“Vendors are selling their solutions to hospital administrators and IT departments who do not understand clinical workflow. Vendor clinical solutions help enhance patient safety and reduce the risk of medical errors BUT fail to streamline nursing workflow processes,” according to the report. “Nurses interviewed are getting increasingly frustrated that no one appears to be addressing their needs and requirements at point of care.”

The market may be ready for widespread adoption, but there are some internal and cultural issues that need to be solved first. “I don’t see many organizations making big investments because they’ve been burned so badly before,” Spyglass managing director Gregg Malkary tells Digital HealthCare & Productivity.

One unidentified nursing IT consultant from California was quoted in the report as saying, “Nurses are the biggest users of information technology, yet healthcare administrators are focused on the needs and requirements of physicians.” That, the nurse says, is because physicians produce revenue for hospitals, while nurses are viewed in some circles as cost centers.

Unlike many of their physician counterparts, nurses seem plugged into the technology revolution.

Spyglass conducted in-depth interviews with 100 nurses nationwide, in various practice settings, and found that 86 percent of acute care nurses and 94 percent of home health nurses use electronic devices at the point of care, for functions including drug reference, electronic versions of clinical manuals, and medical calculations.

Slightly more than half of acute care nurses surveyed have bar-coding technology at the point of care to help reduce errors associated with patient identification and medication administration. But user satisfaction is low, for a variety of reasons.

“When you put all the things together, solutions are really not usable,” explains Malkary.

Form factors of various point-of-care technologies are not ideal. Personal digital assistants are too small for most electronic documentation, while patient rooms in older facilities were not designed to support bedside personal computers. Mobile computers such as laptops on wheels or tablet PCs offer more flexibility, but battery life, security, and infection control remain concerns.

Additionally, nurses say tablets are just too heavy to carry around all day, and wireless infrastructure remains “immature” and unreliable in many facilities.

“The IT organization is paranoid about HIPAA requirements,” Malkary reports. Automatic logouts certainly help secure data, but -- especially with unreliable wireless connections -- users quickly tire of repeatedly having to log back onto the system. “Once again, the IT organization appears to be out of sync with the informatics people.”

Malkary calls healthcare-specific tablets like Motion Computing’s C5 Mobile Clinical Assistant “a step in the right direction,” but says nursing informatics need to be more involved in technology design, purchasing, and implementation decisions.

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