Assignment: Literature Review: The Use Of Clinical Systems To Improve Outcomes And Efficiencies

Assignment: Literature Review: The Use Of Clinical Systems To Improve Outcomes And Efficiencies

The use of technology to leverage care interventions in different clinical settings and facilities cannot be overemphasized because of the critical role that it plays in enhancing patient safety and care outcomes. Clinical systems are essential tools in improving patients’ outcomes and efficiencies in healthcare delivery by reducing medication errors, promoting medication compliance and enabling providers to leverage technology for better decisions and informed interventions (Dykes et al., 2017). Personal health records or portals are some of the critical aspects that providers and healthcare systems use to support patients that have recently been diagnosed with diabetes. These portals offer access to health information from an organization’s electronic health record (EHR) and allow patients to conduct different medical-associated tasks like electronically communicating with their providers and even recording their symptoms (Tapuria et al., 2021). The purpose of this paper is to offer an annotated bibliography of the impact of personal health records or patient portals for individuals newly diagnosed with diabetes.

Coughlin, S. S., Williams, L. B., & Hatzigeorgiou, C. (2017). A systematic review of studies

of web portals for patients with diabetes mellitus. MHealth, 3(6). https://doi.org/10.21037/mhealth.2017.05.05

In this systematic review of studies on the portal for patients with diabetes mellitus, the researchers evaluate the impact of patient health records to improve outcomes from interventions to control glycemic levels. The authors identified 12 studies on the topic that include three cross-sectional and five randomized controlled trials. The researchers required web portals meant for diabetes patients and those tethered to electronic medical records. The findings show that web portals enhance the ability of patients to communicate with their clinicians and attain enhanced glycemic control. The authors emphasize the need for additional research to understand the level of control for patients. However, they are categorical that web portals improve glycemic control for these patients.

The study shows that web portals are essential and improve outcomes for diabetic patients since they enhance communication between them and their clinicians. Through effective communication, clinicians improve efficiencies in care provisions for diabetes patients. The study indicates that providers should leverage technologies and encourage their patients to embrace them to reduce adverse disease outcomes. A critical lesson learned from the use of web portals based on the study is that few patients embrace this technology to enhance diabetes self-management and self-care. Consequently, providers should be trained to leverage its use to improve self-care interventions for patients in remote locations.

Sun, R., Korytkowski, M. T., Sereika, S. M., Saul, M. I., Li, D., & Burke, L. E. (2018).

Patient Portal Use in Diabetes Management: Literature Review. JMIR Diabetes, 3 (4): e11199. https://doi.org/10.2196/11199.

In this article, the researchers affirm the critical role that health information technology tools have in promoting engagement, improvement of patient-provider communication, and enhancing clinical outcomes in the management of chronic disorders like diabetes mellitus. Based on a review of literature, the researchers focus on evidence about the efficacy of patient portal use by patients with diabetes mellitus type 1 and 2. The study examines the link between patient portal use and diabetes mellitus-related outcomes. The authors identified opportunities for future improvement in the management of the condition. The findings also demonstrate the low levels of patient portal use among diabetes patients. The authors observed inconsistency in their findings of the use of these technologies among patients due to several barriers among patients and providers. While these portals enhance care and patient outcomes engagement of both providers and users will be critical to improving uptake. 

The article shows that patient portal are critical to enhancing outcomes for individuals suffering from diabetes mellitus (DM). The portals improve communication and engagement between providers and patients. Effective engagement is a core aspect of patient participation and leads to better outcomes. These systems also improve efficiency as it eases interaction between nurses, clinicians and patients, and their families. The vital lesson learned from the study is that providers should encourage patients to embrace technology as a way to reduce over-reliance on clinicians to make decisions. These portals allow patients to check different components of their disease status and employ the right interventions to address any challenges. The article also implores further research to address the inconsistencies in results about the efficacy of patient portals to enhance care among diabetes patients, especially those newly diagnosed.

Sieverink, F., Kelders, S., Braakman-Jansen, A., & van Gemert-Pijnen, J. (2019).

Evaluating the implementation of a personal health record for chronic primary and secondary care: a mixed-methods approach. BMC medical informatics and decision making, 19(1), 1-12. https://doi.org/10.1186/s12911-019-0969-7

In this study, the authors focus on evaluating the fidelity of personal health records (PHRs) in chronic care based on the level of implementation to ascertain the found effects or impacts. Using a mixed-method design, the researchers measure the responsiveness, the differences, and similarities between the intended and the real use of PHRs among a certain population sample. The study findings show that many providers were unaware of how to deploy the PHR in their present working routines. As such, they find it challenging to motivate and encourage their patients to use PHR. However, those participating in the user group indicated the value of a PHR in future interactions with their clinicians or care providers. The usability participants asserted that improvement in utilization among care providers will highly influence their decision to deploy the patient portals.

