NURS 8210 Week 9 Assignment: Health Information Technology Project
NURS 8210 Week 9 Assignment: Health Information Technology Project
NURS 8210 Week 9 Assignment: Health Information Technology Project
Health information technology (IT) refers to the technology and infrastructure used to document, analyze, and share patient health information. Health technologies include health record systems and personal health tools such as smart devices and applications (Wienert, 2019). Health IT seeks to improve patient care and help attain health equity. It supports the documentation of patient data to enhance healthcare delivery and allows for analysis of the data for healthcare practitioners and the entire healthcare system (Wienert, 2019). Besides, Health IT increases patient safety, improves the quality of healthcare delivery, minimizes medical errors, and supports the interaction between patients and healthcare providers. This paper will discuss a health IT system in my organization, including the organizational information, the system’s design and development, and the innovative aspects of the system.
Information on Organization
This section will discuss the health information technology system adopted in my current organization and describe the organization type. Besides, I will discuss the main purpose of the health IT system and why it was developed. I will also discuss how the organization determined that the IT system will meet its predetermined needs and how it is managed.
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Health Information Technology System
The Electronic medical record (EMR) is one of the health information technology systems adopted in my current healthcare organization. An EMR system is a digital form of patient paper records implemented in hospitals, clinics, and physician offices (Honavar, 2020). The EMR is used to examine a patient’s medical history and is used by health providers for diagnosis and treatments. An EMR usually contains clinical notes and information collected by the providers in the clinic or hospital (Wali et al., 2020). EMR systems are more effective than traditional paper records because they allow clinicians to monitor a patient’s health over time. Furthermore, the EMR allows providers to identify patients who require preventive care and screenings and improve the quality of health care for these patients (Wali et al., 2020). The EMR uses various tools that help improve clinical decisions, thus creating a safe, effective and efficient healthcare system.
Organization Type
My current healthcare organization is an acute mental health hospital providing both inpatient and outpatient mental health services. The organization is a leading provider of mental health and addiction treatment services in the region. We strive to offer a safe and supportive environment where clients in crisis receive comprehensive care delivered with compassion and respect. Inpatient services include child, adult, and geriatric psychiatric care, acute medical detox, and addiction rehabilitation. Outpatient services include addiction treatment and outpatient psychiatric care. The most common conditions treated in the organization include Behavioral and mood disorders, Depression, Anxiety, Bipolar disorder, Emotional Trauma, Schizoaffective disorder, Schizophrenia, and Suicidal disorder. The organization is run by a team of medical and non-medical staff, including receptionists, record officers, informaticists, psychiatrists, PMHNPs, registered nurses, pharmacists, social workers, nutritionists, and counseling therapists.
Type of Health Information Technology System
The EMR was adopted for clinical purposes, mainly collecting and documenting patients’ health data. The EMR is used to record and avail patients’ demographic and clinical health data, such as patient identification data, clinic attendance, and encounter data (Honavar, 2020). Clinical data recorded in the EMR include patients’ medical history, psychiatric history, medication, allergies, diagnostic tests and results, vital signs, weight, nutritional information, and clinical progress notes. Besides, the EMR contains information on clinical encounters between a mental health practitioner and a patient (Honavar, 2020). The EMR has clinical decision support (CDS), which notifies providers of abnormal diagnostic results, vital signs, drug allergies, and potential drug interaction (Sutton et al., 2020). The CDS also reminds clinicians of the appropriate patient care interventions such as tests and medication. Furthermore, the EMR is used by health providers to insert patient care orders in the system, accept drug prescription orders, and manage referrals with details of the referring practitioner and of the specialist.
Key Reasons for the Development of the EMR
The main aim of developing an EMR system in the organization was to improve health care quality. The decision to acquire the system was driven by the need to improve coordination in the healthcare team, reduce medical errors caused by missing patient data, and maximize cost-efficiency (Lin et al., 2020). The previously used paper records were faced with a myriad of challenges from errors caused by illegible handwriting, misspellings, and the use of varying terminologies that created much confusion. Consequently, the EMR was created to eliminate these paper-based irregularities and standardize patient records across the hospital.
