NURS FPX 4040 Assessment 3 Annotated Bibliography on Technology in Nursing GC

NURS FPX 4040 Assessment 3 Annotated Bibliography on Technology in Nursing GC

Introduction 

Information and communication technology has turned out to be a crucial part of the clinician’s routine work. Electronic medical record systems can help make patient care services more efficient, prevent medical errors, and reduce the workload of the clinician. Electronic health records (EHR) can document diagnostic assessments and health treatment, facilitates communication between medical professionals, and offer clinical decision supports. Even with these benefits, it is important to mention that implementing EHR does not always guarantee benefits; research has uncovered several possible adverse effects, particularly concerning the usability of EHR systems and this has slowed its widespread adoption. It is therefore important to know the usefulness of EHR being used in many organizations and the barriers to its implementation. 

To the best of my knowledge, academic journals are always a good place to get credible and trustworthy content and are deemed one of the most reliable sources for use in academic writing. I, therefore, searched for journal articles on various databases on medicine and health. Some of these databases included EBSCO, PubMed, UpToDate, Google Scholar, and PubMed Central. I began searching for general terms like “patient care technologies” and narrowed it down specifically to Electronic health records. Where information was not readily available, I substituted Electronic health records with electronic medical records. I was keen to include journal articles with very current information, starting from 2000 onwards. 

Alanazi, B., Butler-Henderson, K., & Alanazi, M. (2020). Perceptions of healthcare professionals about the adoption and use of EHR in Gulf Cooperation Council countries: a systematic review. BMJ health & care informatics27(1).

In this systematic review, Alanazi et al identified views held by healthcare professionals regarding the benefits and risk or challenges of EHRs usage in Gulf Cooperation Council (GCC) countries. A common view held by healthcare professionals is that the adoption of EHRs leads to improvements across access to clinical information, quality of care, communication, work efficiency, reduced costs, and patient safety such as reduced medical errors. Citing Kings and his colleagues, Alanazi et al found that many doctors in the US perceived the HER to be important in ambulatory care practice because of its benefits of improving overall patient care, reducing medical errors, and enabling access of patient data remotely. The positive perceptions held by healthcare practitioners in GCC were due to the benefits accorded by EHRs. Since healthcare professionals have a positive view of EHRs because of their potential benefits, they are open to adopting the system and this would improve implementation and application in healthcare system. 

The review also identified negative views held by healthcare professionals due to risks and challenges faced in using an EHR system. Some of these challenges include security and privacy issues, complex and non-user friendly systems, lack of EHR literacy and language problems, high initial costs, increased workload, and communication disruptions. These negative perceptions could act as hindrances in the successful implementation of EHRs in healthcare settings unlike positive perceptions which are considered as enablers of EHRs implementation. The attitude of healthcare professionals towards the use of EHRs is influenced by system, personal, and organizational factors such as age, organizational culture, perceived ease of use, perceived usefulness, and computer literacy and training.  Healthcare organizations must therefore take into consideration these factors which can influence users’ perception and subsequent adoption. More so, consideration of the influencing factors can help identified barriers to EHRs implementation in advance and address these barriers for better implementation results. Policymakers and governments in GCC countries should seek to understand factors that affect successful implementation and use of EHRs with emphasis on human factors with medical staff targeted as the end-users of the health IT system. 

Laukka, E., Huhtakangas, M., Heponiemi, T., & Kanste, O. (2020). Identifying the roles of healthcare leaders in HIT implementation: a scoping review of the quantitative and qualitative evidence. International journal of environmental research and public health17(8), 2865.

In this qualitative and quantitative review, the authors examined the role of healthcare leaders in health information technology (HIT) implementation. Many health information technologies have the ability to improve safety, cost-effectiveness, quality, and patient-centered care. Some of the implemented HITs include services for self-treatment and digital value as well as electronic health records (EHR). Unlike other business fields, digitalization of care in healthcare setting is slow and more complicated. Besides, failure in health information technology tends to occur more often in care settings. This can be attributed to poor leadership in healthcare organizations. While it is known that implementation of health information technology requires a strong leadership, leaders often lack aware of their roles in HIT implementation. The role of healthcare leaders such as change manager, facilitator, champion, decision-maker, advocate, project manager, and supporter in HIP implementation is indisputable. When working as change managers and facilitators, healthcare leaders can help diffuse information and manage tasks that come about due to implementation. Also, healthcare leaders act as sellers of health information technology implementation to their colleagues and subordinate staff and try to make them see the new technology more positively. As an advocate, medical leaders can communicate clear visions and goals for IT implementation. Despite these important roles, leaders are reluctant to take part in IT adoption because they have other duties to attend to and lack confidence in relation to HIT implementation. Adequate training and participation on part of leaders is required to help them adapt to complex HIT implementation and assume the required roles and assist in effective implementation by maintaining a positive attitude towards health information technology. 

Mason, P., Mayer, R., Chien, W. W., & Monestime, J. P. (2017). Overcoming barriers to implementing electronic health records in rural primary care clinics. The Qualitative Report22(11), 2943-2955.

