Emerging Technology Brief
Today, the health care system is characterized by massive breakthroughs in health technologies. These technologies are promising in changing the treatment modalities for many diseases and impacting how health care is delivered. Consequently, the identified emerging health care technology that has the potential to overcome current or emerging barriers to care is electronic health records (EHR).
EHR connotes a digital adaptation of patients’ paper chart. It contains electronic format of a collection of patient health information. EHRs characterizes real-time, patient-oriented records that convey available patient information securely and immediately to the permitted users (Ammenwerth et al., 2017). Although EHRs contain patients’ medical and treatment histories, the system is also designed to provide wider view of patient’s care. Essentially, EHRs play serve critical purpose in health care setting by automating and streamlining the workflow of health care providers, containing diagnoses, medical histories, laboratory and tests results, treatment plans, radiology images, immunization dates, and allergies of a given patient. Finally, they also play a role of allowing accessibility to evidence-based tools that can help care givers to make informed decision about patient care.
The introduction of EHR has ensured significant transformation in health care delivery. To begin with, EHR serves as a crucial tool to manage broad and labor-intensive paperwork health records in a more effective way, which ultimately minimizes the cost of storage, transcription, and re-filling (Peters & Khan, 2014). Besides, since the EHR contains all the patient information, it significantly lowers the chances of occurrences of medical errors and also assists in enhancing the patient health by fostering effective management of the diseases. Moreover, EHR facilitates the process of getting, organizing, scrutinizing, and presenting health data to ease decision making process. EHR also minimizes the risk of health data duplication since it is possible to share files across various health care systems including adjusting and updating them, thus, reducing risk of lost data. Other benefits include facilitation of quality healthcare delivery and increased health care safety (Cowie et al., 2017).
The ethical issues that accompany the incorporation of the EHR include the consideration of the security of health data and also protection of the privacy and confidentiality of the patient information (Heart, Ben-Assuli & Shabtai, 2017). Therefore, the implementation of EHR should consider regulatory standards such as the Health Insurance Portability and Accountability Act (HIPAA) and the Privacy Rule and the Health Information Technology for Economic and Clinical Health Act (HITECH). These regulations play an important role in protecting the privacy and confidentiality of the health records of the patients and also helping in avoiding the legal liability.
Essentially, EHR can improve access to care by increasing efficiencies in workflow. It does this by lowering the required time in pulling charts, enhancing scheduling of patient appointment, enhancing access to inclusive patient data, allocating remote access to patients’ charts, and assisting in managing the prescription. On the other hand, EHR promotes patient safety and quality by improving health management, enhancing communication and interface among the primary health providers and patients involved in the care, reducing needless patient investigations, and reductions of medical errors.
Ammenwerth, E., Lannig, S., Hörbst, A., Muller, G., & Schnell‐Inderst, P. (2017). Adult patient access to electronic health records. Cochrane Database of Systematic Reviews, (6).
Cowie, M. R., Blomster, J. I., Curtis, L. H., Duclaux, S., Ford, I., Fritz, F., & Michel, A. (2017). Electronic health records to facilitate clinical research. Clinical Research in Cardiology, 106(1), 1-9.
Heart, T., Ben-Assuli, O., & Shabtai, I. (2017). A review of PHR, EMR and EHR integration: A more personalized healthcare and public health policy. Health Policy and Technology, 6(1), 20-25.
Peters, S. G., & Khan, M. A. (2014). Electronic health records: Current and future use. Journal of comparative effectiveness research, 3(5), 515-522.
Topic 6 DQ 1
In what ways can informatics help health care providers overcome current or emerging barriers to care and increase access to safe, quality health care? Include a discussion of the value and challenges of clinical provider order entry (CPOE) and clinical decision support systems (CDSS) in providing safe patient care in your response.