Paper records were often misplaced, affecting efforts to monitor patients over time, and misplaced data led to repeated tests. As a result, the organization developed the EMR to ensure that patients’ records were securely stored and to improve providers’ access to these records (Lin et al., 2020). Furthermore, the EMR was developed to merge patients’ data in one central system rather than having scattered paper records (Wali et al., 2020). Clients had expressed discontent with the wait times and the loss of their previous clinical data contributed by paper records. They suggested that the hospital adopt an electronic system similar to other organizations to store and quickly retrieve their clinical information, which would reduce the wait times.
How the Organization Determined That the EMR Could Fulfill Its Predetermined Needs
The organization’s management conducted a survey to determine if the EMR could meet its predetermined needs of reducing medical errors, improving quality of care, coordination of care, and cost-efficiency. Healthcare providers were administered questionnaires that collected information on the challenges they came across when providing patient care and the factors that caused these challenges. The most reported challenges included errors in documentation, misplacement of patient data and clinical notes, poor coordination among providers, and time wastage when retrieving patient records. The questionnaires also asked the health providers about the approaches that the organization can implement to address those challenges. Providers suggested an electronic system that would enhance the retrieval of patient data while ensuring that the patients’ records are secure. The success of the EMR implementation in other healthcare organizations further led the organization’s management to determine that the EMR would meet its predetermined needs. Organizations that had successfully adopted the EMR system reported that it improved the quality of patient care, patient experience, and cost-efficiency.
Who Manages The EMR?
The EMR system is managed by health informaticists who have the role of running and maintaining the system. The health informaticists work with other staff by assisting them to key in patient information in the EMR and retrieve it. Informaticists ensure that the EMR’s user interface is easy to navigate to save time for health providers. Clinicians consult the maintenance team in cases of a system failure that is beyond their capacity. The health informaticists who manage the system fall under the IT department in the administrative structure and report to the head of IT.
Information System Application Design and Development
Information systems design and center around accomplishing a project. The design and development of a health information system are crucial since it determines the success of adopting the system in the organization. This section will describe the design and development of the EMR, including how stakeholders make decisions about the EMR, training, security issues, initial funding, arrangements for downtime, system upgrade, and how the EMR changed in response to health care reform and related legislation.
How the Various Stakeholders Make Decisions Related To the EMR
The hospital’s board and the heads of the various hospital departments collaboratively make decisions regarding the EMR. When developing the EMR system, the heads of departments involved the staff on how the EMR can be designed to address priority patient care needs and enhance the quality and coordination of care. The employees in various departments were consulted in the design and development because they would be the end-users and would highly impact the system’s success. For example, the head of the Rehabilitation department enquired from nurses and therapists on how the EMR should be designed, including vital features to help address challenges they encounter when using the paper records. The head of the outpatient department also asked employees about features crucial in making the EHR successful in achieving its predetermined needs. The departmental heads presented the employees’ views to the hospital board members to analyze and choose the most practical ones.
Training of Individuals to Use the EMR
The EMR training was conducted at the beginning of the implementation phase by the health informaticists team. The team conducted seven-day training on the EHR and how to implement it. Training centered on the EHR’s core functions, potential benefits and challenges, security and privacy measures, and HIPAA and HITECH regulations. Besides, health providers were equipped with basic skills on how to maintain the EHR system. They were also trained on recording and retrieving patient information in the system, utilizing the system’s features such as CDS and Order entry, coordinating patient care using the EHR, generating reports, and using usernames and passwords. In addition, training is conducted when the EMR system is upgraded. CMEs and seminars are conducted in the organization to train end-users about the upgrade and how to use new features introduced in the system.
