NR 361 Week 2 Graded Discussion: Experiences with Healthcare Information Systems
Share your experiences with healthcare information systems in the past ... [Show More] or present. How have the needs of a diverse patient population been met by your systems? If you were assigned to improve the healthcare information systems or electronic health record, what would you suggest to better meet the needs of all patients and of nurses? Why?
ANSWER
Response:
According to Silow-Carroll , Edwards, & Rodin (2012), “for an EHR system to be used successfully, it must be integrated through a well-designed process and into a receptive culture” (p. 21). In last week’s discussion I shared an experience regarding an incident when Cleveland Clinic first introduced the ESI department to the EPIC ASAP system. The younger nurses, including myself, were excited about its arrival. Senior nursing staff was less optimistic. During an 8-hour EPIC ASAP competency course one senior nurse who had at last 30 years of experience never returned to class after the lunch break. Even though she asked lots of questions she had a negative attitude towards the change. That same nurse put in her retirement shortly after the course and made her exit out 2 weeks before EPIC ASAP went live. Although I believe having EMR improves the workflow of nurses my own personal challenge has been with barcode medication administration systems. “The barcode systems are designed to prevent common medication errors at the bedside, document medication administration, and capture charges” (Hebda & Czar, 2013, p. 117). I’ve found challenges with scanning medications in rounded vials, such as insulin. I often feel like patients think I’m incompetent because I sit there trying to constantly scan a vial repeatedly till the barcode picks up. This can be time consuming, slows me down, and takes away from my patient care. Not to mention if I acquire two many medication overrides in the system I run the risk of receiving a written incidental from my nurse manager. The other challenge I’ve found is that many patients have newer medications that our organization may not carry. Patients are allowed to bring their own medication for administration, however, the medication must be verified by the staff pharmacist and a barcode must be distributed by the pharmacy department for the nurse to scan for administration. This process can be timely.
Since the implementation of the EPIC system in our organization the patient portal MyChart/MiRecord in English and Spanish enable patients to schedule appointments, ask questions of their physicians, view test results, and order prescription refills. Patients appreciate the convenience of being able to contact their physician at any time of day or night. Providers have the ability to send patients post-visit clinical summaries and lab results via an attachment and respond to patient messages in between seeing patients to complete tasks more efficiently and avoid “phone tag” with patients. Also, for the Arabic community our Patient Global Services Department can be contacted to assist the Arabic patients in making follow up appointments, with Arabic physicians if they chose, using the EPIC system before they are discharged from the ER.
There are number of advantages of an electronic healthcare records and these are following (Hebda & Czar, 2013, p. 116):
• It provides the accurate data and up to date data of the patients which seems helpful for their care.
• It helps for the quick access of the records of the patients which seems helpful for the coordinated treatments.
• It helps in improving the productivity thus a very bigger number of patients can be assessed without any confusion.
• It improves the safety and privacy of patients as well it reduces the cost of paperwork.
• Providers entering orders through computerized physician order entry (CPOE) systems eliminates medical errors caused by poor penmanship of physicians and makes the ordering process more efficient because nursing and pharmacy staffs do not need to seek clarification of orders (Menachemi & Collum, 2011, p. 48).
Despite of such advantages the electronic health record also faces some problems like (Menachemi & Collum, 2011, p. 51-52):
• EHR adoption, implementation, and ongoing maintenance can be costly.
• If the system is changed then we need to give training to the number of the staff members causing disruption in workflow in temporary interruption in productivity and extra money paid to staff for training.
• EHRs may cause unintended consequences, such as, negative emotions, changes in power structure, and overdependence on technology
Thus to avoid these we need to develop an integrated system with active involvement by all levels staff in selection, development, implementation and peer education (Silow-Carroll , Edwards, & Rodin, 2012, p. 21). EHR’s can be more effective with ongoing testing and modifying of the systems.
References
Hebda, T., & Czar, P. (2013). Handbook of informatics for nurses & healthcare professionals (5th ed.). Boston, MA: Pearson
Menachemi, N., & Collum, T. H. (2011). Benefits and drawbacks of electronic health record systems. Risk Management and Healthcare Policy, 4, 47–55. Retrieved from http://doi.org/10.2147/RMHP.S12985
Silow-Carroll, S. , Edwards, J., & Rodin D. (2012 July). Using electronic health records to improve quality and efficiency: The experiences of leading hospitals. Retrieved from http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2012/Jul/1608_SilowCarroll_using_EHRs_improve_quality.pdf [Show Less]
