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

Sample Answer for Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies Included After Question

New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies.

Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.

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 4 peer-reviewed research articles from your research.
For information about annotated bibliographies, visit https://academicguides.waldenu.edu/writingcenter/assignments/annotatedbibliographies

The Assignment: (4-5 pages not including the title and reference page)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography. Be sure to address the following:

Identify the 4 peer-reviewed research articles you reviewed, citing each in APA format.
Include an introduction explaining the purpose of the paper.
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.
In your conclusion, synthesize the findings from the 4 peer-reviewed research articles.
Use APA format and include a title page.
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Assignment Literature Review The Use of Clinical Systems to Improve Outcomes and Efficiencies

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A Sample Answer For the Assignment: Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

Title: Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

Over the past two decades, advancements in the use of technology have transformed the process of care provision. The days of manual record filling and meticulous charting are dwindling. Clinical systems through electronic health records (EHR) and telehealth have increased the accessibility of patients to their personal health information like never before (Islam, Poly, & Li, 2018). From a global perspective, evidence report that adoption of clinical information system by healthcare organizations has led to enhanced patient outcome, efficiency, safety, and financial performance. Clinical information system has also impacted the work of healthcare providers positively, such as nursing practice, by making it easier to retrieve patient information and even take patient history with reduced errors, hence promoting the accuracy and quality of care provided. The paper demonstrates a literature review on the impact of applying clinical systems to improve the quality and efficiency of care provision.

Literature Review

Islam, M. M., Poly, T. N., & Li, Y.-C. J. (2018). Recent Advancement of Clinical Information Systems: Opportunities and Challenges. Yearbook of medical informatics, 27(1), 083-090. DOI: 10.1055/s-0038-1667075

In this article, Islam, Poly, and Li (2018), discuss the opportunities generated by clinical information systems for the improvement of workflow and patient care. However, they still claim that the healthcare system is still far from perfection. For instance, healthcare providers still face challenges associated with data exchange, integration, and management as a result of a lack of functionality among new systems. Islam et al. (2018), carried out a literature review to determine the current stage in which clinical information systems have impacted healthcare practice, as displayed by the current state of knowledge. They selected 23 papers from EMBASE, and PubMed focusing on three major areas such as ancillary information systems, specialty information systems, and inpatients and ambulatory clinical information systems. Based on their results, Islam et al. (2018), concluded that clinical information systems provide significant opportunities in reducing clinical errors, such as diagnostic and medical errors, and offer support to clinicians by availing updated patient information. They also noted improved workflow, and efficiency of care as a result of electronic health records.

Fu, H., McMahon, S. K., Gross, C. R., Adam, T. J., & Wyman, J. F. (2017). Usability and clinical efficacy of diabetes mobile applications for adults with type 2 diabetes: a systematic review. Diabetes research and clinical practice, 131, 70-81. https://doi.org/10.1016/j.diabres.2017.06.016

Fu et al. (2017) carried out a study to evaluate the clinical effectiveness and usability of diabetes mobile applications among adults diagnosed with diabetes mellitus. The study utilized a systemic review of articles retrieved from IEEE XPLORE, COMPENDEX, EMBASE, and MEDLINE. Fu et al. (2017) narrowed it down to ten clinical effectiveness and seven usability studies for their research. The results derived from a measurement of the satisfaction rate from patients and experts revealed a usability percentage ranging from 38% to 80%. The clinical effectiveness was measured by the HgbAIc reduction, which displayed a range from 0.15% to 1.9%. Fu et al. concluded that despite the challenges that might be associated with diabetes mobile application, studies reveal an improved glycemic control among adults with diabetes type 2. The therapeutic impact of the diabetes app can however be improved in terms of usability and effectiveness through the incorporation of principles aimed at changing health behavior.