How Security Issues Are Addressed And How the EMR Support a Legally Sound Health Care Record
Potential security issues in the EMR include malware and ransomware, and cloud threats. The EMR system contains large amounts of sensitive patient data, which puts it at risk of breach by hackers. The health informaticists team handles security issues pertaining to the EMR. The team uses technical, physical, and administrative security-safeguard themes to reinforce the security of the EMR. Technical safeguards protect the whole EMR information system. The safeguards include antivirus software, virus checker, firewalls and encryption, cloud computing, strategies to validate information, and the use of information security officers (Keshta & Odeh, 2020). The physical safeguards seek to physically protect patient data so that the EMR software or hardware cannot be accessed by unauthorized persons (Keshta & Odeh, 2020). They include policies and procedures that dictate the hospital’s access controls, workstation use, workstation security, and device and media control.
The administrative safeguard theme centers on having conforming security procedures and policies. It consists of security measures such as performing audits, establishing contingency plans, and having an informaticist in charge of information security (Keshta & Odeh, 2020). The organization’s EMR system fosters a legally sound health care record by satisfying all regulatory, statutory, and professional requirements on using an EMR for clinical purposes. It uses technical, physical, and administrative safeguards to avoid legal issues arising from data breaches (Keshta & Odeh, 2020). Furthermore, the EMR uses a secure network that links various physical sites in the hospital, and clinicians can access it at home through a secure authentication code.
Initial Funding and Management of Budget
Developing and implementing the EMR requires substantial funds to cater for equipment, contracts, human resource, and training. The initial funds used to develop and implement the EMR were obtained from the organization’s development fund. Every yearly budget in the organization contains funds dedicated to funding new projects. The funds for development are usually a percentage of the profits obtained from the previous financial year. The money from the project’s fund was used to purchase the EMR system and conduct training. Effective budget management is crucial to the success of implementing a health system in any organization. Budget management involves making monthly budget allocations, managing the budget baseline, regulating the budget, and assessing the budget performance. The hospital’s account department manages the EMR’s budget. The accounts department is tasked with creating a cash flow management plan before any expenditure is made. Besides, the accountants manage the budget baseline to establish that the project expenditures are consistent with the cash management plan. Managing the baseline involves verifying and approving all charges coded to the system and timely payment of bills related to the EMR.
Organizational or Political Issues Impacting the Ongoing Funding
Organizational issues that negatively affect the ongoing funding of the EMR system include insurance companies delaying processing bills. Delays by insurance companies result in the organization also delaying the payment of the monthly funds to the system’s vendor. Recruitment of new staff also impacts ongoing funding since it lowers the funds for maintaining the program. Staff recruitment usually requires huge finances and takes a large percentage of the capital budget, which impacts the funding of the EMR.
Arrangements for Planned or Unplanned Downtime
Downtimes in the EMR system are usually caused by problems in the internal hardware or an external source, especially if the system has cloud hosting. The EMR vendor has a contingency plan that ensures data backups are secured during a system failure. This protects crucial information from getting lost permanently during downtime. During a planned downtime, the health informaticists inform the medical and non-medical staff that the EMR system will experience downtime at a specific time. The reception staff then notifies patients when they get to the hospital that there will be a temporary delay due to the EMR system downtime, which may prolong their clinic visit. Besides, the administrative staff usually prepares a set of pre-approved paper forms beforehand in a planned EMR downtime. During unplanned downtime, the health informaticists team usually contacts the EMR vendor to alert them of the system hitch and identify if the downtime is only in the hospital or widespread to other organizations. Paper sign-in forms are used to track when clients arrive in the outpatient department. The organization also has blank encounter forms and charge slips used for new patients to assign them temporary record numbers until an official electronic record can be generated. Paper charts and printed templates are also used for documentation during EMR system downtime.
Schedule of EMR Upgrades
Regular EMR upgrades are essential to avoid having inefficient, outdated software, which causes delays and hinders the desired success of any clinical practice. Our organization’s EMR system has an annual upgrade schedule, which aims at enhancing the system’s overall efficiency, adaptability, and productivity. The health informaticists and system vendor plan for the EMR upgrade by assessing the system’s features and templates that need to be improved, removed, or added. The vendor also examines if the EMR system will be compatible with the new features and templates to be added to the EMR. They check the existing EMR system’s hardware, backups, data exports, and reporting when assessing the compatibility. Besides, the vendor verifies that the needed bandwidth for the system upgrade is available to sufficiently support the upgraded EMR system.
