Healthcare Information Technology Trends

I currently work in a small community hospital that is part of a bigger network. We are one of six hospitals spanning 3 hours away in either direction. Being part of a bigger network provides great resources for our facility but is difficult to maintain continuity at times. A few of the other hospitals are in larger cities, while our community has fostered this small, positive hospital since 1911. Family physicians have grown the hospital prior to hospitalists becoming the new thing. We now have telemedicine and consults that are performed from a distance. Nurses that are performing assessments and being the eyes and ears using technology. While for years I have found this to be unsafe and ineffective, I do believe that there is some benefit to this type of medicine. Do I want a cardiologist trusting an LPN to assess my condition and provide concrete evidence? Probably not.

Test results, radiology exams, diagnostic studies, assessments etc are all data/information that is relayed from our mothership. We can provide the services and perform all the required testing, however, the information is sent to the mothership and diagnosed from a distance. Our facility is limited in its specialty practices. Our ED physician can make decisions immediately in the case of an emergency but must consult our mothership where the specialists are located.

Time is of the essence and by taking the time to reach out to our other facilities, lives are at risk. Physicians are properly educated and should be granted the opportunity to treat their patients. If assistance or a second opinion is needed, then our network should be available. Otherwise, let the physicians and nurses do what they do best and “treat” our patients. This also poses a HIPPA issue as well. We should not be accessing records of patients that we are not treating. Patients enter the ED to obtain treatment locally, not at a hospital that is 3 hours away. We form our best assessments by “laying eyes of the patient” when sending information to the mothership, their assessment is based on black and white. How comfortable does that make you feel like a patient? The information, however, would be relayed quickly and efficiently using the integrated system between hospitals.

With the lack of providers in rural areas, legislatures continue to push for the needs of APP’s to practice to their full capability to assist in the curtailment of the shortage while providing quality care to our communities. Physicians are retiring at a record level and there must be providers available to provide medical treatment. Telemedicine could be a benefit in this type of setting to assist APP’s with the diagnosis and treatment of difficult cases. Patients will have the ability to remain at home, get evaluated and treated, and follow up with other physicians, if necessary, with the use of telemedicine. Patients will also have the availability of seeking treatment from well-known physicians in other states without leaving their homes. This is a huge benefit to rural communities that do not have access to the best technological advances in medicine. If utilized as a benefit to the patient and not as a convenience for facilities, telemedicine can provide many benefits such as saving money, efficiently and effectively care for patients, accessibility, etc. I do not believe that this is an end-all to medicine because I am a strong believer in putting your eyes, ears, and hands-on your patients, but it is definitely a benefit to have for quick and effective treatment. The quick treatment will assist in early diagnosis and improvements in patient health and outcomes. If a provider is able to diagnose a heart or lung condition with the use of diagnostic studies and telemedicine, prompt treatment will eliminate the long process of waiting on an appointment while the condition worsens or even worse causes the demise of the patient.

References

Benefits of Telemedicine. Johns Hopkins Medicine. (n.d.). https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/benefits-of-telemedicine.

Brom, H. M., Salsberry, P. J., & Graham, M. C. (2018, March). Leveraging health care reform to accelerate nurse practitioner full practice authority. Journal of the American Association of Nurse Practitioners. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6800077/.

Issues at a Glance: Full Practice Authority. American Association of Nurse Practitioners. (2021, January). https://www.aanp.org/advocacy/advocacy-resource/policy-briefs/issues-full-practice-brief.

Discussion: Healthcare Information Technology Trends
Throughout history, technological advancements have appeared for one purpose before finding applications elsewhere that lead to spikes in its usage and development. The internet, for example, was originally developed to share research before becoming a staple of work and entertainment. But technology—new and repurposed—will undoubtedly continue to be a driver of healthcare information. Informaticists often stay tuned to trends to monitor what the next new technology will be or how the next new idea for applying existing technology can benefit outcomes.

In this Discussion, you will reflect on your healthcare organization’s use of technology and offer a technology trend you observe in your environment.

To Prepare:

Reflect on the Resources related to digital information tools and technologies.
Consider your healthcare organization’s use of healthcare technologies to manage and distribute information.
Reflect on current and potential future trends, such as use of social media and mobile applications/telehealth, Internet of Things (IoT)-enabled asset tracking, or expert systems/artificial intelligence, and how they may impact nursing practice and healthcare delivery.
By Day 3 of Week 6
Post a brief description of general healthcare technology trends, particularly related to data/information you have observed in use in your healthcare organization or nursing practice. Describe any potential challenges or risks that may be inherent in the technologies associated with these trends you described. Then, describe at least one potential benefit and one potential risk associated with data safety, legislation, and patient care for the technologies you described. Next, explain which healthcare technology trends you believe are most promising for impacting healthcare technology in nursing practice and explain why. Describe whether this promise will contribute to improvements in patient care outcomes, efficiencies, or data management. Be specific and provide examples.

I have used electronic medical records (EMRs) and electronic health records (EHRs) interchangeably until I learned they are not the same. Electronic health records focus on the patient’s total health, and they reach out beyond the health organization that initially collected that information (Garrett & Seidman, 2011). Electronic medical records are more localized and more difficult to transparent with other health organizations or practices. Spending years in the emergency department and having the opportunity to be a travel nurse, I have worked with many EMRs. Out of the seven hospitals, I spent time at, only one made it relatively easy to obtain records from outside facilities. Having the ability to look at a patient’s health gave nursing and providers a better picture of the patient and their health. You can track compliance or noncompliance to medications or specialist appointments. Having access to patient records right at your fingertips can help clinicians make swifter diagnoses and get a fuller patient picture, especially when patients may not effectively verbalize their health history or complaints.