Arndt, B. G., Beasley, J. W., Watkinson, M. D., Temte, J. L., Tuan, W. J., Sinsky, C. A., & Gilchrist, V. J. (2017). Tethered to the EHR: primary care physician workload assessment using EHR event log data and time-motion observations. The Annals of Family Medicine, 15(5), 419-426. doi: https://doi.org/10.1370/afm.2121

Arndt et al. (2017) conducted a study to assess the time spent by primary care physicians on electronic health records (EHR) and its impact on workflow and care delivery. They utilized a retrospective cohort study design with 42 family medicine physicians as the study participants. The study captured all Epic Systems Corporation EHR interactions from “event logging” records for both non-face-to-face activities and direct patient care. According to their results, clinicians spend about 5.9 hours out of the 11.4 hour workday on EHR. Some of the tasks covered during this time, both clerical and administrative, include order entry, documentation, billing, and coding account for about half of the time they spend on EHR systems. About 85 minutes are spent on inbox management. They concluded that the EHR event logs can be utilized in spotting areas of EHR-related works which can be delegated, hence reducing workload, decrease burnout, and improve professional satisfaction which in turn boosts the quality and efficiency of care provision.

Kruse, C. S., & Beane, A. (2018). Health information technology continues to show a positive effect on medical outcomes: a systematic review. Journal of medical Internet research, 20(2), e41. doi: 10.2196/jmir.8793

In this article, Kruse and Beane (2018) reviewed the positive impact of health information technology (HIT) on the medical outcome. Recent studies published between 2013 and 2018 were utilized in this research, retrieved from Medical Literature Analysis and Retrieval System Online (MEDLINE) and Cumulative Index of Nursing and Allied Health Literature (CINAHL) databases. The review was conducted in accordance with the Assessment for Multiple Systematic Reviews (AMSTAR). Out of the 3636 papers that were arrived at, only 37 met the inclusion criteria for their literature review. The results displayed at least one improvement in medical outcomes concerning the adoption of HIT in 81% of the reviewed literature. Three categories of the outcome and twelve categories of HIT were consistent in the studies about 65 and 38 times respectively. As a result, Kruse and Beane concluded that there is substantial evidence supporting the positive impact of HIT on the effectiveness of medical outcomes.

Assignment Literature Review The Use of Clinical Systems to Improve Outcomes and Efficiencies Conclusion

The current healthcare system has greatly transformed towards the adoption of advanced technology in promoting the quality, safety, effectiveness, and outcome of care provision. The current clinical system promotes the utilization of EHR and HIT by healthcare personnel in improving the efficiency of workflow and reduce incidences of burnouts. All the four studies summarized above reveal the positive impacts associated with technology in care provision for effectiveness and improved outcomes. For instance, Islam et al. (2018) and Arndt et al., (2017) revealed the impact of EHR in reducing medical errors and improving workflow and efficiency in the care delivery system. Fu et al. (2017) on the other hand provide evidence supporting the use of diabetes app in improving outcomes among diabetes mellitus patients. Lastly, Kruse and Beane, (2018) provides evidence associated with different aspects of improved medical outcome and effectiveness as a result of HIT. Further advancement in the clinical systems is however expected for further improved outcome and efficiency.

Assignment Literature Review The Use of Clinical Systems to Improve Outcomes and Efficiencies References

Arndt, B. G., Beasley, J. W., Watkinson, M. D., Temte, J. L., Tuan, W. J., Sinsky, C. A., & Gilchrist, V. J. (2017). Tethered to the EHR: primary care physician workload assessment using EHR event log data and time-motion observations. The Annals of Family Medicine, 15(5), 419-426. DOI: https://doi.org/10.1370/afm.2121

Fu, H., McMahon, S. K., Gross, C. R., Adam, T. J., & Wyman, J. F. (2017). Usability and clinical efficacy of diabetes mobile applications for adults with type 2 diabetes: a systematic review. Diabetes research and clinical practice, 131, 70-81. https://doi.org/10.1016/j.diabres.2017.06.016

Islam, M. M., Poly, T. N., & Li, Y.-C. J. (2018). Recent Advancement of Clinical Information Systems: Opportunities and Challenges. Yearbook of medical informatics, volume:27 number:01 year:2018 pages:083-090. DOI: 10.1055/s-0038-1667075 Bottom of Form

