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You will identify how your chosen information management strategy affects the practice of professional nursing. Please explain the implications of the chosen strategy on vulnerable populations. Finally, a discussion of the implications of working in a healthcare setting that employs this chosen information management strategy should be included in this section. For instance, does it improve time management, organizational skills, patient safety, workflow, etc.?

Discuss the evidence that supports the use of the chosen information management strategy in promoting patient safety. Identify patient safety outcomes from the literature that support your chosen information management strategy. Explain how the patient safety outcomes are improved (or could be improved) by using the chosen strategy.

Advantages of EHR Implementation

The information management technology that has been chosen by me for implementation within the hospital setting in order to promote positive patient outcome is the electronic healthcare record system. The electronic healthcare system also known as the EHR, has revolutionised the process of maintain patient record and documentation in the healthcare sector. According to Ajmani and Bagheri-Tadi (2013), an electronic medical record can be defined as an organized and systematic collection of the patients medical health information in the form of a digital format. The digital records can be shared across various healthcare settings. The healthcare records are shared online and the exchange of information is maintained through information networking. As stated by Tanner et al. (2015), EHRs include a wide range of data that includes demographics, medical history, detailed explanation about medication and allergies, status of immunization, laboratory test results and detailed description about the vital signs. In addition to this, it should further be noted that the electronic health records also contain information about the personal statistics of the patients such as the age, height and weight of the patient. Also, it comprises details of billing information and radiology images of the patient. Electronic Health Record maintenance has positively contributed to promote positive patient outcomes. In accordance with current trend, the EHR system is being widely used by the healthcare organizations across the globe. Healthcare providers are proactively making use of the patient data retrieved from the patient records in order to deliver effective care and promote quality outcomes.

The combination of multiple clinical data from the electronic health record system has equipped the care providers to ideally identify and manage chronic illness patients. In addition to this, it should further be noted that EHR has been found useful in improving the quality of care with the use of patient data and analytics to effectively reduce the rate of hospitalization in high-risk patients. As mentioned by Rind et al. (2013), EHR systems have been designed with the purpose of storing data in an accurate manner and critically document the physical as well as mental state of a person across time. The maintenance of EHR eliminates the need to track down the previous records of the patient (Moja et al., 2014). This helps in saving time and also ensures that the patient’s medical records are appropriately organized and is accessible at any instant of time. A number of advantages have been associated with the use of the technology. Firstly, the system reduces the possibility of data replication as the system is based upon a single editable file. This effectively helps in avoiding recording errors and at the same time the file is updated continuously. In addition to this, the digital format of the file saves the risk of losing the hardcopy of a file. Also, EMRs are easily accessible and efficiently extract medical data facilitates convenient extraction of medical data prior to a diagnostic test. At the same time, EHRs also help in convenient maintenance of population-based medical health data.

Disadvantages of EHR Implementation

Quality healthcare refers to the provision of patient safety practices in order to ensure protection of the patients from potentially preventable harm related with the healthcare services (Ajami & Bagheri-Tadi, 2013). Electronic medical records ensure quality and safety of the healthcare facilities provided with respect to traditional paper records (Middleton et al., 2013). It serves as an informative analytical tool for the patients as well as the clinicians to access patient history. It should further be noted in this regard, that EHRs offer an integrated best-practice support system for the maintenance of electronic clinical decision support. The clinical decision support offers general as well as person-specific information to the concerned care teams (Meeks et al.,2014). The information provided is organized and can be appropriately filtered. This improvises the care outcomes by making the information timely accessible and facilitates strong decision making framework.

