Human Factors Affecting HMS Impact on Nurses Jobs: HMS Impact in Nursing

Human Factors Affecting HMS Impact on Nurses Jobs: HMS Impact in Nursing

Tor Guimaraes (Tennessee Tech University, Cookeville, USA), Maria do Carmo Caccia-Bava (University of Sao Paulo Medical School, Sao Paulo, Brazil) and Valerie Guimaraes (Tennessee Tech University, Cookeville, USA)
DOI: 10.4018/IJHISI.2020010104


To improve and facilitate patient care, hospital administrators have implemented healthcare management systems (HMS). Unfortunately, many hospitals have encountered HMS implementation problems. Some user-related factors have been proposed in the literature as important to system success. This study proposes an integrative model and empirically tests the importance of these variables as determinants of HMS impact on the jobs of nurses. Data from 213 nurses using their hospital HMS has been used to test the relationships between the independent variables and the HMS impact on the nurses' jobs. The results confirm the importance of nurse participation, training, good communication with developers, and lack of conflict regarding system implementation enabling a more desirable effect of HMS on nurses' jobs. Based on the results, recommendations are made for hospital administrators to improve the likelihood of HMS implementation success.
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Healthcare information technology in general has been considered as an important factor to reduce costs and improve the efficiency and safety of the health care sector (Fujino & Kawamoto, 2013; McBride, Delaney & Tietze, 2012). Specifically, Healthcare Management Systems (HMS) provide support to many clinical and administrative activities/tasks in a wide variety of hospital areas such as radiology, anesthesia, pathology, emergency medicine, billing services, appointment scheduling, refunds, etc. Within each of these areas the HMS may also be used to support a wide variety of tasks. For example, in radiology alone it may be used for electronic downloads of patient demographic data and to download radiology reports into HMS billing software, on-line coding of transcribed radiology reports, claim submission, posting of remittance notifications, etc. While some hospitals develop some HMS components in-house, most acquire integrated collections of various HMS software/service components commercially available from many vendors. Therefore, in a given hospital the comprehensiveness of the HMS support can vary widely and so can the difficulty of implementing such systems if managers are not careful about the potential implementation problems (Glaser, 2011; Yamazaki, Ikeda, & Umemoto, 2011). Despite continuous efforts to improve hospital productivity and service quality by using information technology (IT), many system implementation problems remain (Bolan, 2011; Glaser, 2011). Perhaps because of HMS’s integrative nature, they tend to be relatively large, expensive systems, normally dictated from above. These characteristics often lead to unwanted and poorly managed changes. As hospitals’ dependence on information systems increases, so does the need to ensure that they perform according to specifications and/or user needs and wants. Primarily for this reason we targeted HMS in this study.

While the reasons for system failure or less than successful system implementation are many, given the increasing hospital IT expenditures, improving system success is of critical importance (Grenuk, 2011). One issue becomes how to measure system success. The more widely used ways are an extent of system usage, user satisfaction with the system, and benefits derived from using the system, the amount or frequency of system usage, and the impact that specific systems have on end-user jobs. Which one represents the best measure of success depends on the objective of the study. According to the literature, there is an urgent need for understanding the issue of nurse retention and turnover (Currie & Hill, 2012; Nei, Snyder, & Litwiller, 2014); and also why nurses have been relatively slow embracing the use of computer technology while performing their jobs (Cross & MacDonald, 2013). Thus, similar to the motivation of previous studies regarding information systems impact on end-user jobs (Yoon & Guimaraes, 1995; Yoon, Guimaraes, & Clevenson, 1996), we chose it as the dependent variable. If hospital administrators can improve organization performance along the HMS development and implementation user factors leading to more positive impact on nurses’ jobs, that are likely to help improve nurses’ adoption of computer technology in general, and hopefully help improve the problems of nurse retention and turnover mentioned above. Thus, we selected nurses as the subjects for this study.

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