Home and Community Care Digest

Home and Community Care Digest June 2003 : 0-0

What makes a point of care information system effective?

Abstract

When developing or implementing a point-of-care information system (PCIS), greater emphasis and care must be placed upon considering the requirements, capabilities, and limitations of the end-user. Providing care in home settings poses challenges unique from those found in hospital. The user interface is critical to the acceptance and use of the technology, as the human-computer interaction is paramount for day-to-day practice. A successful PCIS should be easy to learn, easy to use in a care setting with the patient present, and customizable by the end-user. The unique information needs and requirements of home health care providers must be carefully addressed for effective use of PCIS.
Background: Use of information and communication technology in home health care settings is increasing, and yet there have been relatively few success stories. Clinicians fear this technology will detract from "hands-on time" for care delivery, interfere with patientnurse rapport, and generally distract clinicians from the patient.. Health care providers using a point-of-care laptop computer for two years commented that while the tool allowed them to work more independently, they found that the computer had driven them to change their practice style, making their day much more unpredictable because of difficulties navigating and accessing clinical information. What are the important elements to the end user of pointof- care information systems (PCIS) in home health care from a clinician's perspective?

Method: Two focus group sessions were conducted including users of point-of-care laptop computers. Participants included home care managers and clinicians. The focus groups were conducted after one and two years of PCIS use.

Findings: Health care providers using a PCIS for two years found that while the tool allowed them to work more independently, it had also driven them to change their practice style. These clinicians found their day-to-day clinical activities unpredictable because of difficulties they had navigating the system and accessing clinical information. Clinical information should be housed in an accessible framework to facilitate timely data capture and retrieval.

In home care, the end-user interface is even more unique because the environment in which the interaction occurs is constantly changing. The user needs access to information technology that is lightweight and portable, has long battery life, and is ergonomic. With the rise of home health care, the ease and structure for entering text is increasingly becoming a more critical aspect of patient care information systems.

Conclusions: The user interface is critical to the acceptance and use of the technology, as the human-computer interaction is paramount for day-to-day practice. A successful PCIS should be easy to learn, easy to use in a care setting with the patient present, and customizable by the end-user. The unique information needs and requirements of home health care providers must be carefully addressed for effective use of PCIS.

Reference: Struk C. The end use of home care computer technology… the clinician. Home Healthcare Nurse 2002; 20(7):466-469.

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