Technology-Informatics Use in Your Practice Setting
Hello, my name is Ariel, and today I will be talking about the use of Electronic Health Records (EHRs) in Allen Hospital, Waterloo (Khubone et al., 2020). I have worked in this hospital facility as an emergency nurse for almost 6 months. EHR has been rising in healthcare in recent years as healthcare providers aim to improve patient care, reduce errors, and enhance efficiency (Atasoy et al., 2019). EHRs are digital versions of patient health information that include patient demographics, medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory and test results. EHRs can be either cloud-based or locally hosted. EHR can aid healthcare providers in making well-informed patient care decisions and improving care coordination across various healthcare settings (Atasoy et al., 2019).
This assessment will delve into the advantages and challenges of implementing EHRs in Allen hospital and the best practices to ensure that EHRs are utilized effectively to support high-quality patient care.
Analysis of Benefits of EHR
Allen hospital specializes in emergency medicine, providing critical care to patients who require immediate medical attention (Tingle, 2019). I was an emergency nurse assisting the medical team in providing urgent care to patients who arrived at the emergency department. I was also responsible for documenting patient care in medical records and communicating with other healthcare professionals to ensure coordinated care. Allen hospital had an EHR system that needed to be fixed in most parts, like, implementing EHR after appropriate training and addressing the cybersecurity issues of the databases. Implementing the system without prior assessments and training challenged the nurses to get familiar with the EHR system (Ogbeide et al., 2022). Wrong prescriptions and adverse dose effects were also widespread there. I had many encounters where patients complained about their electronic medical records being vulnerable to leaks to scammers or fraud through suspicious emails (Al-Muhtadi et al., 2019).
Benefits of EHR
EHRs can improve the health practice of a system in many ways. These include improved patient care coordination by making it easier for healthcare providers to access and share patient information (Atasoy et al., 2019). Allen hospital benefited by implementing an effective EHR system. For example, suppose a patient is admitted to the hospital. In that case, the hospital can quickly access the patient’s electronic health record to obtain necessary medical information relevant to the patient’s current care, helping to avoid medical errors and ensuring the patient receives the appropriate treatment. There are increasing incidents of patient sample misplacement in hospitals (Tabatabaee et al., 2020). Allen hospital can manage medical errors and provide satisfactory care delivery to patients with an EHR system. (Tabatabaee et al., 2020).
While working at Allen hospital, I constantly faced issues managing patient health records and medical history. By implementing an EHR system, such outcomes are avoided. For example, suppose a patient needs a prescription refill. In that case, the nurse can access the patient’s electronic health record and send an electronic prescription to the pharmacy without requiring the patient to visit the provider’s office, resulting in a lower burden on different stakeholders, including nurses and pharmacists. If the system is integrated and online, the nurses and pharmacists do not need to manually prescribe or take care of the dose of the patients (Moore et al., 2020).
Also, there are fewer chances of errors if the system incorporates the specific doses and prescriptions for the patients in the EHR system. For a patient having a known allergy to a medication, the information can be included in the patient’s electronic health record and flagged whenever a healthcare provider attempts to prescribe that medication—helping to prevent adverse drug reactions and improve patient outcomes in Allen hospital (Moore et al., 2020).
EHRs will make it easier for the healthcare providers of Allen hospital to access patient information quickly and efficiently. For example, suppose multiple healthcare providers treat patients in different locations (interdisciplinary collaboration for patient care). In that case, all providers can access the patient’s electronic health record to obtain up-to-date medical information, test results, and treatment plans, which makes it easier to improve the quality of care and reduce the risk of medical errors. In such cases, the patient demanding the care of different healthcare providers can be accounted for with one integrated system (Atasoy et al., 2019).
With EHRs, public health is assessed by evaluating potential epidemics and routine disease surveillance with the patient information in the database. The patterns of a viral disease or pathogenic outbreak in a particular population are assessed by evaluating the EHR database of recent patient inflow with similar symptoms or diseases (Willis et al., 2019). In this way, the healthcare providers can project the health trends of the population and manage any potential risk to that population. By integrating such systems, Allen hospital can contribute to the safety of the people and reduce the risk of possible epidemics of pathogenic infections (Willis et al., 2019).
Obstacles While Using EHR
EHRs are beneficial for health practice, but at the same time, it can be very challenging to implement EHR in the practice setting effectively. Various processes can affect the successful implementation of EHR. When I was at Allen hospital, there were multiple issues and obstacles regarding the effective implementation of the EHR system. Major obstacles included:
The hospital implemented the EHR system without prior training or guidelines. Nurses in the Allen hospital needed to become more familiar with EHR and its interface. Allen hospital should have prioritized staff training to familiarize nurses and healthcare providers with the system and its interface. With no prior experience with the help of EHR, the nurses were vulnerable to getting tired and frustrated. Furthermore, using EHRs without proper training poses risks to adequate patient care and prescription. Nurses make more mistakes and errors that can lower patient care and satisfaction. EHR without proper training can make the system hard to understand and cause burnout and job dissatisfaction in nurses (Tabatabaee et al., 2020).