Kruse, C. S., & Beane, A. (2018). Health information technology continues to show a positive effect on medical outcomes: a systematic review. Journal of medical Internet research, 20(2), e41. DOI: 10.2196/jmir.8793

A Sample Answer 2 For the Assignment: Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

Title: Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

In the present era, mobile technology have mostly been used to enhance patient care. Mobile technology enable patients and caregivers to communicate about health-related issues. Mobile health technologies have been found to be effective at delivering low-cost care to patients with chronic conditions such as diabetes, heart failure, and obesity. mHealth is a type of mobile health technology that is used to address health issues such as smoking, obesity, heart disease, and tuberculosis. mHealth makes use of technologies such as applications to provide critical health education messages to populations at risk of developing health problems, resulting in positive lifestyle and behavioral changes. The usage of mHealth technology has been demonstrated to result in improved patient satisfaction, expanded access to care, and cost savings for both patients and healthcare providers. As a result, this study paper evaluates the health effects associated with the use of mHealth technologies.

Y. Wang, H. Xue, Y. Huang, L. Huang, and D. Zhang (2017). A Systematic Review of the Use and Effectiveness of Mobile Health Interventions for the Treatment and Self-Management of Obesity and Diabetes Nutrition Advances, 8(3), pp. 449–462. https://doi.org/10.3945/an.116.014100

Wang et al. evaluated the efficacy of mHealth technology in the management of diabetes and obesity. The aforementioned study examined the efficacy of mobile health treatments for diabetes and obesity treatment and self-management. The study was a comprehensive review of previous research on the subject. The authors conducted a systematic review of interventional studies on the use of mobile health in the treatment of obesity and diabetes and made recommendations for future practice and research. The publications utilized in the study were retrieved from the PubMed database, with the inclusion criteria being that they had to be focused on the study’s subject and had to have been published between 2000 and 2016. The defined inclusion and exclusion criteria resulted in the publication of 24 articles describing mhealth therapies that included text messaging, monitoring devices, and smartphone applications. The investigation’s primary outcomes were weight loss and a reduction or maintenance of blood glucose levels. The investigation’s secondary outcomes were behavioral improvements, self-efficacy, and acceptability of mhealth program use. The data analysis found that using mhealth technologies was associated with a greater than 50% improvement in weight, blood glucose, behavioral change, self-efficacy, and acceptability of technology use. The effects of the mhealth interventions were sustained over time, resulting in excellent diabetes and obesity management. The article’s lesson is that mobile health technology are connected with considerable benefits when used in the treatment of chronic diseases such as obesity and diabetes. Additionally, the technology promotes self-management of these conditions, as evidenced by the participants’ increased self-efficacy and behavioral change. As a result, mhealth should be included into the management of chronic illnesses in the health care system. Assignment: Review of the Literature: Using Clinical Systems to Enhance Outcomes and Efficiencies

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Changizi, M., & Kaveh, M. H. (2017). Effectiveness of the mHealth technology in improvement of healthy behaviors in an elderly population—A systematic review. MHealth, 3. https://doi.org/10.21037/mhealth.2017.08.06

mHealth technologies can also be used to promote positive behavioral and lifestyle changes in the elderly population. The above study investigated the effectiveness of using mhealth technology to improve healthy behaviors in the elderly population. The authors

conducted a systematic review using previously published studies. The articles that were used in the review were obtained from databases that included Web of Science, PubMed, Scopus, Embase and Science Direct. The authors used a pre-developed inclusion and exclusion criteria to select studies that were to be used in the investigation. The search performed on the above databases led to 12 studies that met the inclusion and exclusion criteria for the investigation. The analysis of data showed that the use of mhealth technology is associated with numerous benefits to the elderly populations. The benefits included improvement in care, self-efficacy, self-management, and behavior promotion and medication adherence. The authors further found that the use of mhealth technology is effective for disease prevention, management of diseases such as diabetes and cardiovascular disease and promoting lifestyle changes in the elderly populations. The above study is associated with the strength that it used a bigger number of articles to determine the effect of mhealth on the elderly populations. The authors also investigated the use of the technology in the vulnerable populations. It can be learnt from the study that the use of mhealth technology is effective for individuals of all ages. The technology improves the treatment outcomes, adherence and adoption of healthy lifestyles in the elderly populations. Consequently, healthcare providers, including nurses should educate the elderly populations on the use of different mhealth technologies in the management of their health problems. Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

