DNP 805 Topic 2 DQ 1 Discuss the usefulness of the electronic health record (EHR) and its impact on patient safety and quality outcomes

DNP 805 Topic 2 DQ 1 Discuss the usefulness of the electronic health record (EHR) and its impact on patient safety and quality outcomes

Topic 2 DQ 1

Apr 21-23, 2022

Discuss the usefulness of the electronic health record (EHR) and its impact on patient safety and quality outcomes. Describe strengths and limitations that might apply to its usage.

REPLY TO DISCUSSION

A variety of electronic methods have been used to integrate health information technology into the health system and into primary care for individuals and patients as a group to continue to improve and provide quality care to patients (Agency for Healthcare and Research Quality (AHRQ), 2019). The Electronic Health record (EHR) is defined as a ‘longitudinal’ electronic record of patient’s health information which is generated during several episodes of care in a care delivery setting. It has a robust database of information that has a capacity for customization to the needs of the patients and the healthcare providers (HCP) that could be endless. EHRs have been designed to collect and store so many different types of information on patients such as patient demographics, order entries, laboratory values, radiologic images and documentations by HCPs (Alexander, Hoy, & Frith, 2019).

Some of the strengths and limitations of EHR. In 2017, hospitals growth in the use of EHR is about 96 percent in non-Federal acute acer hospitals. The EHR has been used to redesign and benefit the healthcare system. EHR supports evidence-based practice that helps to improve the outcomes of patient care. With EHR, volumes of data can be stored for years and obtained quickly and easily to evaluate patient populations, manage acute and chronic diseases that will help to ensure adequate preventive care individually, collectively and simultaneously more than would have been possible with paper charts. It has become a clinical for all future clinical practices and is potentially life-saving, efficient and cost-effective (Thurston, 2014). EHR has led to the decrease in the number of errors with medical care in terms of clinical orders. HER has improved the ability to read orders and avoid errors, it has prevented the duplication of all health care orders. It has also led to the sharing of the same information by all HCP and has improved the outcome and quality of care for patients. EHR has improved the privacy of patient information (Thurston, 2014). AHRQ’s EvidenceNOW initiative was established in 2015 to support the delivery of evidence-based care and improve the heart health of patients more than 1000 primary care practices nationwide by supporting ongoing health information technology evaluation of practices and quality improvement efforts. But with small and medium sized practices HER has grown about 93% while some are using programs not designed to improve quality care or research. New practices still need support to navigate through the learning curve to improve their efficiency and adjust their workflows. Some practices do not report clinical quality measures to the outside group like the Centers for Medicare & Medicaid Services (CMS) and private insurers, like most practices do which helps to improve practice. Some practices are not aware of where to go for technical assistance but there are services available such as Hospital data networks, Health information exchanges, and clinical data warehouses though some resources are not available to all practices (AHRQ, 2019).

References:

Agency for Healthcare and Research Quality (AHRQ). (2019). The promise of electronic health records: Are we there yet? Agency for Healthcare Research and Quality. 

Agency for Healthcare and Research Quality (AHRQ). (2019). Health information technology integration. Agency for Healthcare Research and Quality. Rockville, MD. 

Alexander, S., Hoy, H., & Frith, K. (2019). Applied clinical informatics for nurses (2nd ed.). Jones & Bartlett Learning.

Thurston, J. (2014). Meaningful use of electronic health records. The Journal for Nurse Practitioners, 10(7), 510-513. 

REPLY

Nice post, I agree with you that the EHR has been used to redesign and benefit the healthcare system. The Centers for Medicare and Medicaid Services (CMS) has moved towards making EHRs mandatory for all health care professionals and hospitals. The main goals are to improve quality of care, reduce cost, increase efficacy and patient safety. The rationale is that the adoption of EHRs will make it easier for physicians, hospitals, and others serving Medicare and Medicaid beneficiaries to evaluate patients’ medical status, coordinate care, eliminate redundant procedures, and provide high-quality care. Likewise, EHR will help speed the adoption of many other delivery system reforms by making it easier for hospitals and doctors to better coordinate care and achieve improvements in quality (Centers for Medicare & Medicaid Services, 2013).

