Today, nurses across the United States provide excellent patient care with the assistance of technology, but just over 40 years ago this was not the case. In 1970, the first computer was developed as well as the new relationship between healthcare and technology. Technology in healthcare has since grown tremendously from just computers to what can be seen today, forming an essential partnership with healthcare providers. The partnership between healthcare providers and technology is ever changing due to the continuous new advancements in technology, allowing for endless benefits for the whole healthcare team.
Particularly, one advancement and benefit of technology that has improved the quality of patient care and assisted in lowering health care costs is the development of electronic health records or EHRs. (“The Right Balance—Technology and Patient Care”, 2017)Electronic health records simply suggest “automation of clinical documentation” that can be broad “ranging from the ways in which care is delivered, to the types of interactions nurses have with patients in conjunction with the use of technology, to the research surrounding EHRs that will inform nursing practice for tomorrow” (McGonigle & Mastrian, 2018, p. 267). EHRs were first proposed to improve quality of care and lower healthcare costs, which are both major issues in the United States healthcare system.
In 2004, President Bush raised the awareness of EHRs in his “State of the Union address by outlining a plan to ensure that most Americans have an HER by 2014” (McGonigle & Mastrian, 2018, p. 268). He went on to state that “by computerizing health records we can avoid dangerous medical mistakes, reduce costs, and improve care” (McGonigle & Mastrian, 2018, p. 268). At the time, few healthcare organizations went on to adopt EHRs, until 2009 during President Obama’s first term when “Congress passed the American Recovery and Reinvestment Act of 2009” (McGonigle ; Mastrian, 2018, p. 268).
The ARRA also included the HITECH Act which gave healthcare organizations incentives to use EHRs, then went on to penalize organizations that did not use EHRs by the year 2015. Since the implementation of EHRs in healthcare organizations, there have been many changes made to make the system more “interoperable and functional to meet the needs of patients and users” (McGonigle ; Mastrian, 2018, p. 269). With the constant changes being made to the system’s criteria, the IOM simply puts the features of an EHR into eight basic components: “health information and data, results management, order entry management, decision support, electronic communication and connectivity, patient support, administrative processes, and reporting and population health management” (McGonigle & Mastrian, 2018, p.269). The eight basic components of EHRs allow healthcare organizations to choose the vendor of their liking, while also having universal guidelines to ensure all areas of patient care are covered no matter the vender. “The significance of electronic health records to nursing cannot be underestimated” (McGonigle & Mastrian, 2018, p. 267). EHRs are an essential piece to the nurses everyday practice, and the understanding of EHRs can sometimes be considered entry-level competency for new nurses.
A nurse using an EHR can navigate through the eight components for patient information or to document findings. The eight components can be broken down by title, but also by the information each component holds that is relevant to a nurse providing care. Health information and data “comprise the patient data required to make sound clinical decisions, including demographics, medical and nursing diagnoses, medication lists, allergies, and test results” (McGonigle & Mastrian, 2018, p. 271). The component may also contain consents and directives as well as nursing assessments and patient visits.
Results management is the component where the nurse would be able to find and manage all results electronically. Order entry management is where the nurse would find all orders the doctor put in for the patient, such as lab orders, nursing orders, and consultations. Decision support “entails the use of computer reminders and alerts to improve the diagnosis and care of a patient, including screening for correct drug selection and dosing, and preventative health reminders” (McGonigle & Mastrian, 2018, p. 272).
Electronic communication and connectivity is where the nurse would go to communicate among the healthcare team. This component also includes the ability to exchange health information with other healthcare providers. Patient support is the component that holds all patient education information and self-monitoring tools. This component may also include telemonitoring or telehealth. Administrative processes are where the nurse could schedule the patient electronically, or manage billing and claims, as well as insurance information.
Reporting and population health management “are the data collection tools to support public and private reporting requirements, including data represented in a standardized terminology and machine-readable format” (McGonigle & Mastrian, 2018, p. 272). The ability for organizations to choose different vendors of EHRs allow them to meet the needs of the population they serve, therefore one EHR vendor may be appropriate for the adult population, but not for pediatrics. Though the vendors may be different, a nurse properly educated with the EHR system should be able to navigate systems at different organizations without issue. Some names of the different EHR vendors include: EPIC, eClinicalWorks, and Care360.
Measuring the benefits of EHRs can be hard due to the different data supplied from all the different EHR vendors. The most common benefits were: “increased delivery of guideline-based care, enhanced capacity to perform surveillance and monitoring for disease conditions, reduction in medication errors, and decreased use of care” (McGonigle & Mastrian, 2018, p. 274). EHRs have already changed the quality of healthcare so much through the benefits listed, but looking towards the future EHRs are said to lead to: “better health care by improving all aspects of patient care, better health by encouraging healthier lifestyles, improved efficiencies and lower healthcare costs by promoting preventative medicine and better coordination of healthcare services, and better clinical decision making by integrating patient information from multiple sources” (McGonigle & Mastrian, 2018, p. 275). In conclusion, the growth of healthcare technology, particularly EHRs, has been a huge influence in the improvement of quality patient care.
The use of EHRs lowered healthcare costs and created a place where all patient information can be safely kept in an organized manner. EHRs also enhanced interoperability, allowing multiple providers to communicate easily and have access to all patient information when providing care. EHRs organize and store important patient information for the nurse so that they can make nursing care decisions to better care for their patients. The use of EHR systems already have proven many benefits, and with them still expanding, the future of healthcare technology is very bright.
References
- McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge. Burlington, MA: Jones & Bartlett Learning.
- The Right Balance –Technology and Patient Care. (2017, September 27). Retrieved March 26, 2018, from http://www.himss.org/right-balance-technology-and-patient-care