The use of electronic health record system to record and document patient data has been associated with a multitude of advantages within the healthcare context. According to Meeks et al. (2014), it has been mentioned that the implementation of EHR within a healthcare organization facilitates clinicians to record information about the patients in an easier and effortless manner. At the same time, the clinicians are also equipped with the facility to follow the patients stringently from one point of the care to another point of care. Also, studies reveal that the application of EHR facilitates functions that are automated and does not require manual operation. This increasingly helps in acquiring positive patient outcomes and ensure assed patient security. EHR implementation thus promotes electronic prescription for the patients, perform stringent checks on Drug-Drug interactions and Drug-allergy interactions (Ajami & Bagheri-Tadi, 2013). As stated by McCoy et al. (2013), the advantages associated with the implementation of electronic health record technology within a healthcare system can be enumerated as follows:

  • It provides organized, appropriate, updated and complete information about the patients at different points of care
  • It provides an easy access to the patient records and positively promotes in the delivery of an efficient and coordinated care
  • It ensures patient privacy and secures the sharing of the patient related information between the patient and other related healthcare professionals
  • It helps in effectively diagnosing a patient and reduce medical errors to render safer care
  • It improves the quality of interaction between the patients and the concerned healthcare professionals
  • It helps in the maintenance of accurate patient billing
  • It promotes reliable medical prescribing
  • It ensures improved productivity of the professionals and help in fostering work-life balance
  • It enables healthcare providers to efficiently meet business goals
  • It facilitates reduction in costs fostered through decreased paper work and improved health outcome

On the contrary, as mentioned by Lusignan et al. (2014), implementation of EHR has also been associated with a number of disadvantaged that include the following:

Patient Privacy and security issues: Electronic health care data is sensitive to cyber-crimes such as hacking and stealing of patient information. This proves that the patient data could potentially be used in an inappropriate manner

Presentation of inaccurate information: On account of the dynamic nature of the EHR professionals must update the information spontaneously after the patient visit. This is important to ensure that allied health professionals do not rely upon inaccurate and un-updated data to prescribe treatment intervention.

Ethical and Legal Implications

Unwanted anxiety in patients: As the electronic healthcare record is accessible to the patient, there might be a possibility when the patient misinterprets a data file. This can lead to the cause of stress and unwanted anxiety in the patients.

Malpractice and corresponding Liability Concerns: Electronic medical records often pose a problem related to liability issues. It could lead to the dearth of a medical error during the transition of patient data from appear to the system. Therefore, it can be said that the implementation of the process should follow a standard protocol and should be monitored stringently in order to avoid the possibility of committing a medical error.

It should be stated in this regard that a number of ethical and legal implication issues have been associated with the implementation of the EHR across healthcare organizations. The ethical issue involved in the implementation process is ‘beneficence’ and it emphasises on the fact that the patient raw data would constructively facilitate public health research to improvise treatment strategy and promote positive patient outcome. The implication on the other hand include, the development of a research data base to reinforce positive outcome. The high cost of EHR systems to accumulate population data which would ensure benefit to the society on a long term basis (Kwan et al., 2013). The legal issues on the other hand, includes the consideration of ethical laws of data sharing. Also, the legal implications involve the adverse consequences of cyber-criminal laws on infringing patient security and privacy management. Care providers must comply with the legal framework of patient security that includes (Improved diagnostics & Patient outcomes, 2017) ,

  • The right information privacy
  • The right to maintain confidentiality, and
  • The right to information security

According to DesRoches et al. (2013), it has been stated that the implementation of the healthcare record system helps in improving the health status of a vulnerable set of population. A research study stated that the quality of care provided to patients with chronic illness such as Diabetes had significantly improved after the successful implementation of the electronic health record system. Research studies, further predicted that implementation of the system saved the time of patient documentation and the care professionals could devote more time to care for the needs of the patients who are dealing with long term illness. As mentioned by Coorevits et al. (2013), EHR also helps in improving self-reporting of cases dealing with abuse, neglect and other patient concerns that are aligned to human rights. This equips healthcare professionals in prioritizing patient care and the designing of treatment routine to address the need of the patients. It should further be noted in this context, that the implementation of health record system to manage old age patients facilitate awareness, self-efficacy and empowerment about managing disease conditions independently (Chen et al.,2013).

