NUR 514- Week 6 Assignment Emerging Technology Brief

NUR 514- Week 6 Assignment Emerging Technology Brief

NUR 514- Week 6 Assignment Emerging Technology Brief

New health care innovations offer the advanced registered nurse an opportunity to apply emerging technologies in practice to improve quality and patient outcomes.

One of the emerging technologies that the author believes will have a significant impact on barriers to healthcare is the Internet of Medical Things (IoMT). Accordingly, IoMT refers to medical infrastructure that consists of software, sensors, healthcare IT systems and medical devices that are utilized in medical monitoring, testing, as well as diagnostics. The use of this infrastructure can help the healthcare provider a well as the patient to monitor and inform them on the actual data on potential issues that could result in health problems. Through it, potential health problems are averted before they occur (Balas et al., 2019). An example is the use of skin sensors for blood glucose where diabetic patients are installed with sensors that monitor their blood glucose levels. The sensors notify the patient and healthcare provider incidences of low or high blood glucose levels and the need for an immediate action. In some cases, the sensors deliver insulin depending on the blood glucose levels. Through this mechanism, health problems such as diabetic coma and hypeglycemia and prevented prior to their occurrence in patients suffering from diabetes.

The other way in which the technology could function in healthcare is the management of health problem that affect the elderly populations. The elderly are at a risk of problems such as cardiovascular, renal, and respiratory and memory loss problems. The technology proves significant to these populations. For instance, sensors can be used to monitor their blood pressure and immediate actions taken in case of any deviations from the normal range (Stegemann, 2016). Similarly, they can be used to monitor their adherence to medication and notifications sent to them in cases where they forget their medical regimen.

The use of IoMT technology in health is however associated with some legal and ethical issues. One of them is the issue of privacy. Scholars argue that the use of such emergent technologies might violate one’s right to privacy. The system information can be accessed by third parties, thereby, weakening their use in the modern world. The other issue is safety concern. The long-term effects of the monitors are yet to be established. There is the concern that too much monitoring might be unhealthy as it raises individual focus on slight health issues that might be of less concern to them (Keramidas, Voros & Hübner, 2017). Therefore, these issues need to be addressed for the emerging technologies to be relevant in the modern practice of healthcare.

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IoMT will improve access to care and patient safety in several ways. Firstly, it ensures that the patient and healthcare provider interact constantly on healthcare issues affecting them. The healthcare provider will always be in contact with the patient in case of a notification of an impending health problem (Le et al., 2018). The access to care is also enhanced due to the efficiency in which decisions are made. The easy availability of the patient’s data ensures that healthcare providers can collaborate with ease in determining the healthcare needs of the patients. The monitoring of the patient’s physiological status also promotes safety since health problems are identified before they occur. Besides, incidences of poor adherence to treatment are identified earlier, which leads to minimal occurrences of complications associated with the conditions being managed (Vermesan & Bacquet, 2017). Therefore, it makes it apparent that emerging technologies such as IoMT will eliminate barriers that affect the quality, access, and safety of care given to those in need in the society.

NUR 514- Week 6 Assignment Emerging Technology Brief References

Balas, V. E., Solanki, V. K., Kumar, R., & Ahad, A. R. (2019). A handbook of internet of things in biomedical and cyber physical system. Cham: Springer.

Keramidas, G., Voros, N., & Hübner, M. (2017). Components and services for IoT platforms: Paving the way for IoT standards. Cham: Springer.

Le, D.-N., Le, C. V., Tromp, J. G., Nguyen, N. G., & Wiley InterScience (Online service). (2018). Emerging technologies for health and medicine: Virtual reality, augmented reality, artificial intelligence, internet of things, robotics, industry 4.0. Beverly, MA: Scrivener Publishing.

Stegemann, S. (2016). Developing drug products in an aging society: From concept to prescribing. Cham: Springer International Publishing.

Vermesan, O., & Bacquet, J. (2017). Cognitive hyperconnected digital transformation: Internet of things inteligence evolution. Delft: River Publishers.

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.

Ethical Issues

            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.

Conclusion

            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.

