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The Effect of Health Information Technology on Health Care Provider Communication: A Mixed-Method Protocol.

Manojlovich M, Adler-Milstein J, Harrod M, Sales A, Hofer TP, Saint S, Krein SL - JMIR Res Protoc (2015)

Bottom Line: Communication technology (ie, the electronic medical record, computerized provider order entry, email, and pagers), which is a component of health information technology (HIT), may help reduce some communication failures but increase others because of an inadequate understanding of how communication technology is used.The purpose of this study is to describe, in detail, how health information and communication technologies facilitate or hinder communication between nurses and physicians with the ultimate goal of identifying how we can optimize the use of these technologies to support effective communication.As the majority of US hospitals do not yet have HIT fully implemented, results from our study will inform future development and implementation of health information and communication technologies to support effective communication between nurses and physicians.

View Article: PubMed Central - HTML - PubMed

Affiliation: University of Michigan, School of Nursing, Ann Arbor, MI, United States. mmanojlo@umich.edu.

ABSTRACT

Background: Communication failures between physicians and nurses are one of the most common causes of adverse events for hospitalized patients, as well as a major root cause of all sentinel events. Communication technology (ie, the electronic medical record, computerized provider order entry, email, and pagers), which is a component of health information technology (HIT), may help reduce some communication failures but increase others because of an inadequate understanding of how communication technology is used. Increasing use of health information and communication technologies is likely to affect communication between nurses and physicians.

Objective: The purpose of this study is to describe, in detail, how health information and communication technologies facilitate or hinder communication between nurses and physicians with the ultimate goal of identifying how we can optimize the use of these technologies to support effective communication. Effective communication is the process of developing shared understanding between communicators by establishing, testing, and maintaining relationships. Our theoretical model, based in communication and sociology theories, describes how health information and communication technologies affect communication through communication practices (ie, use of rich media; the location and availability of computers) and work relationships (ie, hierarchies and team stability). Therefore we seek to (1) identify the range of health information and communication technologies used in a national sample of medical-surgical acute care units, (2) describe communication practices and work relationships that may be influenced by health information and communication technologies in these same settings, and (3) explore how differences in health information and communication technologies, communication practices, and work relationships between physicians and nurses influence communication.

Methods: This 4-year study uses a sequential mixed-methods design, beginning with a quantitative survey followed by a two-part qualitative phase. Survey results from aim 1 will provide a detailed assessment of health information and communication technologies in use and help identify sites with variation in health information and communication technologies for the qualitative phase of the study. In aim 2, we will conduct telephone interviews with hospital personnel in up to 8 hospitals to gather in-depth information about communication practices and work relationships on medical-surgical units. In aim 3, we will collect data in 4 hospitals (selected from telephone interview results) via observation, shadowing, focus groups, and artifacts to learn how health information and communication technologies, communication practices, and work relationships affect communication.

Results: Results from aim 1 will be published in 2016. Results from aims 2 and 3 will be published in subsequent years.

Conclusions: As the majority of US hospitals do not yet have HIT fully implemented, results from our study will inform future development and implementation of health information and communication technologies to support effective communication between nurses and physicians.

No MeSH data available.


Theoretical model.
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Related In: Results  -  Collection

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figure1: Theoretical model.

Mentions: A theoretical framework allows researchers to empirically test relationships among concepts of interest, facilitating accumulation of knowledge and progression in the field. Our theoretical model provides a plausible explanation for both why and how technologies may influence communication. The theoretical model for this study explains how health information and communication technologies might meet the demand for more information through better alignment between technology and the message to be conveyed. Our theoretical model, depicted in Figure 1, posits that through communication practices and work relationships, health information and communication technologies contribute to alignment or mismatch between the technology and the message which, in turn, can affect communication.


The Effect of Health Information Technology on Health Care Provider Communication: A Mixed-Method Protocol.

Manojlovich M, Adler-Milstein J, Harrod M, Sales A, Hofer TP, Saint S, Krein SL - JMIR Res Protoc (2015)

Theoretical model.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4526935&req=5

figure1: Theoretical model.
Mentions: A theoretical framework allows researchers to empirically test relationships among concepts of interest, facilitating accumulation of knowledge and progression in the field. Our theoretical model provides a plausible explanation for both why and how technologies may influence communication. The theoretical model for this study explains how health information and communication technologies might meet the demand for more information through better alignment between technology and the message to be conveyed. Our theoretical model, depicted in Figure 1, posits that through communication practices and work relationships, health information and communication technologies contribute to alignment or mismatch between the technology and the message which, in turn, can affect communication.

Bottom Line: Communication technology (ie, the electronic medical record, computerized provider order entry, email, and pagers), which is a component of health information technology (HIT), may help reduce some communication failures but increase others because of an inadequate understanding of how communication technology is used.The purpose of this study is to describe, in detail, how health information and communication technologies facilitate or hinder communication between nurses and physicians with the ultimate goal of identifying how we can optimize the use of these technologies to support effective communication.As the majority of US hospitals do not yet have HIT fully implemented, results from our study will inform future development and implementation of health information and communication technologies to support effective communication between nurses and physicians.

View Article: PubMed Central - HTML - PubMed

Affiliation: University of Michigan, School of Nursing, Ann Arbor, MI, United States. mmanojlo@umich.edu.

ABSTRACT

Background: Communication failures between physicians and nurses are one of the most common causes of adverse events for hospitalized patients, as well as a major root cause of all sentinel events. Communication technology (ie, the electronic medical record, computerized provider order entry, email, and pagers), which is a component of health information technology (HIT), may help reduce some communication failures but increase others because of an inadequate understanding of how communication technology is used. Increasing use of health information and communication technologies is likely to affect communication between nurses and physicians.

Objective: The purpose of this study is to describe, in detail, how health information and communication technologies facilitate or hinder communication between nurses and physicians with the ultimate goal of identifying how we can optimize the use of these technologies to support effective communication. Effective communication is the process of developing shared understanding between communicators by establishing, testing, and maintaining relationships. Our theoretical model, based in communication and sociology theories, describes how health information and communication technologies affect communication through communication practices (ie, use of rich media; the location and availability of computers) and work relationships (ie, hierarchies and team stability). Therefore we seek to (1) identify the range of health information and communication technologies used in a national sample of medical-surgical acute care units, (2) describe communication practices and work relationships that may be influenced by health information and communication technologies in these same settings, and (3) explore how differences in health information and communication technologies, communication practices, and work relationships between physicians and nurses influence communication.

Methods: This 4-year study uses a sequential mixed-methods design, beginning with a quantitative survey followed by a two-part qualitative phase. Survey results from aim 1 will provide a detailed assessment of health information and communication technologies in use and help identify sites with variation in health information and communication technologies for the qualitative phase of the study. In aim 2, we will conduct telephone interviews with hospital personnel in up to 8 hospitals to gather in-depth information about communication practices and work relationships on medical-surgical units. In aim 3, we will collect data in 4 hospitals (selected from telephone interview results) via observation, shadowing, focus groups, and artifacts to learn how health information and communication technologies, communication practices, and work relationships affect communication.

Results: Results from aim 1 will be published in 2016. Results from aims 2 and 3 will be published in subsequent years.

Conclusions: As the majority of US hospitals do not yet have HIT fully implemented, results from our study will inform future development and implementation of health information and communication technologies to support effective communication between nurses and physicians.

No MeSH data available.