The Role of Nurses in Hospital Implementation of Electronic Health Records (EHR)
The rising number of deaths due to medical errors have necessitated the implementation of Electronic Health Records (EHRs), to improve safety and care in hospitals. In a report by the Commonwealth Fund, the United States ranks amongst the least satisfactory when compared with other first world countries on the issue of medical safety. Automating hospital data will help improve documentation for efficiency and may also prevent or reduce medical errors due to incorrect information.
Government Incentives
Studies have shown that there is a direct link between Electronic Health Records and improved medical office documentation, as well as reduced errors in diagnosis, medication and treatment. As a result, the government has ramped up EHR implementation in hospitals through an incentive program. As of May 2015, over $20.5 billion and $9.7 billion in EHR-related payments have been made for Medicare and Medicaid, respectively.
However, government-imposed regulations and standards must be met by implementation of EHR in hospitals, as well as third party health information technology (HIT) vendors which are offering EHR-related services and products. This limits the opportunity for advanced customization in order to fully suit the needs of the hospital. Fortunately, in most cases, customizing the program isn’t necessary. Effective training is actually the key to optimal performance with EHR systems.
“The United States ranks amongst the least satisfactory when compared with other first world countries on the issue of medical safety.”
More EHR Benefits
Apart from the usual advantages associated with implementing electronic health record programs, EHR is a gold mine for data. This data can be easily accessed by hospitals and used, not only for the facilities’ local records, but for medical research as well. Patient charts and department drawers are reliable sources, but EHR provides a way to instantly access the same information, making the process even more efficient.
For non-risk and OPD patients, e-prescription is also made possible through EHR. Doctors can just refer to a patient’s existing records in order to prescribe medication via email. This consumes less time for the physician and the patient.
The possibilities are endless, when using the innovations of EHR.
The Role of Nurses in EHR
A survey in 2014 revealed that 34% of doctors who utilize EHRs were unsatisfied with their system. The percentage dropped from 62% in 2010. According to a similar research, even nurses were not convinced by EHR utilization. Only 26% made positive remarks. A shocking 94% from the same specimen group thought that EHR doesn’t improve communication among fellow staff members and 90% were worried that it has actually damaged their ability to communicate with patients. This is because 98% of the respondents were never consulted for the facility’s Electronic Health Records system.
“26% of nurses are not satisfied with their EHR system because 98% are not consulted during the process of planning and designing the system.”
Because most nursing college courses in the past decade have incorporated Electronic Health Record training into their curriculum, younger nurses will likely find no trouble adjusting to EHR systems. Veteran employees, on the other hand, may be challenged by the technological changes, especially when they are not consulted prior to implementation.
Furthermore, older staff are often technologically challenged. Hospitals which assume that everyone is tech-savvy because it’s the Internet age, will certainly find nurses who are dissatisfied with EHR as a whole.
So, in order to overcome such issues and allow EHR to work its magic, computer literacy should be addressed. Nurses must also be involved throughout the entire process of planning, designing and implementing an Electronic Health Records program.
Nursing Informatics
Information technology for healthcare purposes isn’t exclusive for IT professionals. Even nurses are involved with medical technology. In fact, there is a field for nursing informatics now. Informatics nurses and informatics nurse specialists work closely with clinical nurses, as well as nurse executives, managers and shift leaders in order to design, develop, test, implement, and optimize EHR solutions for the workplace. Since clinical nurses have direct access to patient care, they can relay relevant first-hand experience about specific hospital departments and units to informatics nurses.
Step-by-step EHR Guide
Before launching the EHR system, here is a good step-by-step guide:
“EHR should include the following stages: planning, adaptation, installation, implementation, evaluation, and maintenance.”
- Planning. What is the ultimate goal? In most cases, it is a drive toward productivity and efficiency by simplifying medical administration, documentation and data recording.
- Adaptation. How will this affect the usual workflow, scheduling and other aspects of a nurse’s usual shift?
- Installation and Implementation. A simulation will help, in addition to the usual training session prior to launch. Technical installation can be performed by the hospital’s local IT or with the aid of externally hired services. There are expert agencies which focus on EHR-related products. This can be the same agency or company which will work on the technical aspect of building the system.
- Evaluation, Optimization, and Maintenance. The effectiveness of the program must be tested after installation and implementation, using methods like surveys of hospital staff, as well as patients. Maintenance can be performed by trained specialists, which might be internal employees or external agencies.
Electronic Health Records, like any other Health Information Technology options, offer advantages, which also come with issues; but with a more effective and efficient medical records system, the benefits certainly outweigh the barriers.
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Article Sources:
- LWWW Journals by Wolters Kluwer
http://journals.lww.com/nursing/Fulltext/2015/10000/Clinical_nurses_lead_the_charge_with_EHR.8.aspx - Capterra Blog
http://blog.capterra.com/nurses-vs-ehrs-why-nurses-need-to-be-included-in-ehr-planning/ - University of California San Francisco (UCSF) School of Nursing
https://scienceofcaring.ucsf.edu/patient-care/nurses-adopt-electronic-health-records
