HLT 362 Topic 5 Discussion Question Two
Topic 5 DQ 2
Discuss ways your organization uses technology to gather patient and health care information, and how this information and data are used to direct patient care and outcomes.
REPLY TO DISCUSSION
My organization uses technology to gather patient and health care information by using an electronic record system. The United States Department of Defense (DoD) has transformed health care delivery by using information technology to automate patient data documentation, leading to improvements in patient safety (Charles, Harmon, & Jordan, 2005). The Composite Health Care System II (CHCS II) is the military’s electronic Computer-based Patient Record, which is an enterprise-wide medical and dental clinical information system that will generate, maintain, and provide secure 24-hour online access to a comprehensive, longitudinal, and legible health record (Harmon, Wah, & Inae, 2003).
How Technology is used
According to Harmon, Wah, & Inae (2003), CHCS II provides three fundamental capabilities: · A seamlessly integrated clinical graphical user interface (GUI) for documenting patient care by health care professionals at the point of care and for displaying data that may have been derived from diverse external sources [labs, radiology, pathology, wellness alerts]. From the battlefield back to the large tertiary care hospitals and all locations in between, the interface to the military CPR will be the same.
- An enterprise-wide, industry standards-based Clinical Data Repository (CDR) of DoD beneficiary’s life-long medical information. This is the core of the DoD CPR. A proper central database will allow the mining of data for wellness alerts, symptom surveillance, clinical research, and population health improvement.
- Migration Architecture. The integrated clinical GUI will remain the same, but the underlying code base “behind the screens” will be exchanged for newer, more robust, and maintainable products.
Before the Soldier arrives at the units, we are notified by an email manifest of all Service Members (SM) who will come by medivac (aircraft). This information contains the SM demographics and reason for entry. Once the medivac team greets the SM, they are in-processed, and that’s when the SM record is opened. All medical and administrative units have access to this record and are responsible for notating treatment and diagnosis, doctors’ appointments, and the transition plan.
Charles, M. J., Harmon, B. J., & Jordan, P. S. (2005). Improving Patient Safety with the Military Electronic Health Record. In K. Henriksen (Eds.) et. al., Advances in Patient Safety: From Research to Implementation (Volume 3: Implementation Issues). Agency for Healthcare Research and Quality (US). Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK20562/#A3807
Harmon, B. J., Wah, R., & Inae, T. (2003). The Military Health System Computer-based Patient Record. AMIA … Annual Symposium proceedings. AMIA Symposium, 2003, 1068. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1480121/
Your Clinical data repository example was remarkable.
The true magnitude of diagnostic errors is difficult to quantify. However, the National Academy of Medicine estimates that most
people will experience at least one diagnostic error over the course of their life. While diagnostic errors may not always necessarily lead to a harm, they can result in a delayed- or inappropriate- treatment. HIT has the potential to help providers improve the diagnostic process and reduce diagnostic error by providing easier access to critical patient data, facilitating information exchange, offering complex analysis, and retrieving workflow and decision making information. Specific HIT approaches may include the use of CDS, diagnostic study interpretation, and trigger tools.
In 2019, PSNet included multiple resources that identified artificial intelligence (AI) systems as a rapidly emerging healthcare technology with the potential to improve diagnostics. Specific examples highlight the use of AI in pediatric diseases. AI-based systems could support physicians in the analysis of large amounts of data for diagnostic evaluations and provide clinical decision support when there is diagnostic uncertainty or complexity. Some deep learning AI diagnostic algorithms achieve similar diagnostic accuracy to physicians, although authors note more testing in clinical settings is needed.
Barcoding to Improve Safety in Transfusions
More than 20 million blood components are transfused annually in the U.S., with approximately 51,000 adverse reactions related to transfusions. Labeling issues are a major source of transfusion errors, causing patients to receive incorrect blood types. Barcoding can alleviate the risk of labeling errors in transfusions by reducing the potential for human error in the validation processes. One 2019 article demonstrated that barcoding, in conjunction with an electronic auditing system, was safer than a manual verification system for transfusions in the operating room.
Alotaibi YK, Federico F. The impact of health information technology on patient safety. Saudi Med J. 2017;38(12):1173-1180. doi: 10.15537/smj.2017.12.20631.
Wittich CM, Burkle CM, Lanier WL. Medication errors: an overview for clinicians. Mayo Clin Proc. 2014:89(8):1116-25. doi: 10.1016/j.mayocp.2014.05.007.