Healthcare organizations adopt the EHRs to reduce costs, comply with federal regulations, and improve medical delivery. But there is no guarantee that investing in electronic health records can yield good returns. Since health information technology requires investment in software, maintenance, training, and changes in governance, this reflects how complex it is to implement the health information technology systems. In this qualitative study, Mason and his colleagues sought to explore the experiences of rural primary care physicians and assistant physicians on how to overcome the barriers to implementing electronic health records. Four implementation problems were identified. First, many healthcare professionals do not receive formal business training while pursuing medical education which allow medical staff to be more confident and productive. Also, lack of change management in rural medical clinics must be addressed. Primary care hospitals in rural areas faces the problem of EHRs implementation when major stakeholders, including staff, managers, and physician do not support it; for this program to be successfully implemented, everyone must be onboard. There is also a problem with health information exchange in which the electronically communicated data is often incomplete. Lastly, lack of finances to support EHRs was found to hinder electronic medical records implementation. Organizational leaders must be aware of these challenges to help manage change process. Hospital administrators must also ensure that business leaders have the required tools for a change effort when weighing a new change program to lessen resistance. Ensuring that EHRs are financially feasible standardized, and communication mandated can help business leaders, physicians, assistant physicians, and other stakeholders to implement, adopt, and diffuse EHRs to design innovative solutions to lower costs and improve responsiveness to customer needs. 

Schopf, T. R., Nedrebø, B., Hufthammer, K. O., Daphu, I. K., & Lærum, H. (2019). How well is the electronic health record supporting the clinical tasks of hospital physicians? A survey of physicians at three Norwegian hospitals. BMC health services research19(1), 1-9.

A common belief among healthcare professionals and tech experts is that electronic medical records can improve the efficiency and quality of patient care. While much new functionality has been invented to enhance communication between medical care professionals and the decision-making process, there is scarce evidence on whether such novel functionalities are meaningful. The authors sought to determine how well the EHR system supports doctors in handling their routine clinical tasks. Physicians were selected from three famous hospitals in Norway to take part in the study. Through online questionnaires, they were asked how well the EHR system supported 49 clinical tasks and their level of satisfaction. 22% of the physicians had their work delayed or interrupted daily due to EMR hanging or crashing daily while 72% experienced this problem weekly. 53% of physicians reported that EMR adds to their workload and is cumbersome to use. However, the majority of them felt satisfied with managing tests such as managing electrocardiograms and radiological tests, requesting lab tests, and reading test results. Doctors were not satisfied with how EMR was being used to make referrals and prescribe drugs. The physicians identified the need to improve on key aspects of EMR functionalities such as clinical workflow supporting including planning and better overviews and planning. Also, there is a need to concentrate on better instructions on available EHR features, number of logins, system stability, and reliability. Significant development is required in current EMR systems to enhance satisfaction and usefulness. 

Conclusion

The use of information technology, including electronic medical records (EMRs), can help transform the present healthcare system into one that is safer, efficient, and delivers high-quality care. Beyond the retrieval of patient information like warnings of drug interactions and allergies, EHRs can help develop management protocols for chronic illness, establish communication links with other professionals, and generate pre-appointment reminds. Also, EMRs enhance the quality of documentation over manual health records through automatic reminders to medical providers of missed data. Besides, EMRs facilitate medical care delivery improvement and measures safety, efficiency and quality of patient care via the use of alerts, electronic prescribing, and predictive tools. In addition, patients and the healthcare system can gain from the implementation of the EMRs, including a reduction in medical errors, the leading cause of preventable injuries within the healthcare setting. While this system is being touted as an ideal replacement for manual records, evidence has shown that its success and adoption rate is still unsatisfactory. Despite their benefits, incorporating EHRs in clinical practice require huge technological investments, changes in existing processes and systems, lack of awareness, resistance to change, staff training, and its implementation disrupts workflow. Factors that can facilitate successful implementation of EMRs at primary health care units include selecting and adopting a suitable EMR system with enough resources and IT technical support, as well as provision of nonfinancial and financial incentives and motivation.

References

Alanazi, B., Butler-Henderson, K., & Alanazi, M. (2020). Perceptions of healthcare professionals about the adoption and use of EHR in Gulf Cooperation Council countries: a systematic review. BMJ health & care informatics27(1).

Laukka, E., Huhtakangas, M., Heponiemi, T., & Kanste, O. (2020). Identifying the roles of healthcare leaders in HIT implementation: a scoping review of the quantitative and qualitative evidence. International journal of environmental research and public health17(8), 2865.

Mason, P., Mayer, R., Chien, W. W., & Monestime, J. P. (2017). Overcoming barriers to implementing electronic health records in rural primary care clinics. The Qualitative Report22(11), 2943-2955.

Schopf, T. R., Nedrebø, B., Hufthammer, K. O., Daphu, I. K., & Lærum, H. (2019). How well is the electronic health record supporting the clinical tasks of hospital physicians? A survey of physicians at three Norwegian hospitals. BMC health services research19(1), 1-9.

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