Maximizing Healthcare Professionals’ Use of New Computer Technologies in a Small, Urban Hospitalʼs Critical Care Unit

Abstract

INTRODUCTIONThe past decade has witnessed a tremendous increase in technology use in hospitals and healthcare centers, due, in part, to a 2004 federal mandate calling for nationwide electronic health record (EHR) adoption (Kirkley & Stein, 2004). According to the Centers for Medicare & Medicaid Services (CMS), 2014 was the last year for eligible providers and hospitals to initiate their participation in the Medicare & Medicaid EHR Incentive Program. In 2015, adjustments to reimbursements began for those that are not meaningful users of EHR technology as defined by the Health Information Technology for Economic and Clinical Health Act of 2009 (CMS, 2016).Health professionals-nurses, medical assistants, and allied health professionals for the purposes of this article-must understand that converting to EHRs is not a choice but a necessity an issue that is still prevalent in some small, urban hospitals. Healthcare staff members are expected to use new computer technologies to better serve their patients, increase productivity, and generate proper reimbursement for their organizations (Blumenthal &, Tavenner, 2010; Fetter, 2009). Their positive contributions to EHR implementation sharpen the focus of the entire organization on patient care (Kirkley & Stein, 2004).Transitioning from paper to EHRs is slow in most healthcare institutions because it requires resources, availability, and workforce training (George, Garth, Fish, & Baker, 2013). Haughom, Kriz, and McMillan (2011) state that new computer technology implementation in any organization has its problem points, especially in settings with hundreds of physicians and healthcare professionals. Moreover, they note that users' attitudes, perceptions, and satisfaction with new technologies influence implementation more than the technologies' design or efficiency does. George et al. (2013) point to the importance of leaders in making sure staff understand the organizational, social, and technological issues related to using new technologies. Meibner and Schnepp (2014) note that equipment availability in the patient care units and technical functionality of the equipment are important factors in the implementation of new technology. Lack of technical support, malfunctioning equipment, and unspecific issues regarding general maintenance matters may increase feelings of frustration and uncertainty in using new technology and therefore delay implementation (Meibner & Schnepp, 2014).Despite the increase in new computer technologies in healthcare and the pressure from the federal government to change from paper to electronic documentation (Huryk, 2010), few studies have been conducted on effective ways to engage staff in the implementation of new computer technologies, particularly in a critical care unit (CCLI) of a small, urban hospital-the focus of this article, CCLIs have unique challenges regarding technology implementation because they are, by nature, data intense (De Georgia, Kaffashi, Jacono, & Loparo, 2015).COMPUTER TECHNOLOGY ADOPTION CHALLENGES IN CCUsTo frame the present study, Davis's (1989) technology acceptance model was used, as it remains a valid means to explain how CCU healthcare professionals perceived usefulness and ease of use of new technologies. The CCU at the small, urban hospital under study has a capacity of 260 acute care beds and approximately 85 healthcare professionals on staff. The unit needs to begin participating in the Medicare & Medicaid EHR Incentive Program. At present, some computer systems in the CCU are designed to save staff time by eliminating phone calls. For example, requests for beds, transporters, housekeeping, maintenance, radiology, and so forth are entered in the hospital's main computer. When received by the designated department, the requested tasks are delegated, thus avoiding the need to make phone calls to different departments. Another computer system enables staff to print forms. …