The findings show that the actual use of PHR by patients depended on the responsiveness of caregivers. Caregiver responsiveness relies on perceived support and fidelity by patients. However, the use of PHR intends to enhance efficiency and outcomes for patients with chronic conditions as outlined by the study. The critical lesson learned from this article is that providers have a substantial influence on technology uptake by patients in their settings, especially in the management of chronic conditions like diabetes mellitus.

Fidelity by patients to PHR is an added advantage in enhancing the use of this technology among patients and their families. The study indicates that responsiveness from providers is a critical aspect of encouraging diabetic patients to embrace patient portals to enhance efficiency and care provision. The implication is that nurses should focus on interactive sessions and engage their diabetes patients to leverage technologies like web portals to improve care outcomes.

Reed, M. E., Huang, J., Brand, R. J., Neugebauer, R., Graetz, I., Hsu, J., … & Grant, R.

(2019). Patients with complex chronic conditions: Health care use and clinical events associated with access to a patient portal. PLoS One, 14(6), e0217636. https://doi.org/10.1371/journal.pone.0217636

In this article, the researcher asserts that patients with diabetes can leverage patient portals to support self-management and coordination of health care services. The authors’ objective in the study was to examine the effects of access to the patient portal on the frequency of visits, emergency visits, and preventable admissions or hospitalizations. Using an observational study design, the researchers compare the visit rates with or without portal access among patients with chronic conditions, especially diabetes.

The study shows that access to patient portals is linked to increased rates of outpatient office visits in both diabetic patients and those with multiple complex conditions. Patient portals have a significant reduction on overall visits, right from emergency to office physician visits among diabetes and chronically ill patients. These findings show that portals web technology enhances care provision remotely for diabetes patients and improves expected outcomes. Access enhances engagement in outpatient visits allowing providers to address unmet clinical needs. The portals also reduce downstream health events that may necessitate emergency and hospital care, especially for diabetes patients and those with complex comorbidities.

Findings from this study are categorical that patient portals improve outcomes as they increase engagement between clinicians and patients in different care settings. The results also show that the motivation to use PHR is based on provider knowledge and engagement with patients and their families. The study demonstrates the need for providers to leverage educational interventions to enhance the deployment of patient portals for the management of diabetes and multiple chronic conditions.

Vital lessons learned from the use of the patient portal include the need for an interactive approach among the providers, patients, and the healthcare system. The study also shows the need to patients to enhance their engagement with technology to enhance overall outcomes and reduce visits to emergency rooms and physician offices. The article demonstrates the crucial role that web portals play in overall care delivery for diabetes patients.

Conclusion

The findings from the four peer-reviewed research articles demonstrate that patient portals are a critical component of enhancing overall care for individuals with diabetes, particularly those newly diagnosed. The portals allow patients to interact with providers remotely, record their symptoms, access tests, and laboratory results, and review their care plans. while several obstacles and factors influence the use of these portals, it is evident that they continue to constitute a core response to improve care delivery for patients with chronic conditions like diabetes.

Studies by Abd-alrazaq et al. (2019) and Ruh and Chugh (2021) show that despite certain barriers to their deployment and embracement, patient portals are enhancing overall care delivery and allowing users to interact more. Through these interventions, clinicians and patients and their families work collaboratively to enhance overall care outcomes. These products provide a host of content, connectivity, and collaboration-associated features and functions for their users. The overall value of these technologies goes beyond the constituents of the health care delivery chain. However, there is a need for further research to enhance usability, adoption, and value among providers and patients to attain effective benefits and leverage from patient portals.

References

Abd-Alrazaq, A. A., Bewick, B. M., Farragher, T., & Gardner, P. (2019). Factors that affect the

use of electronic personal health records among patients: a systematic review. International journal of medical informatics, 126, 164-175. https://doi.org/10.1016/j.ijmedinf.2019.03.014

Dykes, P. C., Rozenblum, R., Dalal, A., Massaro, A., Chang, F., Clements, M., Collins, S.

