals continue
to keep the 12-hour shift schedule. In 2004, the Institute of Medicine (Board on Health
Care Services & Institute of Medicine, 2004) published a report that referred to studies as
early as 1988 that discussed the negative effects of rotating shifts on intervention accuracy.
Workers with 12-hour shifts realized more fatigue than workers on 8-hour shifts. In
another study done in Turkey by Ilhan, Durukan, Aras, Turkcuoglu, and Aygun (2006),
factors relating to increased risk for injury were age of 24 or less, less than 4 years of
nursing experience, working in the surgical intensive care units, and working for more
than 8 hours.
�Consider how the resources identified in the scenario above could influence an
organization’s practice.
�Select an issue in your practice that is of concern to you. Using health information
technology, locate at least three evidence-based practice resources that address your
concern and that could possibly inform further action.
By Day 3
Post a description of your practice concern. Outline how you used health information
technology to locate evidence-based practices that address this concern. Cite and include
insights from the resources. Analyze how health information technology supports evidence-
based practice.
Health Information Technology Support of Evidence-Based Practice
The practice that is of concern in the organization is the slow pace of service at the
General Out-Patient Department (GOPD), which makes patients wait for long hours before they
can see the physician. Currently, there is only one health care worker who is serving patients at
HEALTH INFORMATION TECHNOLOGY SUPPORT OF EVIDENCE-BASED PRACTICE
2
the GOPD. Although the health care worker uses a computer to enter clients’ details, she still
takes a long time to help one patient owing to the detailed information that needs to be captured.
The long outpatient waiting time has an adverse impact on patient satisfaction and significantly
affects the number of returning patients. As Jamal, McKenzie, and Clark (2009) point out,
patient satisfaction is a fundamental index of health care quality in organizations. For the current
organization to be able to deliver quality care, it must take appropriate actions to reduce the
waiting time at the General Out-Patient Department (GOPD). The best way to address this
concern is to implement a computer-technology system to allow patients to book an appointment
while they are still at home. The organization should proceed to implement this suggestion only
if it is supported by evidence-based practice.
To find out whether the current practice is supported by research evidence, I have used
health information technology to locate evidence-based practices that support the use of
computer-based appointment systems to improve waiting time at the General Out-Patient
Department (GOPD). I have located the resources by searching through the PubMed Central
research database using ‘computer-based technology appointment systems’ and ‘patient waiting
time’ as the key words. Following a comprehensive search, I have been able to locate two
empirical quantitative studies and one descriptive cross sectional study that support the use of
computer-based technology appointment systems to help reduce waiting time at the General Out-
Patient Department (GOPD).
In one of the resources, Cao et. al. (2011), have studied the impact of a web-based
appointment system on outpatient waiting time at Xijing Hospital in China. These researchers
have reported that using a computer-based booking system can significantly reduce the waiting
time for registration at the hospital, thereby increasing patients’ satisfaction. In another study, Yu
HEALTH INFORMATION TECHNOLOGY SUPPORT OF EVIDENCE-BASED PRACTICE
3
et. al. (2013), have investigated the causes and impacts of prolonged waiting time at the
outpatient registration unit in a Chinese hospital. They have concluded that appointment
registration systems are very efficient in improving waiting time as well as patient satisfaction.
The ultimate evidence-based resource has been published by Mohebbifar et al. (2014). These
researchers have carried out an investigation with the aim of understating the waiting time
process in health care and educational institutions in Iran. From their research, they have
concluded that booking for visits electronically through the Internet can significantly help to
improve waiting time by patients. Based on information contained in these resources, the
organization should implement a computer-based appointment system to help reduce waiting
time at the General Out-Patient Department (GOPD).
These resources show how health information technology supports evidence-based
practice. With resources available in research databases, nurses can easily obtain evidence that
can be used to inform further action. According to McGonigle and Mastrian (2015), nursing
research, together with the information stored in research databases, is a great foundation of
nursing knowledge. Hynes et. al. (2010) greatly supports the significant role that health
information technology plays in promoting evidence-based care. Health care organizations
should continue to implement those practices that are supported by evidence-based research that
is available in health information technology systems (Jamal, McKenzie and Clark, 2009; &
Umscheid, Williams and Brennan, 2010).
HEALTH INFORMATION TECHNOLOGY SUPPORT OF EVIDENCE-BASED PRACTICE
4
References
Cao, W., Wan, Y., Tu, H., Shang, F., Liu, D., Tan, Z., Sun, C., Ye, Q. & Xu, Y. (2011). A web-
based appointment system to reduce waiting for outpatients: A retrospective study. BMC
Health Services Research, 11: 318.
Hynes, D. M., Weddle, T., Smith, N., Whittier, E., Atkins, D., & Francis, J. (2010). Use of health
information technology to advance evidence-based care: Lessons from the VA QUERI
program. Journal of General Internal Medicine, 25(Suppl. 1), S44–S49.
HEALTH INFORMATION TECHNOLOGY SUPPORT OF EVIDENCE-BASED PRACTICE
5
Jamal, A., McKenzie, K., & Clark, M. (2009). The impact of health information technology on
the quality of medical and health care: A systematic review. Health Information
Management Journal, 38(3), 26–37.
McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge
(3rd ed.). Burlington, MA: Jones and Bartlett Learning.
Mohebbifar, R., Hasanpoor, E, Mohseni, M., Sokhanvar, M., Khosravizadeh, O. & Isfahani, H.
M. (2014). Outpatient waiting time in health services and teaching hospitals: A case
study in Iran. Global Journal of Health Science, 6(1): 172-180.
Umscheid, C. A., Williams, K., & Brennan, P. (2010). Hospital-based comparative effectiveness
centers: Translating research into practice to improve the quality, safety, and value of
patient care. JGIM: Journal of General Internal Medicine, 25(12), 1,352–1,355.
Yu, W., Yu, X., Hu, H., Duan, G. & Wang, Y. (2013). Use of hospital appointment registration
systems in China: A survey study. Global Journal of Health Science, 5 (5): 193-201.