Rhonda D. Squires, PhD, APRN-BC, FNP


Topics in Advanced Practice Nursing eJournal. 2009;9(3) 

In This Article

Selection of ECL Systems

Whether selecting an ECL for the first time or reevaluating the use of a current program, a systematic approach is critical for satisfaction and success of the product in the educational setting. Selection steps include:

  1. Identification of the decision makers;

  2. Identification of desired functionality or goals for use of the system;

  3. Selection of potential products/vendors;

  4. A request for proposal;

  5. Product demonstrations;

  6. Rating of the products/vendors;

  7. Site visits; and

  8. Final selection of a product.

Functionality of ECL Systems: What We Want

Identifying the functionality attributes of an ECL system can assist in prioritizing needs. Some of the attributes to consider include:

  1. Results reporting -- individual and aggregate (student, preceptor, site);

  2. Access options -- Web-based (PDA, smartphone, computer), server;

  3. Search capabilities;

  4. Security -- audit trails, user access hierarchy, passwords;

  5. Health Insurance Portability and Accountability Act (HIPAA) compliance;

  6. Clinical decision support;

  7. Alerts (data entry errors, educational reminders);

  8. Other priority decision points -- affordability, compatibility, interoperability, and data stewardship; and

  9. Data entry -- central administration or course administration, student, faculty, preceptor; method (typing, tapping/drop-down lists, voice input).

A key function of an ECL system, and an important consideration in the selection process, is the different types of data that can be captured in data fields. Options for data fields include the student's clinical experience with patients (patient demographics, clinical information, diagnoses, and interventions), student progress (clinical role, level of responsibility in the patient encounter, clinical and professional skills, clinical hours, and evaluations), preceptor information (certification, licensure, specialty, résumé, contact information, placement history, and evaluations), and clinical site data (contact information, placement history, and evaluations).

ECL Products: Where to Find Them

The selection process continues with the identification of potential products to review and finding the vendors who sell them. Health professional ECL tracking systems that are currently available are listed in Table 1.

Table 1. Electronic Clinical Log Tracking Systems Currently Available

Marketed to nursing education programs:
  • e-Logs  https://www.elogs.org

  • E*Value  https://www.e-value.net/index.cfm

  • HandEchart, Clinical Log  https://www.ddhsoftware.com/handechart.html

  • TyphonGroup  https://www.typhongroup.com/products/ahst.htm

  • Advanced Nursing Practice Encounter Log  https://www.nonpf.com/publicat.htm

Marketed to medicine residency training programs:
  • Patient Tracker  https://www.patienttracker.com/

  • New Innovations, Inc.  https://www.new-innov.com/pub/

  • Patient Log  https://www.acgme.org/residentdatacollection/documentation/information.asp

  • T-Res  https://www.t-res.net/PublicWeb/Presentation/Welcome.aspx

  • IUSM MS3 Skills Checklist  https://handheld.softpedia.com/get/Health/Utilities/IUSM-MS3-Skills-Checklist-for-HanDBase-32129.shtml

  • Rural Procedure Log  https://handheld.softpedia.com/progDownload/Rural-Procedure-Log-OB-GYN-for-HanDBase-Download-33255.html

  • E*Value  https://www.e-value.net/index.cfm

University-developed programs for nursing education:
  • CWebLog  https://cweblog.usuhs.mil/

  • E-SEL, EncounterIt  https://missinglink.ucsf.edu/encounterit/

A request for proposal (RFP) tells prospective vendors what they need to know about your educational setting to provide you with useful information about their products. The use of an RFP outline, as suggested in Table 2, will allow you to more readily compare vendors and products.

Table 2. Request for Proposal Outline for Electronic Clinical Log Tracking Systems

  1. Cover Letter

  2. Introduction and selection process with timelines

  3. Background information about your school of nursing (SON)

    • Size and location

    • Current electronic tracking system

    • Current Network information

  4. Your SON's desired electronic tracking system's functionality (prioritzied)

  5. Vendor Information

    • Company history

    • Number of employees (separate numbers for sales, support, research and development, and management)

    • Financial statements

    • History of their product

    • List of all current users and users similar to your SON in size and type, and how long they have been using the product

  6. Product Description

    • How it performs/functionality

    • Other functions

    • Product brochures, Website demonstrations, etc

  7. Hardware and network requirements

  8. Customer maintenance and support

  9. Vendor training

  10. Implementation plan

  11. Interface history and capabilities

  12. Proposed costs and payment schedule

  13. Warranties

  14. Sample contract

Data from Adler K.[8]

Rating ECL Systems: Which Is the Best?

Decision-making can be challenging given the variable product capabilities and effectiveness of the vendors' sales teams. A systematic review of the products and vendors should include:

  • Ability to meet the RFP functional requirements as evidenced by the response to the RFP and subsequent demonstration of the software;

  • Ability to provide a cost-effective solution that meets the financial goals of the school of nursing and the students;

  • Ability to provide timely software modifications and upgrades in response to changing educational needs, accreditation requirements, and emerging technology;

  • Demonstration of expertise and functionality as evidenced by client references and site visits; and

  • Ability to provide a superior level of customer service and technical support, both preinstallation and post installation, to clients as evidenced by references.

Implementation of ECL Systems

During the implementation phase, it is critical to have an information technology (IT) specialist or faculty project manager with IT skills and a project faculty champion who is well respected, a good communicator, and a tireless supporter of the new technology. Most technology implementations use a "train the trainer" approach. A group of trained power users are selected for their accessibility and ability to learn new technology so that they can train and support the end users. Students are not only end users but are helpful in training other students formally and informally. Training for end users is best accomplished no earlier than 2 weeks prior to the go-live date so that new skills are not forgotten. Using sound change management principles additionally ensures success.


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