…Bates, D. W. (2017). Prospective evaluation of a multifaceted intervention to improve outcomes in intensive care: The Promoting Respect and Ongoing Safety Through Patient Engagement Communication and Technology Study. Critical Care Medicine, 45(8), e806–e813. https://doi.org/10.1097/CCM.0000000000002449

Coughlin, S. S., Williams, L. B., & Hatzigeorgiou, C. (2017). A systematic review of studies

of web portals for patients with diabetes mellitus. MHealth, 3(6). https://doi.org/10.21037/mhealth.2017.05.05

Tapuria, A., Porat, T., Kalra, D., Dsouza, G., Xiaohui, S., & Curcin, V. (2021). Impact of patient

access to their electronic health record: a systematic review. Informatics for Health and Social Care, 46(2), 192-204. https://doi.org/10.1080/17538157.2021.1879810

Reed, M. E., Huang, J., Brand, R. J., Neugebauer, R., Graetz, I., Hsu, J., … & Grant, R.

(2019). Patients with complex chronic conditions: Health care use and clinical events associated with access to a patient portal. PLoS One, 14(6), e0217636. https://doi.org/10.1371/journal.pone.0217636

Ruhi, U., & Chugh, R. (2021). Utility, Value, and Benefits of Contemporary Personal Health

Records: Integrative Review and Conceptual Synthesis. Journal of medical Internetresearch, 23(4), e26877. https://doi.org/10.2196/26877

Sieverink, F., Kelders, S., Braakman-Jansen, A., & van Gemert-Pijnen, J. (2019).

Evaluating the implementation of a personal health record for chronic primary and secondary care: a mixed-methods approach. BMC medical informatics and decisionmaking, 19(1), 1-12. DOI: https://doi.org/10.1186/s12911-019-0969-7

Sun, R., Korytkowski, M. T., Sereika, S. M., Saul, M. I., Li, D., & Burke, L. E. (2018).

Patient Portal Use in Diabetes Management: Literature Review. JMIR Diabetes, 3 (4): e11199. DOI: 10.2196/11199.

You brought out some essential points, Benefits overtake the challenges like internet connectivity and other hurdles, but I want to add more about Mobile health to your post,

In my Home Health RN practice, I found helpful changes due to increased use in medication management, diabetic management, infection control, immediate response to symptom change, and many more services. 

Mobile apps offered by pharmacies such as CVS and Walgreens can be incredibly beneficial and convenient for patients, particularly those who take multiple medications or have complex medication regimens (Asiri, Khalifa, El-Metwally, & Househ, 2018). These apps typically allow patients to manage their prescriptions, including requesting refills, setting reminders for when to take medications, and receiving notifications when it’s time to refill their medications (Tachakra & Wang, 2017). This can be especially helpful for geriatric patients, who may have difficulty remembering when to take their medications or managing multiple prescriptions. Mobile apps can help to reduce the risk of medication errors, such as taking the wrong medication or missing a dose, by providing patients with accurate information about their prescriptions and reminding them when it’s time to take their medications (Wei & Knight, 2020). Overall, mobile apps offered by pharmacies can be a valuable tool for patients, improving medication adherence and reducing the risk of adverse events (Asiri et al., 2018; Tachakra & Wang, 2017; Wei & Knight, 2020).

Added to this are the Computerized physician order entry (CPOE) systems, which later became Mobile order placement, mainly through the use of electronic health records, has been shown to improve patient safety by reducing the risk of errors and adverse events, as well as enhance efficiency by eliminating the possible errors in paper-based order entry and transcription (Koppel, Metlay, Cohen, Abaluck, Localio, Kimmel, & Strom, 2005). Mobile order placement also helps to reduce delays in care and improve the overall quality of care provided to patients (Koppel et al., 2005).

All these new inventions and additions are improving the quality of care by all providers.

References:

Asiri, E., Khalifa, M., El-Metwally, A., & Househ, M. (2018). Evaluation of medication management mobile applications available on app stores in the United States: A content analysis. JMIR mHealth and uHealth, 6(4), e74. https://doi.org/10.2196/mhealth.8812

Links to an external site.

Koppel, R., Metlay, J. P., Cohen, A., Abaluck, B., Localio, A. R., Kimmel, S. E., & Strom, B. L. (2005). Role of computerized physician order entry systems in facilitating medication errors. Journal of the American Medical Association, 293(10), 1197-1203. https://doi.org/10.1001/jama.293.10.1197

Links to an external site.

Tachakra, S., & Wang, X. H. (2017). A systematic review of mobile apps for medication management: Examining the user interface and usability. Journal of Medical Systems, 41(7), 111. https://doi.org/10.1007/s10916-017-0762-5

Links to an external site.