Staff training is also included when planning the system upgrade to ensure the health providers are well-versed with the new features and system upgrades and promote the smooth running of the system. Training is a major element in adopting, sustaining, and ensuring the success of the EMR system after the upgrade. EMR system upgrades in our organization result in improved patient care efficiencies and increased patient satisfaction. Besides, an improved EMR system enables clinicians to monitor a patient’s progress closely, improving patient care.
How the EMR Changed In Response to Health Care Reform and Related Legislation
The Affordable Care Act (ACA) of 2010 introduced comprehensive health care insurance reforms that aim to improve quality of care, access to health care, and reduce health care costs. The EMR has changed with respect to the ACA reform by including features that guide health providers to implement evidence-based interventions and reduce duplication of services, improving quality and lowering healthcare costs (Borbolla et al., 2019). In addition, the HITECH Act gives authority to DHHS to create programs that improve health care quality, safety, and efficiency using health IT systems, such as EMRs (Borbolla et al., 2019). The EMR has evolved with regard to the HITECH legislation by integrating the CDS feature. The CDS streamlines the healthcare process and clinical outcomes by enhancing the quality and efficiency of patient care.
Changes Needed To Support Health Care Reform and Related Legislation
The changes that can be effected in the EMR to support the ACA reform include incorporating features that increase patients’ engagement, thus improving efficiency in patient care. The features can include those that allow patients to schedule their clinic appointments and request prescription refills, which increases engagement in their health care and encourage them to take charge of their health (Borbolla et al., 2019). In addition, the EMR can be modified to have a feature that allows clinicians to send patients appointment reminders, thus reducing cancellations and increasing patient engagement.
Innovative Aspects of the System
Healthcare is an area that has gained the most from technological innovations, which continue to make healthcare delivery more efficient. Technology innovations ensure that systems used in healthcare contain key inputs to increase access and promote quality and logical use of inputs. This section will describe how our organization’s EMR uses technology innovations and recommend technological innovations that would benefit the organization and promote evidence-based practice and efficiency.
How the EMR Utilize Technology Innovations
Technology innovations have had an immense impact on healthcare technology systems, including the EMR. The EMR has embraced technology innovations, significantly reducing technology barriers in EMR interoperability, usability, and documentation (Guo et al., 2017). For example, technology innovations have been used to incorporate a well-designed EMR scribe tool into the EMR system’s workflow. It also uses innovations such as the CDS system, which helps reduce unnecessary or repetitive medical procedures through soft and hard stops (Sutton et al., 2020). For example, if a psychiatrist requests a diagnostic test not indicated in the clinical guidelines, an EMR soft stop informs the psychiatrist. The CDS system may then require the psychiatrist to indicate the rationale for overruling (Sutton et al., 2020). Besides, the CDS hard stop inhibits the psychiatrist from requesting unnecessary tests without approval from the radiologist. The EMR’s technological innovations streamline the workflow for clinicians in the hospital and enable them to provide patient care efficiently.
Technology Innovations I Would Recommend For the Organization
Cloud computing is my recommended technology innovation for my organization. Cloud computing entails using remote servers over the internet to offer on-demand access to information services (Ratten, 2020). It uses IT infrastructure to foster flexibility with accessing online data. Cloud computing supports the delivery and access to computing services and resources through the internet, including databases, developmental platforms, and analytics (Ratten, 2020). It allows for safe and affordable data storage with portable access to health informatics. Health informatics depends on access to huge amounts of medical data and EMRs. The cloud computing capacity for high-volume data storage can thus lower costs for health care organizations. Besides, real-time information sharing can foster better communication among healthcare providers (Ratten, 2020). Cloud computing monitors patient and clinician interactions remotely and thus promote better patient care in the organization. Furthermore, it promoted fast data sharing, which can improve psychiatric research in our organization.