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Information technology can have a substantial impact on patient safety. As with most technology, there may be benefits and potential concerns. With any implementation or use of healthcare technology, it is critical patient safety and quality always remain the primary focus. Technology has also become an integral part of medicine today. The right technology can assist with increased efficiency, improved quality, and reduced costs. Some of the many advantages technology can provide include the facilitation of communication between clinicians, improving medication safety, reducing potential medical errors, increasing access to medical information, and encouraging patient-centered care. Doctors, nurses and other healthcare team members can improve patient safety by engaging with patients and their families, checking procedures, learning from errors, and communicating effectively with the health-care team. Such activities can also save costs because they minimize the harm caused to patients. In today’s dynamic health systems, technology plays an important role in education and nursing work. The criteria used for selecting studies primarily focused on nursing informatics and the importance of expertise in the effective use of information technology in all aspects. Healthcare data management is the process of storing, protecting, and analyzing data pulled from diverse sources. Managing the wealth of available healthcare data allows health systems to create holistic views of patients, personalize treatments, improve communication, and enhance health outcomes. Big data is very useful in the healthcare industry. Over the past decade, electronic health records (EHR) have been widely adopted in hospitals and clinics worldwide. Important clinical knowledge and a deeper understanding of patient disease patterns can be studied from such data. As more of the population ages, as life expectancy increases, and as the nursing shortage continues, these new medical technologies are crucial for continued patient care and the healthcare system at large. New medical technologies can make life easier for medical professionals and patients alike. Certain technologies can make patient care easier and more efficient for the doctors and nurses who manage a large patient load. They can also assist patients in getting the care they need with more convenient and accessible options.
The healthcare industry finds many of these new medical technologies help them with routine processes, as well as decrease human mistakes and errors that can come from too few nurses who are working long hours with too many patients.
While healthcare workers agree that new healthcare technology and innovative medical devices can help them, they also agree that technology shouldn’t replace day-to-day human interactions. Working directly with patients is a huge element of healthcare, and nurses and doctors provide a crucial element of interaction that allows patients to feel at ease. Working with families, explaining procedures, and helping to take a patient’s mind off their sickness are all part of nursing jobs. Many healthcare professionals worry that increased healthcare technology could try to remove that human element. Unlike in other sectors, healthcare’s human interaction is crucial for patient success. It’s critical to find the right balance between technology and the human nuances that make nursing and healthcare successful. Professionals also largely agree there shouldn’t be an overreliance on healthcare software and technology, and that human eyes on both symptoms and needs should be as important as what healthcare technology is saying. While technological advancements aren’t a cure-all as healthcare solutions, new technology is changing the way nurses work in positive ways.
There are seven stand-out technologies transforming medical care. As nurses are educated about new medical technologies and practices, patients, and provider’s benefit.
The following are just a few ways technology is helping to improve patient safety
1.Facilitates Communication Between Clinicians — Often in a patient’s medical journey, multiple healthcare professionals are involved in their care. This can dramatically increase the potential for miscommunication or error. Communication failures are one of the most common factors that contribute to the occurrence of adverse events. EHRs are designed to help reduce those errors by compiling and maintaining all of the patient’s health information into one easily accessible record.
2.Reduces Medication Error — Prescribing errors are another common medical error that can potentially lead to serious complications. Electronic prescribing can help reduce prescription errors by allowing clinicians to send prescriptions electronically to the pharmacy. Medical alerts, clinical flags, and reminders are also ways technology can help reduce medication errors and improve patient safety.
3.Provides Access to Information — Many serious medication errors are the result of clinicians not having sufficient information about the patient or drug. Information technology has drastically improved the access to reference information. A large range of drug-reference information is now available for hand-held devices, and clinicians can quickly access textbooks, databases, and other medical references online.
4.Increases Patient-Centered Care — Encouraging patients to be more involved in their care is important for many reasons including increased compliance and patient satisfaction. Technology helps contribute to patient-centered care by fostering communication between providers and patients via online portals, text messaging, and email. It also increases access to information such as online medical records, which can improve self-monitoring and patient convenience.
In my organization, Clinical decision support or CDS is used to gather patient and health information. It is a key functionality of health information technology. It has the potential to improve care and is a centerpiece of the Medicare and Medicaid EHR Incentive Programs (Winfred, 2012).
Some of the technologies being used are:
- Automated IV Pumps
Automated IV pumps control the dosages and drips given to patients. Software and medical tech allow nurses to change the drip amounts and medication doses, so patients aren’t waiting for changes. There are IV pumps for nutrition that give needed meals at the right times. Additionally, there are self-pumps that allow patients to increase a controlled amount of pain medication for themselves.
Automated IV pumps help speed up nursing processes and can be crucial if there is a need for immediate adjustment. Changing medication through an automated process also removes elements of human error that could present issues for clinical patients and hospitals.
Automated IV kits give nurses opportunities to focus on other areas of work, instead of having to measure and give medication or food. Hospitals all have different kinds of automated IV pumps, so training and education is often based on the specific hospital or clinic where nurses work.
Additionally, many nursing schools give training and information on new software and technology, including how automated IV pumps work and why they’re valuable.
- Portable Monitors
Portable monitor equipment allows nursing professionals to check on patients, even if they’re on the move or busy helping someone else. Portable devices monitor vital signs like ECG, respiratory rates, and oxygen saturations while transmitting the information back to a central monitor. This means that nurses will get an alarm notification if there’s an emergency.
Most hospitals have nurses check levels hourly. Portable monitoring technology allows nurses to track and note stats at the right time, even if there are a lot of other things going on. This helps them constantly monitor patients from anywhere in the hospital. The alerts and alarms sent to nurses through the portable monitor can save lives.