NUR 514- Week 6 Assignment Emerging Technology Brief References

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

Health informatics helps health care providers in a number of ways. One of the ways in which informatics help health care providers overcome the challenges to care is improved documentation. The modern nursing practice is primary driven by the specific patient needs and history as documented in the electronic patient records (McGonigle & Mastrian, 2018). Through the documentation provided in the electronic patient records and sharing of the patient information, nurses and other health care providers are in a position to manage and provide care more effectively. Thus, the informatics have helped in improving the quality of care provided to the patients.

The second way in which health informatics assist health care providers increase access to safe and quality health care is reduced medical errors. Patient safety is a major objective for any health care provider and especially nurses who are the forefront in ensuring that the patients are safe from medication errors, misdiagnoses, and other adverse outcomes associated with provision of health care services (Carayon & Hoonakker, 2019). The modern health informatics such as the clinical decision support systems (CDSS) offer critical data that can assist health care providers minimize these errors (Carayon & Hoonakker, 2019). For example, CDSS provides strategies through which medication errors can be minimized. On the other hand, clinical provider order entry (CPOE) is equipped with drug safety software that has safeguards for dosing. In order to be effective in offering these benefits there is need to improve the usability of health technologies. Through this, efficient clinical information systems such as CPOE and CDSS can be effective.

References

Carayon, P., & Hoonakker, P. (2019). Human Factors and Usability for Health Information Technology: Old and New Challenges. Yearbook of Medical Informatics, 28(1), 71-77. https://doi.org/10.1055/s-0039-1677907.

McGonigle, D., & Mastrian, K. G. (Eds.). (2018). Nursing informatics and the foundation of knowledge (4th ed.). Jones & Bartlett Learning.

In an ideal world, we would all work together to create systems that are integrated within our own organization while having the interoperability to cross organizational boundaries and unite the healthcare delivery system to realize the common goal of improving the quality of care provided to consumers. Every organization’s situation is unique. Your technology journey may not match with someone else’s and you may not find another organization that mirrors your organizational challenges. Your needs will be unlike others’, just as your patient population is diverse and the community you serve is different (Health Information and Management Systems Society, 2018). 

Review one of the following case studies: 

·     The Oregon Clinic: https://www.himss.org/library/interoperability-case-study-oregon-clinic 

·     Atrium Health: https://www.himss.org/library/interoperability-case-study-atrium-health 

What trial and errors did you witness in each of these case studies? What barriers did they face? What were their successes? 

Thank you for sharing! 

References: 

Health Information and Management Systems Society. (HIMSS, 2018). Interoperability and health information exchange. https://www.himss.org/library/interoperability-health-information-exchange. 

REPLY 

Computerized physician (provider) order entry (CPOE) solves the safety issues associated with poor handwriting and unclear or incomplete medication orders. As with any technology integration, introduction of CPOE is associated with a resistance and a learning curve to gain proficiency, and users must learn to trust the system (McGonigle & Mastrian, 2018). What resistance have you noted in your workplace to these changes and how has your organization or unit handled them? 

Thank you for sharing!

References: 

McGonigle, D. & Mastrian, K. (2018). Nursing Informatics and the Foundation of Knowledge. (4th ed.). Jones & Bartlett Learning. 

REPLY 

When I worked as a nurse in labor and delivery, there was one physician who was older and refused to use the CPOE system for orders. He insisted on continuing to hand write orders and having the nurses enter the orders in the CPOE system, despite the electronic health record and CPOE systems having existed in this hospital for over five years. This created a significant increase in workload for any nurses taking care of patients being cared for by this doctor. This physician’s refusal to use the CPOE system not only created more work for the nurses, but also risked patient safety as the provider did not benefit from any of the CDSS algorithms that the computer prompts the physicians with when they are entering orders. 

In the current hospice home care agency I work at now, I often hear some of the nurses who have worked at the agency since before the electronic health record was implemented lament about how they miss paper charting. They state that the paper charting for physician orders was easier and less time consuming than electronic documentation. I do believe that it probably was faster, but I think this has a lot to do with user capabilities. If a nurse is not proficient in typing or using a computer, then paper documentation is of course faster. As someone who has had the privilege of growing up with technology, documenting electronically is faster for me than paper documentation as I type much faster than I am able to write. I think often the resistance to changing from paper documentation to electronic documentation has to do with the fact that if nurses or physicians are used to performing their job one way it is uncomfortable and challenging to change that workflow. Once healthcare professionals get past the initial learning curve, however, I think they often find that the benefits of the new technology outweigh the challenges of the change implementation process. 