Wei, C., & Knight, J. (2020). Medication adherence apps: Review and content analysis. JMIR mHealth and uHealth, 8(3), e14080. https://doi.org/10.2196/14080

Assignment: Literature Review: The Use Of Clinical Systems To Improve Outcomes And Efficiencies

 

In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.

To Prepare:

  • Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
  • Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
  • Identify and select 5 peer-reviewed articles from your research.

The Assignment: (4-5 pages)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:

  • Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
  • Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.

The patient portal is a secure online that enables patients to access their health data whenever they require it. It has 24/7 accessibility, which reduces the need for patients to contact their primary care provider’s (PCP) office to inquire about their scheduled appointments or their prescribed medications (Sieck et al., 2018). The portal lets them view and download health information such as immunization records, diagnostic test results, allergies, prescriptions, previous PCP visits, instructions and appointment notes, discharge summaries, and billing information(Sieck et al., 2018). Patient portals increase patients’ access to health care and health information, thus improving patients’ outcomes and functional status and decreasing healthcare costs. Patients with chronic conditions benefit the most from using the portals as they are the highest consumers of healthcare.

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS Assignment: Literature Review: The Use Of Clinical Systems To Improve Outcomes And Efficiencies:

 The purpose of this paper is to summarize peer-reviewed articles that examine the impact of patient portals in improving patient outcomes and outline the lessons learned from the application of patient portals in each article.

Alturkistani, A., Qavi, A., Anyanwu, P. E., Greenfield, G., Greaves, F., & Costelloe, C. (2020). Patient portal functionalities and patient outcomes among patients with diabetes: Systematic review. Journal of medical Internet research22(9), e18976. https://doi.org/10.2196/18976

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Alturkistani et al. (2020) conducted a systematic review to outline the evidence concerning the use of patient portal use and patient portal functionality use and their reported connection with health and outcomes in health care quality among adult diabetic patients. The review included twelve studies, which reported: The overall patient portal use and its connection with diabetes health and health quality outcomes; E-messaging/email use– related outcomes; Prescription refill–related outcomes. The reported health outcomes included the association of patient portal use with blood pressure, low-density lipoprotein cholesterol, and BMI.

The studies in the systematic review reported that patient portals and patient portal functionality attributed to improved health outcomes, such as glycemic control in DM patients. Besides, secure messaging, emailing, and repeat prescription ordering using the patient portal were connected with enhanced glycemic control, and patient outcomes seemed to improve with increased portal use. It was also established that the use of the patient portal might be connected with enhanced low-density lipoprotein cholesterol outcomes and blood pressure control.

From this article, we learn that patient portals use and patient portal functionality can impact the utilization of health care services and can result in increased office visits and reduced emergency department visits. The article establishes that patient portal use is connected with improved quality of care for diabetic patients, thus improving their health outcomes.

Carini, E., Villani, L., Pezzullo, A. M., Gentili, A., Barbara, A., Ricciardi, W., & Boccia, S. (2021). The impact of digital patient portals on health outcomes, system efficiency, and patient attitudes: Updated systematic literature review. Journal of Medical Internet Research23(9), e26189. https://doi.org/10.2196/26189

Carini et al. (2021) conducted a systematic review to summarize the available evidence on the effect of patient portals on health outcomes and health care efficiency and to explore user characteristics, attitudes, and satisfaction. The researchers used primary studies discussing the impact of the adoption of the patient portal with regard to health outcomes, efficiencies in health care, and patient attitudes and satisfaction. The study found that patient portals were associated with improved preventive behaviors among patients and improved control of chronic conditions with enhanced control of diabetes parameters and asthma flares. In addition, patient portals were associated with positive results in control and maintenance of diseases and improved adherence to treatment. Patient portals also reduced the number of missed appointments.

From the article, we learn that the patient portal is usually designed to minimize inappropriate health care utilization. However, barriers are limiting the utilization of portals, including user-related factors, such as time constraints, lack of interest in managing their disease, and inadequate digital knowledge. There are also clinician-related barriers, such as age and attitude toward the portal, as well as technology-related barriers, such as limited internet access, limited capacity to use technology, and security concerns. Therefore, health organizations should address privacy and security concerns and ensure patients and providers can utilize technological appliances when introducing patient portals in their settings.