Re: Topic 6 DQ 1
McGonigle & Mastrian (2018) states informatics is “A ﬁeld that integrates a specialty’s science, computer science, cognitive science, and information science to manage and communicate data, information, knowledge, and wisdom in a specialty’s practice.” (p. 568) Information technology (IT) can greatly improve the safety and quality of care delivered to patients when it does what the user intends for it to do, the user interface is created in a way that is easy to understand and use, and the is appropriate for the environment it is being used in. Traditionally delivery of healthcare services required an in-person interaction between patients and healthcare providers. One way informatics has helped address barriers to care is by bringing healthcare services to the patient. The COVID pandemic highlighted the need to continue delivery of healthcare services, even when it was not possible to have an in-person interaction between clinical providers and patients. Though telehealth services were available prior to COVID, the pandemic moved telehealth from simply being a useful alternative to it becoming a critical means for continued access to quality healthcare services that did compromising the safety of patients or healthcare professionals. “Telehealth allows nurses to use telecommunication and videoconferencing software to communicate more effectively and more frequently with patients at home by using the technology to monitor patients’ vital signs, supervise their wound care, or demonstrate a procedure.” (McGonigle & Mastrian, 2018, p. 209) At the height of the pandemic patients were triaged from home and given direction regarding what level of care services were needed. Triaging patients is accomplished more efficiently using clinical support decision support systems (CDSS). The CDSS is “A computer-based program designed to assist clinicians in making clinical decisions by ﬁltering or integrating vast amounts of information and providing suggestions for clinical intervention.” (McGonigle & Mastrian, 2018, p. 559) The CDSS promotes safety by making evidence-based information uniformly and readily available to nurses. Another informatics tool that improves quality and patient safety is the computerized provider order entry system (CPOE). Taieb-Maimon et al. (2018) states “CPOE systems are computer-based systems that allow a physician or other ordering authority (nurse practitioners, physician’s assistants, etc.) to directly enter orders for medications, tests, or other medical procedures, for a specific patient.” (p. 383) The CPOE is programmed to alert providers to erroneous, unsafe, or incomplete information and provides decision support to clinicians. The electronic format of the CPOE minimizes the potential for misinterpretation of order information due to issues with legibility, thus increasing patient safety. (McGonigle & Mastrian, 2018)
When informatics does not produce the intended results or the user interface is not functional, technology can create barriers to care and decrease the quality and or safety of care delivered. At a minimum, when information and technology are inappropriately or ineffectively utilized the effort may result in wasted resources. As many as 75% of physicians do not verify patient information after selecting when writing orders and that improved user interface design can help mitigate the problem. (Taieb-Maimon et al., 2018) The user interface should be developed specifically with the needs of the end user in mind. Gaining insight from users to understand how the technology will be used is critical to ensuring the user interface is developed appropriately. When a user interface does not adequately address the needs of the end user or account for the level of risk inherent to the functions being performed by the user, technology can produce or facilitate new errors that compromise patient safety.
McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Jones & Barnett Learning. nursing_informatics_and_the_foundation_of_knowledge_4e | WebViewer (gcu.edu)
Taieb-Maimon, M., Plaisant, C., Hettinger, A. Z., & Shneiderman, B. (2018). Increasing Recognition of Wrong-Patient Errors through Improved Interface Design of a Computerized Provider Order Entry System. INTERNATIONAL JOURNAL OF HUMAN-COMPUTER INTERACTION, 34(5), 383–398. https://doi-org.lopes.idm.oclc.org/10.1080/10447318.2017.1349249
Topic 6 DQ 2
Differentiate between EMRs and EHRs. Discuss the importance of interoperability in relationship to both types of records and to how the EMR and EHR improve quality and access to care.
Re: Topic 6 DQ 2
Both an Electronic Medical Record (EMR) and Electronic Health Record (EHR) are digital records of patient health information. An EMR is best understood as a digital version of a patient’s chart, while an EHR contains the patient’s records from multiple doctors and provides a more holistic, long-term view of a patient’s health. Both EHRs and EMRs offer benefits to patients and healthcare providers such as; reduced medical errors improved health care, patient charts are more complete and clear, information sharing can reduce duplicate testing, saving patients and providers time, money and trouble, improved information access makes prescribing medication safer and more reliable, the promotion of patient participation can encourage healthier lifestyles and more frequent use of preventative care, and with more complete information means more accurate diagnoses (Practice Fusion, 2019).
