A Roadmap for Evaluation and Return On Investment for a Clinical Documentation System In a Pediatric Critical Care Setting

Author: Dawn M. Shelton

Primary Advisor: Curtis Kennedy, MD (co-author), BCM-TCH

Committee Members: Craig W. Johnson, PhD

Masters thesis, The University of Texas School of Health Information Sciences at Houston.

This paper demonstrates the theory of medical informatics evaluation and principles of Return on Investment (ROI) as they relate to the implementation of a critical care documentation system. These are applied to the pre-implementation phase of the Picis system at Texas Children's Hospital (TCH). The purpose of this formative evaluation is to provide strong baseline data in order to assess the future impact of the system. User needs and organizational goals help identify project metrics. There are three: nursing time observations, nursing attitudes towards computers, and quality of documentation. We selected or created validated methods and instruments to assess metrics. The results show nurses spend 25^^25 of their time on clinical documentation and 32^^25 on direct patient interactions. They have positive attitudes on the impact of computers on nursing. Quality issues could not be analyzed due to a limited data set. Strong baseline data is needed to support organizational decisions.