REPLY 

I have worked in hospitals with CPOE and hospitals with out CPOE. Back in the Bahamas when I started nursing, we were still utilizing written documentation. This system is still in placed at the government operated facilities. During my rotation in the Dialysis Unit, the nurse manager wanted to implement a computerized charting system for the unit however, the medical director didn’t want the change. He was a mature doctor who had practiced for many years and was comfortable with the written documentation. That was very challenging because the technology was included with the new dialysis machines but it was only utilized by the nursing staff. So nurses still had to decipher through poorly written orders to gave patient care. Eventually, the technology was abandoned and we went back to the written documentation. 

REPLY 

the fact that physician’s handwriting has rarely been decipherable and dangerous for patient safety, has always been a real concern of mine. I think the CPOE is phenomenal, even though there are risks associated with it. One drawback is the cost of these programs but even more than that I can see from working with these programs personally that many times the nurse puts the order in, and the doctor just comes along and signs the order. The nurse usually has more insight to what is actually happening with the patient, but we are not doctors. It’s good that the Dr. trusts us to assess and make recommendations, but in the end the Dr. needs to be the decision maker. I’ve seen orders put in by nurses and the order was not what should have been prescribed for the patient. 

McGonigle, D. & Mastrian, K. (2018). Nursing Informatics and the Foundation of Knowledge. (4th ed.). Jones & Bartlett Learning. 

REPLY 

Eliminating reliance on handwriting for ordering medications related to global concern for patient safety as a result of incorrect and misinterpreted orders, healthcare organizations are incorporating computerized physician (provider) order entry systems into their operations as a standard tool for practice. Nursing professionals have an ethical duty to ensure patient safety. Medical errors are the third leading cause of death and cost the United States $37.6 billion each year (McGonigle & Mastrian, 2018)! Can you list some benefits of the CPOE? Do you have personal experience in your workplace with this system? 

Thank you for sharing! 

References: 

McGonigle, D. & Mastrian, K. (2018). Nursing Informatics and the Foundation of Knowledge. (4th ed.). Jones & Bartlett Learning. 

REPLY 

It is truly shocking to read that medical errors are the third leading cause of death in the United States and cost the country almost $40 billion per year. Computerized provider order entry (CPOE) helps to prevent medication errors due to illegible, erroneous, or omitted information (Baysari et al., 2018). The amount of time saved by nurses no longer having to read and interpret the handwriting of clinicians is significant. In several studies of ICU mortality rate CPOE implementation was associated with a 12% mortality reduction in ICU patients (Baysari et al., 2018). CPOE also helps to provide clinicians with order sets that prompt clinicians to order all the related orders a patient needs in the moment, instead of having to be paged later to add orders they may have forgotten.

The order sets also help to ensure that evidenced-based care guidelines and policies are followed. In my personal experience in the hospital, when I was caring for an acutely ill patient, it was beneficial to be able to remain at the bedside with my patient and see new physician orders in real time in the electronic health record, despite the physician not being in the room or possibly even on the floor. CPOE systems also decrease the time between a physician writing an order and the pharmacy receiving the order or a nurse receiving and acting on the order. I am thankful that most of my time spent in nursing has been with CPOE in place, as this has saved me lots of time and has helped the patients I have cared for to have better outcomes. 

Reference 

Baysari, M. T., Hardie, R. A., Lake, R., Richardson, L., McCullagh, C., Gardo, A., & Westbrook, J. (2018). Longitudinal study of user experiences of a CPOE system in a pediatric hospital. International journal of medical informatics, 109, 5-14. https://doi.org/10.1016/j.ijmedinf.2017.10.018 

REPLY 

Majority of my nursing career has been in an environment where computerized provider order entry (CPOE) system is virtually nonexistent. One major issue that we deal with in such a