The primary benefit is the collaborative nature of an EHR. They are designed to be shared with other healthcare providers and to aid the level of care provided across the care continuum. EHRs also present the ability to track additional information inclusive of demographic data, lab results, insurance information, prior authorizations and data from personal wellness devices from across the internet, enhancing patient access to care.
EHRs also played a significant role in the rollout of Meaningful Use, the Medicare/Medicaid program that mandates the use of EHR to improve patient outcomes and subsequently performance-based compensation. An HER, that is certified technology, meets meaningful use standards for incentive-based programs administered by the CMS (Practice Fusion, 2019). EMRs do not. EHRs are designed to be shared and expanded upon outside of a single practice, where EMRs are not. EMRs are restricted in scope to primarily diagnosis and treatment information. EHRs provide in-depth data across a patient’s medical history from a variety of sources. EHRs move with the patient across providers, states and even country borders. EMRs do not travel with patients easily. The ability to share information across organizations, or interoperability, is vital for organizations to meet requirements of the HITECH Act (McGonigle & Mastrian, 2018. P. 185). Electronics records are expected to make healthcare more efficient and less costly and have a possibility to reduce the number of medical errors and therefore increase the safety of the patients.
The Health Insurance Portability and Patient Accountability Act of 1996 (HIPPA), requires that all protected health information be secure. Keeping health information safe is a major challenge for all members of the healthcare team. EHRs improve accountability with audit trails and security that detail who has accessed the medical records and when and what the individuals did while accessing each record. EHRs also keep information safe from anyone who does not have permission to see patient data. However, patients have access to their own EHRs through patient portals and can read, print and send their health information to providers, empowering patients to be their own advocate (Hoover, 2017).
Hoover, R. (2017). Benefits of using an electronic health record, Nursing Critical Care, (12), 1, 9-10. Retrieved from https://doi: 10.1097/01.CCN.0000508631.93151.8d
McGonigle, D., and Mastrian, K. (2018). Administrative Information Systems, in Nursing Informatics and the Foundation of Knowledge. (4th Ed).
Practice Fusion. (2019). EHR (electronic health record) vs. EMR (electronic medical record). Retrieved May 27, 2021 from: https://www.practicefusion.com/blog/ehr-vs-emr/
The drastically advancing technology in the evolving world plays a significant role in solving healthcare problems and improving the quality of care provided at a reduced cost. Recent technology has not only been beneficial to the healthcare providers in their line of duty but also improves the well-being of the diverse population. Such advanced technology utilized in healthcare include genomics, robotics, wearable sensors, management system, and telehealth (Wang, & Kricka, 2018). One point of focus is the utilization of three-dimensional (3D) printing as an emerging technology that has displayed significant impact in overcoming current healthcare barriers.
Overview of 3D Printing
The 3D printing technology, previously referred to as rapid prototype technology, enables customized fabrication of three-dimensional constructs based on images obtained from magnetic resonance imaging (MRI) and computed tomography (CT) or the computer-aided design (CAD) software. The main purpose of this technology in healthcare is the fabrication of anatomical replicas. Models produced by the 3D printing machines are currently utilized by healthcare professionals in enhancing disease diagnosis, treatment clarification, and practice in certain surgical interventions to enhance outcomes. The models also help in promoting patient education as clinicians utilize them in demonstrating certain medical conditions and the available interventions for the treatment of such conditions (Hornick, 2017). 3D printing is also utilized in orthopedics, in manufacturing custom-made prosthetic limbs which help in promoting movement hence improving the quality of life of the patient. The prosthetic ensures that the specifications of the model match the actual anatomical structure of the user.