Nurses learn at their specific hospital how to utilize portable monitors, and nursing schools help teach students the value and general use of many common pieces of equipment.
Medical technology smart beds
- Smart Beds
Smart bed technology can help nurses track movement, weight, and even vitals. Smart beds also play a major role in keeping patients safe and comfortable during a long hospital stay. With the number of falls and patient injuries inside hospitals, smart beds are very important for patient safety. Smart bed technology gives nurses a constant in-room monitor that provides them with regular updates and communications on a patient’s activities. It can also help them identify patterns, which can lead to a new diagnosis or a different understanding of a condition.
Nurses also spend less time coming in and adjusting supplies and medical equipment for comfort or safety because they can help control that with their smart bed. It allows providers to get back to other important work that only humans can do.
- Wearable Devices
Wearable devices and mobile apps are transforming the healthcare industry. Devices that help track heart rates, exercise, sleep, respiration, and more are helping people take their health into their own hands.
With increased accessibility to iPhones, nurses also benefit from apps and devices that help them care for patients. For example, the Steth IO smartphone stethoscope is essentially a stethoscope app that allows nurses and doctors to simply use their smartphone to get breathing sounds and see heart rates. Using a phone can be less intimidating—especially for younger patients—and gives providers a full range of information and easy tracking of medical needs.
Wearable devices from health tracking to specific patient monitoring are often called the future of healthcare. With access to huge amounts of data, wearable devices can help the entire healthcare process, from diagnosis to recovery.
They also help remove elements of human error for nurses because the communication of data comes directly from the device itself. It allows for faster record keeping and helps patients and nurses maintain consistent monitoring of health.
Wearable devices from health tracking to specific patient monitoring, are often called the future of healthcare. With access to huge amounts of data, wearable devices can help the entire healthcare process, from diagnosis to recovery.
Wearable devices help remove elements of human error for nurses, because the communication of data comes directly from the device itself. It allows for faster record keeping, and helps patients and nurses maintain consistent monitoring of health.
- Electronic Health Records
Electronic Health Records (EHR) are replacing older paper filing methods. Electronic Health Records allow nursing experts to document care provided to patients and retrieve information that can help prioritize care. Additionally, information entered computer systems can then be accessed by the care team, including doctors and even patients themselves when necessary.
While security continues to be a concern for Electronic Health Records, HIPAA laws ensure security and privacy of electronic records are maintained by healthcare organizations, and new technology like blockchain and cryptography are easing privacy concerns. EHRs can tell registered nurses (RNs) whether there are further steps they need to take for a patient, monitor small condition changes, and give them information immediately as alerts or reminders.
Real-time health updates impact the speed and accuracy of medical care. RNs learn how to use software systems on the job, but their education and training will help them quickly understand what different indications on medical records mean and what their course of action should be to ensure improved patient outcomes.
- Centralized Command Centers
One of the newest ideas for hospitals, centralized command centers promise improved patient experiences and better ways for RNs and doctors to manage supplies, clinical technology, and capacity. This is done through software applications such as dashboards that provide real-time updates. With shorter or non-existent delays between transitions of care, nurses and doctors can actively be aware of room availability, OR schedules, and what individual patients still need before being discharged. This allows everyone to do their job more efficiently and help patients more effectively.
Specifically designed for capacity management, command centers are performing well around the country. Many hospitals report operating at higher capacity with overall improved patient experiences.
Smart phone telehealth
- Telehealth and Apps
Telehealth is a valuable, newer element in healthcare. Hospitals and clinics allow patients to virtually video chat with a doctor or nurse to describe their symptoms or show doctors things like rashes or bumps. This helps patients with a quick diagnosis without leaving the comfort of their own home. They can find out if they need to come in for further testing or diagnosis, get a prescription for medicine, or get medical advice.
Telehealth saves both patients and doctors money and time. Similarly, it prevents sick patients from coming to public places and exposing other patients. This technology is changing the way clinics operate and how patients are cared for.
Similarly, medical apps and wearables help patients and doctors work to improve health. Doctors and nurses can monitor vital signs of patients without them being in the office. They can be utilized for overall health and wellness, or for specific medical concerns such as seizures or diabetes. Apps can also help patients understand when they should call a doctor and when a simple over-the-counter medication could help. This again conserves resources in clinics and helps patients save time and frustration. Apps can also help address mental health issues. Mindfulness apps help individuals understand their mental health and energy and remind them to take time for these important aspects of wellness.
Increasing app and telehealth technology gives doctors, nurses, and patients themselves more control over their health.
Kowitlawakul, Y., Wang, L., & Chan, S. W.-C. (2013). Development of the electronic health records for nursing education (EHRNE) software program. Nurse Education Today, 33(12), 1529–1535. https://doiorg.lopes.idm.oclc.org/10.1016/j.nedt.2012.12.001.
Tubaishat, A. (2018). Perceived usefulness and perceived ease of use of electronic health records among nurses: application of technology acceptance model. Informatics for Health and Social Care, 43(4), 379-389.
Winfred, Y., et al., (2012). Impact of integrating public health clinical decision support alerts into electronic health records on testing fir gastrointestinal illness. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22473114