Innovations That Could Further Promote Evidence-Based Practice and Efficiency within the Organization
The Smart bed technology innovation can further promote EBP and efficiency in the organization. Smart bed technology helps nurses track patients’ movement, weight, and vitals (Hong, 2018). It allows nurses to monitor patients constantly and provide frequent updates and communications on a patient’s activities, especially for acute-ill psychiatric patients. Smart beds play a key role in keeping patients safe and comfortable during a long hospital stay by preventing falls since the nurse can monitor the patient’s movement (Hong, 2018). Falls are a point of concern for psychiatric and dementia patients. Smart bed technology uses a sensor, which is placed under the mattress, to help prevent patient falls. Besides, they can help nurses identify patients’ patterns, leading to a new diagnosis or a different understanding of a patient’s disorder (Hong, 2018). Smart bed technology promotes efficiency in patient care since nurses spend less time going to patients’ rooms to monitor them or adjust their comfort since they can control that with the smart bed.
Conclusion
The EMR is a health IT system implemented in my health care organization, a psychiatric hospital. Mental health practitioners utilize the EMR in the hospital to store and access patient information and clinical notes and aids in the diagnosis and treatment. It was developed to improve the quality of health care. There was a need to improve coordination in the healthcare team, reduce medical errors, and maximize cost-efficiency. Besides, it is managed by health informaticists who operate and maintain the system. The EMR has embraced technology innovations, significantly reducing technology barriers in EMR interoperability, usability, and documentation. It uses clinical decision support, which reduces unnecessary medical procedures and tests through soft and hard stops. I would recommend the organization to adopt cloud computing since it promotes safe and affordable data storage with portable access to health informatics. The smart bed technology would promote EBP by promoting patient safety and improving the efficiency of nursing care.
References
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Ratten, V. (2020). Cloud computing technology innovation advances: a set of research propositions. In Disruptive Technology: Concepts, Methodologies, Tools, and Applications (pp. 693-703). IGI Global. https://doi.org/10.4018/978-1-5225-9273-0.ch034
Sutton, R. T., Pincock, D., Baumgart, D. C., Sadowski, D. C., Fedorak, R. N., & Kroeker, K. I. (2020). An overview of clinical decision support systems: benefits, risks, and strategies for success. NPJ digital medicine, 3(1), 1-10. https://doi.org/10.1038/s41746-020-0221-y
Wali, R. M., Alqahtani, R. M., Alharazi, S. K., Bukhari, S. A., & Quqandi, S. M. (2020). Patient satisfaction with the implementation of electronic medical records in the Western Region, Saudi Arabia, 2018. BMC family practice, 21(1), 1-6. https://doi.org/10.1186/s12875-020-1099-0
Wienert, J. (2019). Understanding health information technologies as complex interventions with the need for thorough implementation and monitoring to sustain patient safety. Frontiers in ICT, 6, 9. https://doi.org/10.3389/fict.2019.00009
Nursing informatics is among the highly advancing health care specialties as the health care field continues being more technology-driven and data-centered. Like many other specialties, nursing informatics has pioneers who commenced and promoted it. Their valuable work ensured that the nursing practice could benefit from informatics as witnessed presently. Analyzing the contributions of Virginia Saba and Marion Ball can better illustrate informatics innovators’ work.
In the video about her work as an informatics innovator, Virginia Saba talks about pioneering computer technology in nursing. She also played a critical role in supporting and developing health care information technology systems, with the Clinical Care Classification (CCC) system development among her leading innovations (American Medical Informatics Association [AMIA], 2022). Other accomplishments include research to develop the systems and promoting meaningful use. In health practice, meaningful use guides information exchange between health care providers to ensure that it improves patient outcomes (Lite et al., 2020). Marion Ball also contributed massively as a nursing informatics innovator. Like Virginia Saba, Marion Ball pioneered computer technology in nursing, albeit focusing on the clinical lab system. Her other accomplishments include publishing books on health care informatics to guide its integration in care and research to encourage nurses to adopt current enabling technologies in health practice (AMIA, 2022). Both innovator