Studies show that implementation of the electronic health record system has effectively helped in improving service quality with respect to management of human resources, workflow, medical health policies and work culture (Bowman, 2013); (Chen et al., 2018). The inclusion of the information management system within the ambulatory and emergency department of the hospital has significantly been associated with positive outcomes. The major areas where the use of the electronic health care record system has proved to be beneficial include, reduction in medication error, diagnosis error, administrative management errors and communication errors. Primary issues such as documentation of incorrect dosages, inappropriate handling of patient sample for laboratory tests, misdiagnosis, delayed communication and intimidation, failure to preserve patient information and improper handling of patient information have been accounted as major faulty concerns in an emergency department. It should be critically noted, in this context that within emergency and ambulatory settings, the positioning of different departments such as diagnostic and administrative unit is widely spaced from the primary care unit. This leads to commotion within the health care setting. It also, includes a possibility of communication error or delayed intimidation to the multidisciplinary health care units that might be working together to provide care to the patient (Moja et al., 2014). Research studies state that successful implementation of electronic medical records help in the maintenance of effective communication (Middleton et al., 2014). It also helps in ensuring patient safety by detecting incidences of missed diagnoses and generating diagnosis error alert notifications to make care providers aware about the medical error.

The Health Information Technology for Economic and Clinical Health Act has revolutionised the health care sector with the introduction of electronic health records. The implementation has rendered a positive implication on the nursing professional practice (Chen et al., 2018). Studies reveal that, hospitals that implemented the system had nursing professionals who were able to handle work pressure efficiently. The system also ensures the protection of the healthcare workers during the instances of patient-nurse liability issues (Tanner et al., 2015). Studies also mentioned that nursing professionals found it easier to collect and record patient data. In addition to this, it has also been mentioned that hospital settings that witnessed organizational change or problematic decision making, the implementation of EHR promoted improved nurse-physician relationships, positive practice culture and effective administrative support (Rind et al., 2013). The implication of the system within the nursing professional practice would require nursing professionals to be on the frontline while communicating with the patients and the family members of the patients. In addition to this, it would require nurses to remain updated with the application of the technology and accordingly educate the patients about the use of technology. Studies further indicate that the use of electronic medical records help in the sequential maintenance of data overview, medication safety, management of handoffs and transitions and improving competency in order to foster effective care.

According to Tanner et al. (2015), it has been stated that the use of EHR helps in providing positive and holistic care to the vulnerable population set. The findings of the research study indicated that the implementation of the system yielded positive outcome on older patients. The Aged Care unit typically comprises of patients aged 60 and above who are diagnosed with long-term illness that require critical care. Studies show that the healthcare organizations that have implemented EHR can substantially address the physical as well as the mental health needs of the target audience (Health Information, 2017). It can be mentioned in this regard, that automated documentation and recording of patient facilitates appropriate diagnosis that further helps in devising a satisfactory treatment routine. Also, it saves time for making appropriate referrals and reduces the chances of medical errors. In addition to this, the primary care physicians and nurses do not need to invest time on recording patient history and tracking medication that could possibly elicit an allergic reaction and negatively impact the health of the client. The medical record efficiently presents the list of medications that the patient could be allergic to and this sufficiently reduces risks related to misdiagnosis of disease conditions (Ajami & Bagheri-Tadi, 2013).

It has been estimated that almost 94% of the healthcare service providers have stated that maintenance of electronic health record system has proved to be extremely beneficial to promote quality patient outcomes (Kwan et al., 2013). According to Lusignan et al. (2014), the implementation of EHR within the healthcare system effectively generated a 35% reduction in the rate of medical error and misdiagnosis. At the same time, it should also be noted that the implementation was tightly linked with increased satisfaction level of the patients post treatment. At the same time, care professionals reported smoother communication flow and positive patient outcomes within a hospital setting.

On the basis of the discussion above, it can be said that the inclusion of electronic health record system would facilitate increased patient safety, better access to care and positive patient outcome. However, it should be noted in this context that the use of the system must be stringently supervised or monitored so as to ensure quality outcome while dealing with a set of vulnerable population. For instance, while dealing with elderly patients, it is important to consider the background and the technological aptitude of the patients while proceeding with the treatment regimen. On a general bases, elderly patients find it difficult to manage electronic health records and often seek help from others to interpret and manage data. This leads to cases of fraudulences where the patient data is used in an unethical manner. Therefore, I believe that the system should be equipped with some form of feature to make it feasible for the older people to use it. The feature could accessing the application with the use of voice command or include a short term training to the patients about the use of the application by a care professional.

