Things to Consider Before Buying a Clinical Information System
Clinical information systems come in many different shapes and sizes to fit the different needs of different EDs. Managers must be sure to understand the needs of the department before making this kind of investment. Here are some key issues to consider when selecting a clinical information system.
Do your homework. Managers must carefully evaluate what the needs of the department are and how a clinical information system will help solve those problems, says Molly Ciliberti, RN, Clinical Specialist with Orca Medical Systems in Bothel, WA. If there are flaws in the department's design, or the department is understaffed, a clinical information system is not going to help, she notes.
"Get some kind of feel for the department," she advises. "What are you trying to accomplish? Set goals, then look at the goals realistically."
Jackie Hjelm, RN, MSN, a Clinical Consultant with Logicare Corp. in Eau Claire, WI, suggests department managers make a list of their needs before beginning to look at a particular system.
"Once you understand what your needs are, then you can start identifying vendors who can match solutions to your needs," she says.
Consider the hidden costs. In addition to the money spent on the information system and the computer hardware to go with it, there are some other costs to consider before jumping in, say both Ciliberti and Hjelm.
"There are training costs and maintenance costs," explains Ciliberti. "What happens when someone shows up to work on a Saturday night. She’s a per diem nurse who has never worked in the department before. How long will it take to bring her up to snuff so she can function in my system? Know at the same time that the person who is training her is also not seeing patients, it’s Saturday night and I am up to my eyeballs in patients."
Don’t computerize as part of overall redesign. Implementing a new information system is a huge effort in itself and would be overwhelming in combination with a structural redesign, says Ciliberti.
"It’s just too much change. It will drive people crazy," she says.
Ciliberti also recommends forming coalitions within the hospital before looking for a vendor.
Input from the hospital’s information systems staff and the forms committee is essential when starting the process, she adds. "You will have to get along with IS to make this work. Medical records [department] needs to be a part of the process, because we are going to change the way they do business,’ Ciliberti says. The forms committee needs to know because you will use different forms.’
Decide on the process. Many departments decide to send an RFI (request for information) to several vendors as a first step in looking for a clinical information system.
"What you are going to get is a lot of information," says Ciliberti. "Find out what's out there."
The RFI should include a description of the department and what it's needs are. Managers can then go to their peers for more detailed information.
"Go to the ENA or ACEP meetings, the big ones, and fine tune it," she says. "You may hear from 100 different vendors, but there may be only five that actually do what you want."
The department can then send out an RFP to the five or six vendors with systems that most closely match the ED’s needs.
Ciliberti recommends having the vendors come into the department for a tour and a question/answer session with the staff.
"Putting a clinical information system in your hospital is equivalent to having your house remodeled," she explains. "Would you have someone come in and redecorate your house without first letting them into your house or telling them about yourself?"
Ensure a good relationship with the vendor. Buying a clinical information system means a long-term involvement with the vendor, says Hjelm. Buyers should expect a product that offers new services to meet changing needs.
"You should look for a vendor that matches solutions to the needs, not just features to the needs," she says.
Both consultants say it’s important to obtain information about the company’s history and financial stability.
Unfortunately, says Hjelm, many vendors come and go in this market. "You need to assess the vendor’s ability to stay in business."
One way to evaluate the vendor is how long the product has been on the market and how many customers it has, she says.
[Note: The Informatics Manual, a publication designed to guide ED managers in selecting a clinical information system is available through the Emergency Nurses Association, 216 Higgins Road, Park Ridge, IL 60068. Telephone: (800) 798-1822.]
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