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The Effect of Information Technology on Nurses and Patients in the Veterans Health Administration

About the Program

In the late 1990s, the Veterans Health Administration (VHA) implemented two major information systems to enhance record-keeping and quality of care. The Computerized Patient Record System (CPRS), phased in over the past decade, consists of a comprehensive electronic patient medical record, including outpatient and inpatient services. The Bar Code Medication Administration (BCMA) system, which was in all VA medical centers by 1999, created a computerized pharmacy ordering, distribution, and administration system for use in the inpatient setting. These two systems are among the largest investments in information technology in the hospital industry over the past decade, and the VA has been a leader in implementing information technology.

The VHA's implementation of CPRS and BCMA offers a unique opportunity to study the effects of information technologies on hospital staff and patients in the largest hospital system in the United States. In the hospital setting, new information technologies have an important relationship with nursing staff. Nurses are responsible for the majority of inpatient bedside care, recordkeeping, and administration of medications. Thus, this study will focus on the effect of CPRS and BCMA on nursing staff. In particular, we will examine the effects of CPRS and BCMA on hours worked by nursing staff and adverse events experienced by patients. The experience of a large diverse system like the VA, with a wide mix of rural, urban, teaching, community hospitals, will provide valuable information about the issues surrounding new information systems for hospitals in the private sector.

This project is a joint effort of researchers at the University of California, San Francisco and the Veterans Health Administration's Health Economics Research Center.

Funders:

The Robert Wood Johnson Foundation
The Gordon and Betty Moore Foundation