As a nursing professional, I stringently believe that the use of electronic healthcare record to store and maintain patient data has made the process of documentation extremely convenient. It has effectively reduced the possibility of committing medical error and has saved a major proportion of time. However, I feel the system should be constantly monitored to upgrade the security so as to foster patient privacy and avoid mismanagement and unethical use of the confidential data of the patients.

References:

Ajami, S., & Bagheri-Tadi, T. (2013). Barriers for adopting electronic health records (EHRs) by physicians. Acta Informatica Medica, 21(2), 129.

Bowman, S. (2013). Impact of electronic health record systems on information integrity: quality and safety implications. Perspectives in health information management, 10(Fall).

Chen, J., Malani, P., & Kullgren, J. (2018). Patient portals: Improving the health of older adults by increasing use and access. Health affair blogs. Retrieved https://www.healthaffairs.org/do/10.1377/hblog20180830.888175/full/.

Coorevits, P., Sundgren, M., Klein, G. O., Bahr, A., Claerhout, B., Daniel, C., ... & De Moor, G. (2013). Electronic health records: new opportunities for clinical research. Journal of internal medicine, 274(6), 547-560.

DesRoches, C. M., Charles, D., Furukawa, M. F., Joshi, M. S., Kralovec, P., Mostashari, F., ... & Jha, A. K. (2013). Adoption of electronic health records grows rapidly, but fewer than half of US hospitals had at least a basic system in 2012. Health Affairs, 32(8), 1478-1485.

Health Information. What can you do to protect your health information. (2017, September 5). Retreived https://www.healthit.gov/topic/privacy-security/what-you-can-do-protect-your-health-information.

Improved-diagnostics & Patient outcomes. (2017, October 12). Retrieved https://www.healthit.gov/topic/health-it-basics/improved-diagnostics-patient-outcomes.

Kwan, J. L., Lo, L., Sampson, M., & Shojania, K. G. (2013). Medication reconciliation during transitions of care as a patient safety strategy: a systematic review. Annals of internal medicine, 158(5_Part_2), 397-403.

Lusignan, S., Mold, F., Sheikh, A., et al. (2014). Patients’ online access to their electronic health records and linked online services: a systematic interpretative review. BMJ Open. Volume 4, issue 9. Retrieved https://bmjopen.bmj.com/content/4/9/e006021.citation-tools.

McCoy, A. B., Wright, A., Kahn, M. G., Shapiro, J. S., Bernstam, E. V., & Sittig, D. F. (2013). Matching identifiers in electronic health records: implications for duplicate records and patient safety. BMJ Qual Saf, 22(3), 219-224.

Meeks, D. W., Smith, M. W., Taylor, L., Sittig, D. F., Scott, J. M., & Singh, H. (2014). An analysis of electronic health record-related patient safety concerns. Journal of the American Medical Informatics Association, 21(6), 1053-1059.

Middleton, B., Bloomrosen, M., Dente, M. A., Hashmat, B., Koppel, R., Overhage, J. M., ... & Zhang, J. (2013). Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA. Journal of the American Medical Informatics Association, 20(e1), e2-e8.

Moja, L., Kwag, K. H., Lytras, T., Bertizzolo, L., Brandt, L., Pecoraro, V., ... & Iorio, A. (2014). Effectiveness of computerized decision support systems linked to electronic health records: a systematic review and meta-analysis. American journal of public health, 104(12), e12-e22.

Rind, A., Wang, T. D., Aigner, W., Miksch, S., Wongsuphasawat, K., Plaisant, C., & Shneiderman, B. (2013). Interactive information visualization to explore and query electronic health records. Foundations and Trends® in Human–Computer Interaction, 5(3), 207-298.

Tanner, C., Gans, D., White, J., Nath, R., & Pohl, J. (2015). Electronic Health Records and Patient Safety. Applied clinical informatics, 6(01), 136-147.

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