Liu, H., Xiao, X., Lu, C.-M., Ling, D.-L., & Wei, R.-H. (2018). A systematic review of the effect of mobile health on cardiac rehabilitation among coronary heart disease patients. Frontiers of Nursing, 5(3), 217–226. https://doi.org/10.1515/fon-2018-0029

As noted in the above annotations, mhealth technology can be used to improve the treatment outcomes of patients with chronic conditions. The above study investigated the effect of using mhealth technologies on cardiac rehabilitation in patients with heart disease. The study was a systematic review of previous studies conducted to determine the effectiveness of mhealth technologies in patients with cardiac problems. The authors used articles that were obtained from performing a systematic search on databases that included NICE, Embase, CINAHL, Google Scholar, Medline, and Cochrane library. The researchers used mainly randomized controlled studies that were published between 2002 and 2017. The search led to eight articles that were used in the systematic review. The analysis of data showed that the use of mhealth has positive impact on behaviors that included medicine adherence, engagement in physical activity and quality of life. However, the effect of mhealth on the level of anxiety and smoking cessation was inconsistent in studies. The authors therefore recommended studies that use large sample sizes to be conducted to provide conclusive evidence on the effect of mhealth technologies on patients on cardiac rehabilitation. It can be learned from this article that mhealth technologies have some benefits to patients with cardiac problems. The technology promotes healthy lifestyle and behavioral change that improves the outcomes of treatment in patients with cardiac health problems. Therefore, nurses and other healthcare providers should explore the possibilities of incorporating mhealth technologies into the treatment of cardiac-related health problems.

Xiong, S., Berkhouse, H., Schooler, M., Pu, W., Sun, A., Gong, E., & Yan, L. L. (2018). Effectiveness of mHealth interventions in improving medication adherence among people with hypertension: a systematic review. Current Hypertension Reports, 20(10), 86. https://doi.org/10.1007/s11906-018-0886-7

The above study investigated the effectiveness of using mhealth interventions to improve adherence to medication in people with hypertension. The authors conducted a systematic review of the studies that have examined the effect of mhealth technologies on medication adherence in people with hypertension. The authors performed search on professional databases that included Web of Science, PubMed and Embase. The search yielded 21 studies that were included following the application of the developed inclusion and exclusion criteria. The studies used in the investigation were published between 2000 and 2017. The results of the analysis showed that the use of mhealth technologies was associated with significant improvement in treatment adherence alongside blood pressure control in people with hypertension. The authors projected that the use of mhealth technologies had sustained benefits to patients with hypertension. Therefore, it can be learned from this study that mhealth can improve the treatment outcomes due to adherence in patients with hypertension. The improvement also enhances the control of blood pressure in these patients. Therefore, the use of mhealth should be incorporated into the self-management interventions used in the management of hypertension. 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 Conclusion

The above annotation has shown that mHealth technology is effective when used in healthcare. mHealth technologies provide the opportunities to reduce the cost of care incurred by the patients and health organizations. The analysis has also shown that mhealth technologies promote behavioral changes. The behavioral changes can be seen from the improved adherence to treatment and engagement in physical activity among patients with obesity, hypertension and diabetes. The analysis also showed that mhealth promotes the self-management of chronic health problems that include diabetes, hypertension and obesity. mHealth has also be shown to improve the self-efficacy of patients with different health problems. The improvement in self-efficacy implies that the use of this technology in health has a high possibility of sustainability. In addition, the acceptability level of mhealth technology is significantly high. The high rate of acceptability implies that its utilization in health will result in enhanced outcomes of treatment for the patients. Healthcare providers including nurses should therefore consider incorporating mhealth technology into their plans of care. The technology will optimize the treatment outcomes for value-based care in health.