Reference

Centers for Medicare & Medicaid Services. Lower Costs, Better Care: Reforming our Health Care Delivery System. 2013 Feb 28. Available from: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-Sheets/2013-FactSheets-Items/2013-02-28.html

REPLY

In the United States, EHRs implementation is a major requirement for healthcare organizations, a transition that was led by the Centers for Medicare and Medicaid Services (CMS) through financial incentives supported by policies such as the 2009 HITECH (Health Information Technology for Economic and Clinical Health) Act (Aguirre et al., 2019). In supporting clinical tasks, EHRs have a legacy in visit documentations, ordering drugs, laboratory, and diagnostic tests, reviewing test outcomes, and tracking/following up patients.

The most important usefulness of EHRs is in its application to promote population health through monitoring and surveillance of both infectious and non-infectious diseases, improved patient management, particularly patients with chronic illnesses and identification of populations at high risk of specific diseases. In ensuring the continuity of care, EHRs have proven to be beneficial in managing chronically ill patients by preventing fragmented care, and promoting coordination. Honavar (2020) highlights that, in the Emergency department, EHRs use improve evidence-based therapeutic and diagnostic decision-making through the CDSS (Clinical Decision Support) embedded in its system.

EHRs improve healthcare quality and outcomes by improving management, decreasing unnecessary investigations, improving interactions among healthcare staff, patients, and healthcare providers from other institutions involved in the care of patients (Kataria & Ravindran, 2020). From physician’s perspective, EHRs improve efficiency and workflow by decreasing the time needed to retrieve data, improve patient appointment scheduling, and allow remote access to patient data.

The limitations of using EHRs are associated with medical information errors, interoperability, and the financial resources needed to implement health information technology. Despite the increased efficiency in gathering and storing information using EHRs, medical errors still happen. According to Kataria & Ravindran (2020), medical errors are particularly associated with wrongly matching patients to their records or creation of duplicate records. Such errors do not only compromise the quality of care but also compromise the safety of patients.

 

References

Aguirre, R. R., Suarez, O., Fuentes, M., & Sanchez-Gonzalez, M. A. (2019). Electronic health record implementation: a review of resources and tools. Cureus, 11(9). doi:10.7759/cureus.5649

Honavar, S. G. (2020). Electronic medical records–The good, the bad and the ugly. Indian Journal of Ophthalmology, 68(3), 417. https://dx.doi.org/10.4103%2Fijo.IJO_278_20

Kataria, S., & Ravindran, V. (2020). Electronic health records: a critical appraisal of strengths and limitations. JR Coll Physicians Edinb, 50(3), 262-8. doi: 10.4997/JRCPE.2020.309

REPLY

Good post. What is one limitation of the EHR within your own practice? How could this limitation be resolved? Dr Gabua

REPLY

Greeting Asiatu! I enjoyed reading your post. My agreements with you resided in how you asserted that with the existence of duplicate records comes the accompaniment of detrimental quality of care alongside patient safety. Likewise, records possessing duplicates also coincide with considerable ramifications that follow within healthcare-based organizations, specified towards HIIM health professionals, patients, and even healthcare providers. For example, when duplicate records are present in the EHR, data can become conflicted amongst providers, causing poor patient care and incorrect treatment (BaniIssa et al., 2020). According to a study conducted by Black Book Research, duplicate records, including patient identification errors, consistent care, medical examinations birthed from redundancy, and claims that had undergone denial, can serve as factors that contribute to heightened costs (BaniIssa et al., 2020). In its entirety, these specific complications can prove detrimental to the system of healthcare, accounting for billions annually. Due to how duplicates are procured within an environment prevalent with haste and efficiency, such as registration desks, this chain of events can ensure that every process receives ample time, even during surges, drastically reducing duplicate record creation (BaniIssa et al., 2020).

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