Lack of Security
Practices must implement security measures to protect patient data from unauthorized access, which can be challenging to maintain (Al-Zubaidie et al., 2019). Allen hospital encountered significant threats of phishing and cyber-attacks occasionally. Scammers and fraudulent often target unprotected health databases. However, there was no significant breach. It can compromise the health data of millions of patients and healthcare providers, affecting patient confidentiality and privacy (Al-Muhtadi et al., 2019). Once in Allen hospital, a nurse was giving bedside care to a 15-year-old patient suffering from pneumonia; accidentally, she almost shared his medical history and credentials publicly by irrationally using the patient EHR portal, which is against nursing ethics (Al-Zubaidie et al., 2019).
Perspective of Stakeholders
Regarding stakeholders, nurses in Allen hospital often face obstacles to EHR implementation. They perceived that implanting and using EHRs added to their workload and needed more time documenting patient information in the system. Nurses experienced technical issues with the EHR system, such as system crashes or slow performance, which affected their ability to provide timely care. In such circumstances, nurses need to spend additional time troubleshooting or seeking technical assistance, which can add to their workload and stress and cause burnout (Ogbeide et al., 2022).
Patients are always concerned about the security and privacy of their personal health information when it is stored in an EHR system. As these systems are interconnected and online, there are significant chances of hacks and security breaches that can leak patients’ personal information and medical data and, in turn, violate patient confidentiality and privacy (Al-Muhtadi et al., 2019). Patients need help accessing their health information in the EHR system, mainly if unfamiliar with the technology. They perceive a need for more communication or engagement from their healthcare provider when they use EHRs without proper guidance (Lyles et al., 2020).
Workflow Redesigning for EHR
The implementation of EHRs or any other technology fails due to a lack of appropriate workflow design for the technology in a particular system (Zheng et al., 2020). The redesigned workflow will address all the challenges and obstacles and make the system fluent, credible, and free of errors and risks (HealthIT, 2019). By mapping out the current workflow in Allen hospital, it can be found that there is a need for redesign in the domains of patient care, medical errors, and threats of cyberattacks (Qiu et al., 2020). The usual workflow design of Allen hospital included straight patient care through manual processes and a suboptimal underused EHR system. There will be regular educational sessions and staff training on EHR before its implementation, and the workflow for Allen hospital redesigned accordingly.
Patients will check in at the front desk, and the receptionist will verify their information and enter it into the EHR system. The system will check for duplicates and inconsistencies to reduce the risk of medical errors. The redesigned system will have tools to spot duplicate patient names or data (Murugadoss et al., 2021). After the check-in, the nurse or medical assistant will bring the patient to an exam room and begins the patient assessment. They will use the EHR system to review the patient’s medical history, medications, and other relevant information. Then the system will provide prompts and alerts for potential drug interactions or contraindications, reducing the chances of medical errors significantly (Khubone et al., 2020). The patient will be provided with appropriate medication after evaluating major contraindications or allergic reactions, and the patient will be either discharged or hospitalized based on their health status. The system will track and save all the information in the EHR database (Lyles et al., 2020).
There is a significant threat of cyberattacks and fraudulent breaches in the EHR of Allen hospital. Blockchain technology implementation is needed to completely revolutionize the Allen hospital’s EHR system. Blockchain technology will transform the healthcare unit by improving the interoperability of healthcare databases, allowing for increased access to patient medical records, device tracking, enhanced security measures, and prescription databases (Qiu et al., 2020). With blockchain infrastructure, healthcare providers will track the complete life cycle of a device and access patients’ medical histories to ensure accurate medication prescriptions, which will significantly help to enhance the Allen hospital framework (Zubaydi et al., 2019). The redesigned workflow diagram for the Allen hospital is given in figure 1.
Figure 1. Conventional and redesigned workflow diagram of Allen hospital
In conclusion, implementing EHRs in healthcare facilities can improve patient care coordination, increase the efficiency and productivity of healthcare providers, and provide quick access to patient information. However, several obstacles need to be addressed, such as the cost of implementation, staff training, and concerns about privacy and security. Effective implementation of EHRs requires collaboration between all stakeholders, including healthcare providers, nurses, and patients. Allen hospital’s new workflow design will improve patient care and healthcare framework by addressing these challenges and utilizing EHRs effectively to support high-quality patient care and improve overall healthcare outcomes.
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