Nursing Information Systems – Vendor Market Analysis
Introduction
 Healthcare
informatics can be broken down into two main categories of clinical and
administrative systems. Within the subset of clinical systems is the nursing
information system, which deals with the specific needs of nursing care
documentation. The nursing field plays an important role in the documentation of
the patient’s condition, and with proper training computer-based entry has been
shown to improve this documentation (Mahler, Elske, Wagner, Tautz, Torsten,
Hoppe & Eichstaedter, 2007). Creating a software product that can be
successfully implemented in broad scope requires the creation of standardized
languages and patient centric processes. The two pieces of software reviewed and
analyzed for these characteristics were EpicCare and VersaSuite.
Standardized Nursing Languages (SNL)
This has been a tenant of software development: if you can’t define something in
a standardized language, it is impossible to create a software product that
allows broad scope input capture (Rutherford, 2008). There are twelve recognized
sets of standardized languages for nursing care: NANDA International, Clinical
Care Classification System (CCC), The Omaha System, Perioperative Nursing Data
Set (PNDS), International Classification for Nursing Practice (ICNP), Systemized
Nomenclature of Medicine Clinical Terms (SNOMED CT), Logical Observation
Identifiers Names and Codes (LOINC), Nursing Minimum Data Sets (NMDS), Nursing
Management Minimum Data Sets (NMMDS), ABC Codes, Nursing Interventions
Classification (NIC), and Nursing Outcomes Classification (NOC) (National
Association of School Nurses, 2012). The NANDA International, formerly known as
the North American Nursing Diagnosis Association is a standard concerning
diagnosis language in nursing care, and currently provides licenses for software
manufacturers to use their off the shelf terminology provided in eXtensible
Markup Language (XML) or Microsoft Access database formats (NANDA International,
Inc., 2013). NANDA International, Inc. provides a listing of software companies
licensed currently to utilize their standardized language for nursing software.
The list only contained one out of the top five software giants in the list of
Healthcare Informatics Magazine’s HCI100 leading in revenue. Both EpicCare and
VersaSuite had an entire webpage dedicated to defining their member affiliate
organizations, although didn’t make note of any of the standard organizations
listed above. It is interesting that no mention was made to any standards of
language for such a large component of the patient documentation workflow.
Patient-Centric Care
 Both
EpicCare and VersaSuite have the capabilities to integrate with voice
recognition software. EpicCare comes with built in voice recognition and
VersaSuite actually requires additional software like Dragon or M Modal, but
boasts compatibility with these vendors including keyboard-free data entry.
Voice as a means of input can be seen as a means to reduce required time away
from patients or increase patient centric care (Marukami, Tani, Matsuda,
Takemoto, Shindo & Inada, 2012). Another important component of patient-centric
care is the testing of products on traditionally limited random access memory
(RAM) of a tablet or mobile computing devices. This is now becoming less of an
issue due to increase in processing power per square unit area chip space,
although interoperability of NIS software on tablet or mobile units is very
important to further allow patient centric care. More data input can be
conducted bedside in a patient care setting. Both software products claim they
have been tablet tested.
Nursing Approved
The choices for electronic NIS solutions were surprisingly not well documented
on the web pages of both vendors analyzed. Such a crucial part of the patient
care documentation workflow should be a large component of the decision process
for IT purchases and I was shocked to see no mention of how the software vendors
had accounted for this through incorporating standardized nursing languages or
other tested approaches. Given the lack of information displayed on the web
pages, it may be best to conduct an interview with a product specialist to
provide a better assessment of specific software aspects.
References
2013 hci100. (2013). Retrieved from //www.healthcare-informatics.com/hci100/2013-hci-100-list
Mahler, C., Elske, A., Wagner, A., Tautz, A., Torsten, H.,
Hoppe, B., & Eichstaedter, R. (2007). Effects of a computer-based nursing
documentation system on the quality of nursing documentation. Journal of medical
systems, 31(4), 274–282. doi: 10.1007/s10916-007-9065-0
Marukami, T., Tani, S., Matsuda, A., Takemoto, K., Shindo, A.,
& Inada, H. (2012). A basic study on application of voice recognition input to
an electronic nursing record system -evaluation of the function as an input
interface. Journal of medical systems, 36(1), 1053-1058. doi:
10.1007/s10916-010-9567-z
NANDA International, Inc. (2013). About our name. Retrieved
from //www.nanda.org/nanda-international-about-our-name.php
National Association of School Nurses. (2012,
June).Standardized nursing languages. Retrieved from
//www.nasn.org/PolicyAdvocacy/PositionPapersandReports/NASNPositionStatementsFullView/tabid/462/ArticleId/48/Standardized-Nursing-Languages-Revised-June-2012
Rutherford, M. (2008). Standardized nursing language: What
does it mean for nursing practice? The online journal of issues in nursing,
13(1), doi: 10.3912/OJIN.Vol13No01PPT05
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