Dendere, R., Slade, C., Burton-Jones, A., Sullivan, C., Staib, A., & Janda, M. (2019). Patient Portals Facilitating Engagement With Inpatient Electronic Medical Records: A Systematic Review. Journal of medical Internet research21(4), e12779. https://doi.org/10.2196/12779

Dendere et al. (2019) sought to review literature examining patient portals connected to an EMR in inpatient settings, including the portals’ role in patient engagement and their impact on health care delivery to establish factors and best practices for successful portal implementation. The study employed a systematic review of the literature. It found that patient portals improved patient engagement, patient safety, medication adherence, and patient-provider communication. Although patients and providers perceived that portals could improve patient care, they also thought it could cause anxiety. We learn from the article that patient portals are beneficial as they have improved medication adherence, promoted the discovery of medical errors, and enhanced patient-provider communication. Besides, we learn that improving patient engagement is an aim of patient portals, but the providers’ engagement is equally important as patients approach them with portal-related questions.

Han, H. R., Gleason, K. T., Sun, C. A., Miller, H. N., Kang, S. J., Chow, S., … & Bauer, T. (2019). Using patient portals to improve patient outcomes: systematic review. JMIR human factors6(4), e15038. https://doi.org/10.2196/15038

Han et al. (2019) conducted a systematic review to synthesize evidence concerning patient portals’ characteristics and psychobehavioral and clinical outcomes. The study found that most portals employed tailored alerts or educational resources tailored to a patient’s disease. The use of patient portals contributed to improvements in a myriad of psychobehavioral outcomes, including health knowledge, medication adherence, decision making, self-efficacy, and preventive service use. The impact of the patient portal on health outcomes included improved glycemic control, blood pressure, cholesterol, and weight loss.

The study’s findings demonstrate the patient portal as a promising approach to improving particular psychological outcomes and health behaviors through simple strategies such as individually tailored messages, refill services, and communication between the patient and the PCP. We learn from the article that understanding the role of patient portals as a useful intervention approach is crucial to encouraging patients to be actively involved in their health care.

Conclusion

The above articles examined the impact of using patient portals in improving health outcomes, including outcomes of diabetes patients. The articles establish that patient portals enhance patient engagement and provider-patient communication resulting in improved preventive behaviors, control of chronic diseases, and health outcomes. Patient portals also enhance care safety by reducing medical errors and increasing medication adherence resulting in better health outcomes. However, for the maximum adoption of patient portals, organizations should address digital knowledge, privacy, and security issues to increase engagement from patients and providers.

References

Alturkistani, A., Qavi, A., Anyanwu, P. E., Greenfield, G., Greaves, F., & Costelloe, C. (2020). Patient portal functionalities and patient outcomes among patients with diabetes: Systematic review. Journal of medical Internet research22(9), e18976. https://doi.org/10.2196/18976

Carini, E., Villani, L., Pezzullo, A. M., Gentili, A., Barbara, A., Ricciardi, W., & Boccia, S. (2021). The impact of digital patient portals on health outcomes, system efficiency, and patient attitudes: Updated systematic literature review. Journal of Medical Internet Research23(9), e26189. https://doi.org/10.2196/26189

Dendere, R., Slade, C., Burton-Jones, A., Sullivan, C., Staib, A., & Janda, M. (2019). Patient Portals Facilitating Engagement With Inpatient Electronic Medical Records: A Systematic Review. Journal of medical Internet research21(4), e12779. https://doi.org/10.2196/12779

Han, H. R., Gleason, K. T., Sun, C. A., Miller, H. N., Kang, S. J., Chow, S., … & Bauer, T. (2019). Using patient portals to improve patient outcomes: systematic review. JMIR human factors6(4), e15038. https://doi.org/10.2196/15038

Sieck, C. J., Hefner, J. L., & McAlearney, A. S. (2018). Improving the patient experience through patient portals: Insights from experienced portal users. Patient Experience Journal5(3), 47-54. https://pxjournal.org/journal/vol5/iss3/8

I enjoyed reading your post. I also concur that patients can consult their doctors through telehealth services thanks to modern computer technology. One of the most important healthcare trends currently is telehealth, particularly in light of the COVID-19 epidemic. Home telehealth care is predicted to give extended care to the growing number of senior Americans living with difficult chronic diseases and disorders, making it the most promising area of concentration for nurses (McGonigle & Mastrian, 2018). Technology is making it simpler for doctors and other professionals to routinely and automatically check patients for a variety of chronic conditions at home (Waldren et al., 2017).

Clinical consultations can now be conducted over video conversations thanks to telehealth, ensuring that patients continue to receive the treatment they require while while adhering to infection control protocols. The licensing requirement, which requires that the nurse delivering the treatment be licensed in the state where the patient resides due to a lack of interstate licensing, is one of the difficulties that may be encountered when using this technology (Mahoney, 2020). This means that in order to practice telemedicine remotely outside of the state they are currently located in, a nurse or other medical practitioner must obtain multiple licenses in different states.

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