Assignment Literature Review The Use of Clinical Systems to Improve Outcomes and Efficiencies References

Wang, Y., Xue, H., Huang, Y., Huang, L., & Zhang, D. (2017). A systematic review of application and effectiveness of mHealth interventions for obesity and diabetes treatment and self-management. Advances in Nutrition, 8(3), 449–462. https://doi.org/10.3945/an.116.014100

A Sample Answer 3 For the Assignment: Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

Title: Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

Thank you for sharing your insight on telehealth. The delivery of health care, health education, and health information via remote technologies has positively impacted medical care. Telehealth provides medical care electronically through live video, conferencing, mobile apps, electronic transmission, and remote patient monitoring. Although both telehealth and telemedicine are used by healthcare professionals interchangeable, the advancement of telehealth has led to the incorporation of more advanced technologies. Telemedicine is the use of technologies and telecommunication systems to deliver care to patients who do not have access to healthcare due to their geographical location. Consultations via video conferences is also a component of Telemedicine. Telehealth encompasses telemedicine and the supporting technical attributes that support telemedicine. Wearable devices that record and transmit vital signs and other diagnostics test are examples of telehealth (Gu et al., 2021). As the demand and awareness of telemedicine grows, many health insurances plans started providing coverage for teleconsultations. Insurance providers in the in the United States have plans in place to reimburse providers and encourage consultation via telehealth. In July 2022, legislations to extend vital telehealth reimbursement were passed by the House. If passed by the senate, the bill would prolong Medicare telehealth flexibilities through 2024 (Policy & Medicine, 2023).

I enjoyed your post, and I, too, used the patient portal for myself and my family. When my doctor introduced me to the patient portal and gave me access to my chart, labs, and results. Being involved was the best thing that could happen to a patient, in my opinion. As soon as the patient is admitted, they have access to the portal. I encourage my PT to use the portal and educate patients as soon as possible, even before they are discharged. It will be yet another teaching opportunity for us as well as a learning experience for the patients, both of which will significantly improve their outcomes. The portal’s challenge would be for our older adult population, who are very independent or do not have family members to assist them with technology. As a result, unique support and teaching methods are necessary to facilitate learning for our senior population (Son & Nahm, 2019).

To be useful, patient portals must be designed to be user-friendly, available in a variety of languages both online and in printed materials, there must be adequate time for in-person or online training for navigating the portal, and healthcare providers must engage family members or caregivers in the portal’s use as well (Lyles et al., 2017). Patient portals are a significant benefit of extending the EHR to patients’ homes. Patients have control over and the right to know their medical record through patient portals, which allow them to schedule appointments, view laboratory values, message doctors for simple questions, and even find out why they were hospitalized. It would be preferable if billing information could be integrated into the portal in the future, as patients frequently have questions about why they were billed for a specific intervention during their hospitalization.

Reference

Lyles, C. R., Fruchterman, J., Youdelman, M., & Schillinger, D. (2017). Legal, Practical, and Ethical Considerations for Making Online Patient Portals Accessible for All. American

Journal Of Public Health, 107(10), 1608-1611.

https://doi-org.ezp.waldenulibrary.org/10.2105/AJPH.2017.303933

Son, H., & Nahm, E.-S. (2019). Older Adults’ Experience Using Patient Portals in Communities:

Challenges and Opportunities. Computers, Informatics, Nursing: CIN, 37(1), 4-10.

https://doi-org.ezp.waldenulibrary.org/10.1097/CIN.0000000000000476Links to an external site.

Medlineplus. (2020, August 13). Patient portals – an online tool for your health: MedlinePlus Medical Encyclopedia. Medlineplus.gov.

https://medlineplus.gov/ency/patientinstructions/000880.htm