A huge challenge with electronic medical records is the possibility of a security breach. Many hospitals and organizations have gone to lengthy measures to ensure a patient’s medical information remains safe and is not accessed by anyone but their care team. For example, many systems have an audit tool that allows tracking who has been in a patient’s chart and what information they accessed (Menachemi & Collum, 2011).

Having an electronic health record has many benefits. With the use of tracking and alerts, physicians can maintain best practices for their patients. It can notify them when a patient’s immunizations are due, notification of abnormal labs, or when a medication was ordered but is contraindicated by an allergy. Physicians who use HER have a lower rate of medication errors such as dosing levels or frequency, which, in turn, aids patient safety (Aldosari, 2017).

The further we can integrate EMRs to EHRs, all providers can quickly obtain quicker patient information in giving the patient the best clinical outcomes. Combining a patient’s entire medical record gives clinicians a better picture of the patient’s health and goals. A comprehensive HER can significantly improve patient outcomes, especially knowing many patients are not privy to their medications or health concerns.

Aldosari, B. (2017). Patients’ safety in the era of EMR/EHR automation. Informatics in Medicine Unlocked, 9, 230–233. https://doi.org/10.1016/j.imu.2017.10.001

Garrett, P., & Seidman, J. (2011, January 4). EMR vs EHR – What is the difference? Health IT Buzz. https://www.healthit.gov/buzz-blog/electronic-health-and-medical-records/emr-vs-ehr-difference.

Menachemi, N., & Collum, T. (2011). Benefits and drawbacks of electronic health record systems. Risk Management and Healthcare Policy, 47. https://doi.org/10.2147/rmhp.s12985

By Day 6 of Week 6
Respond to at least two of your colleagues* on two different days, offering additional/alternative ideas regarding opportunities and risks related to the observations shared.

Interesting point you made about the difference between EMR’s and the EHR. I think most of us use these terms interchangeably, and going forward, I will try to correct that issue. One of the issues with EMR or also patient portals is, in fact, protecting that information from cybercriminals.These types of systems are very appealing to cybercriminals. They contain valuable information, and it is all centrally located while there are many access points into the system. They are also remarkably vulnerable to penetration because of the fluid and always-evolving nature of a patient’s medical care and because of the number of clinicians, facilities, and transactions required to connect patient care across multiple settings.( Koppell & Kuziemsky, 2019) One important difference between the two is. Usually, the EHR’s have simple information like medication lists, patients problems, and demographics. Han, Gleason, Sun, Miller, King, Chow, Anderson, Nagy, & Bauer, 2019). They do not always have a high value in data; however, they can help gain information to access more sensitive information. It is a big responsibility for companies one I wonder if they considered before transitioning over to electronic record keeping.

References:

Han, H.-R., Gleason, K. T., Sun, C.-A., Miller, H. N., Kang, S. J., Chow, S., Anderson, R., Nagy, P., & Bauer, T. (2019). Using Patient Portals to Improve Patient Outcomes: Systematic Review. JMIR Human Factors, 6 (4), e15038. https://doi-org.ezp.waldenulibrary.org/10.2196/15038

KOPPEL, R., & KUZIEMSKY, C. (2019). Healthcare Data Are Remarkably Vulnerable o Hacking: Connected Healthcare Delivery Increases the Risks. Studies in Health Technology & Informatics, 257, 218–222. https://doi-org.ezp.waldenulibrary.org/10.3233/978-1-61499-951-5-218

response 2

Well done with your post. I agree with you you that Electronic medical records are more localized and more difficult to transparent with other health organizations or practices. One of the challenges of using the e-MAR (electronic medical records) is that most healthcare professionals have limited knowledge on how to use the system. My organization has fully implemented electronic health records, with electronic medical administration records (e-MAR) being the most recent addition. The e-MAR is a system designed to aid healthcare providers in the real-time transmission of information while guaranteeing that only authorized employees have access to it. One of the difficulties with using the e-MAR is that most healthcare practitioners are unfamiliar with how to utilize it. New nurses who have never used the system before or who have not gotten proper training may find it challenging to use. As a result, they may enter medicine orders incorrectly into the system.

The two most notable advantages of e-MAR are accuracy and flexibility. In terms of precision, e-MAR reduces medication administration errors. Any order that is mistakenly entered, such as ordering the wrong dose, is flagged or hard stopped by the system. When it comes to flexibility, using Emar eliminates the challenge of finding time to administer medications or organize patient records. It makes it easier to keep track of med passes, which is the procedure of giving medications to patients. A flexible record med pass not only minimizes medication errors, but it also allows employees to focus on other patient-care activities.

References

Alanazi, A., Alomar, M., Aldosari, H., Shahrani, A., & Aldosari, B. (2018). The effect of electronic medication administration records on the culture of patient safety: a literature review. Data, Informatics and Technology: An Inspiration for Improved Healthcare, 223-226.

McGonigle, D., & Mastrian, K. (2021). Nursing informatics and the foundation of knowledge. Jones & Bartlett Publishers.

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