Despite the benefits associated with 3D printing in the current healthcare system, the technology tends to raise several ethical issues. The main ethical issue is justice and access, as most 3D products are costly, hence only affordable by the rich, such as prosthetic limbs. The other ethical issue is safety. Medical professionals are trained to adopt the evidence-based practice to enhance the safety of the patient and promote well-being (Ripley et al., 2017). However, limited studies have revealed the safety of custom-made prosthetics despite their effectiveness in solving current healthcare problems. As such, more studies need to be conducted to ascertain the safety of 3D products such as prosthetic limbs among patients across all ages, from children to the geriatric population.
Improving Access to Care, Patient Safety and Quality
Several advantages are associated with 3D printing in the current healthcare system. However, with maximum utilization of this technology, patient safety and access to quality and effective care can be attained. For instance, enhancing pre-surgical practice using 3D models can help hasten the surgical procedure with increased accuracy and safety of the patient (Wang & Kricka, 2018). Additionally, the technology will help shorten theatre time per patient hence increasing the accessibility for more patients undergoing similar procedures. Lastly, 3D printing can help enhance the patient outcome, as demonstrations using actual models that are similar to the patient’s anatomical structure can help boost their understanding.
The incorporation of technology in the current healthcare system has played a significant role in solving healthcare problems. Different forms of technology have been utilized in promoting the safety and quality of care provided at a reduced cost. For instance, the utilization of 3D printing has helped enhance diagnostic procedures, surgical interventions, and the use of prosthetic limbs for those who have undergone amputation. Further advancements are expected in the future to attain safe and readily accessible healthcare services.
Hornick, J. (2017). 3D printing in Healthcare. Journal of 3D printing in medicine, 1(1), 13-17. https://doi.org/10.2217/3dp-2016-0001
Liaw, C. Y., & Guvendiren, M. (2017). Current and emerging applications of 3D printing in medicine. Biofabrication, 9(2), 024102. DOI: 10.1088/1758-5090/aa7279.
Ripley, B., Levin, D., Kelil, T., Hermsen, J. L., Kim, S., Maki, J. H., & Wilson, G. J. (2017). 3D printing from MRI data: harnessing strengths and minimizing weaknesses. Journal of Magnetic Resonance Imaging, 45(3), 635-645. https://doi.org/10.1002/jmri.25526
Wang, P., & Kricka, L. J. (2018). Current and emerging trends in point-of-care technology and strategies for clinical validation and implementation. Clinical chemistry, 64(10), 1439-1452. https://doi.org/10.1373/clinchem.2018.287052
Electronic medical records (EMR) can help health care providers increase access to safe, quality health care. If a patient is seeing multiple specialty providers at an organization, the records can be easily shared so the providers can collaborate to deliver the best care possible. One example is if a patient needs multiple surgeries. The surgeons can complete a combined case so the patient only has to be put under anesthesia one time, reducing the risks of being put under anesthesia multiple times, especially if the patient is at a higher risk for complications.
Clinical provider order entry (CPOE) is valuable in providing safe patient care because it can help eliminate errors. A nurse or other medical professional does not have to try to decipher the penmanship of the ordering provider. It also saves time because the orders are a click away, and order sets can be saved as favorites when a provider frequently orders them. However, there are also challenges with CPOE. Undocumented processes need to be taken into consideration when a new CPOE system is put into place. For example, there is not a person to double check the doctor’s orders when using CPOE. A nurse had been correcting a doctor that had been writing the wrong dose for a medication for 20 years, so the doctor did not understand when the new system would not allow them to prescribe the medication when they were really ordering too much (DeNiso, 2019).
Clinical decision support systems (CDSS) are also helpful to provide patient care. DeNisco (2019) notes for the system to work, the computerized “interventions must deliver the right information, to the right person, in the right format, through the right channel, at the right point in workflow” (p. 422). One example is routinely providing a first line antibiotic for an infection, but maybe the provider forgot to check the patient’s allergies. An alert will populate once the order is placed, and the provider can change the antibiotic order.