In an effort to improve patient safety and lower costs, the American government and healthcare system made the massive shift from paper to electronic health records (EHRs) in the early 2000s. Presidents Bush and Obama both facilitated this process by creating the Office of National Coordinator, landmark legislation, and financial incentives and penalties to encourage the use of EHRs, respectively (McBride & Tietze, 2023, p. 155). Although important to the health of the country, this exponential rise in EHR usage did not optimally use the phases of the systems development life cycle (SDLC). The five phases of the SDLC are planning, analysis, design and implementation, system and functionality testing, and implementation, evaluation, maintenance, and support (McBride & Tietze, 2023, p. 177). I do not have firsthand experience of this rapid transition, but I have spoken to nurses who worked during this time. Often, the adjectives used are overwhelming and stressful. They are not alone, as the national quality survey updated their aims to improve the countrys health by including managing clinician well-being and burnout rates in the 2010s because of EHR implementation (McBride & Tietze, 2023, p. 168). So heavy is the burden of a new EHR that reports reveal that some healthcare workers today quit when a new EHR system is implemented (Jedwab et al., 2021). If institutions had thoroughly utilized the SDLC and involved key stakeholders such as doctors and nurses during this process, they could have reduced the level of national burnout. How often do we nurses today have more charting added to our already full plate because of an EHR update or policy change? How frequently do we feel overwhelmed? And we are in the age of 5G internet, mobile applications, and telehealth visits. I cannot imagine that with the well-intentioned but strong push from the government, EHRs in the early 2000s optimized the SDLC.
Were you a nurse during this national transition? What experiences are the most memorable to you during this time?
- Focus on Meeting Government Mandates: The primary driver for EHR adoption was government incentives and penalties, which may have prioritized rapid implementation over a thorough and user-centered approach.
- Limited Nurse Involvement: Nurses, as the primary users of EHRs, were often not sufficiently involved in the planning, design, and implementation phases of the SDLC. This lack of input resulted in systems that were not optimally designed for their workflows and needs.
- Insufficient Training and Support: Many nurses received inadequate training on the new EHR systems, leading to frustration, errors, and decreased efficiency.
- Focus on Meeting Government Mandates: The primary driver for EHR adoption was government incentives and penalties, which may have prioritized rapid implementation over a thorough and user-centered approach.
- Limited Nurse Involvement: Nurses, as the primary users of EHRs, were often not sufficiently involved in the planning, design, and implementation phases of the SDLC. This lack of input resulted in systems that were not optimally designed for their workflows and needs.
- Insufficient Training and Support: Many nurses received inadequate training on the new EHR systems, leading to frustration, errors, and decreased efficiency.