Health Care Informatics Implication for Advanced Practice Nursing - Essay Example

Executive Summery As an important strategic technology initiative, clinical information systems (CIS) have emerged in the healthcare industry and it include computer software, computerized equipment, electronic documentation vast digital databases, and instantaneous electronic communication. A clinical information system has replaced the traditional paper orders, notes, and records that have been the historic basis for delivering and documenting healthcare clinical services. A CIS collects and organizes data related to the care given to a patient. Typically, the foundation of a CIS is the electronic medical record or computerized patient record, which is a digital record of the care delivery episode. Building on this electronic record, a comprehensive clinical information system also incorporates computerized order entry and results reporting, as well as integration with information systems in the laboratory, radiology and other diagnostic services, and the pharmacy. A CIS frequently also includes elements of expert systems that perform quality functions such as alerting physicians to potential drug interactions or dose errors. The CIS also provides for data collection and analysis for administrative and quality processes. All nurses have a role in informatics because nurses are primarily responsible for maintaining patients' records and helping doctors and their supervisors by providing relative information about the patients under their care. That is why nurses must embrace the clinical information system to facilitate and improve patients' healthcare related issues. Most of the time nurses practice informatics without prerequisite education. However, it is the need of time that all nurses must be fully aware of the healthcare informatics and well conversant with the use of computers software and equipments so they put their full potencies to facilitate timely delivery of healthcare to the much needing patients under their direct supervision. It is a matter of great concern that in spite of the great potential of CIS, healthcare, with its complexity and long-standing traditions has been even slower than many other industries to recognize the strategic value of information technology (Luftman & Brier, 1999, p. 110). The obvious reason for this may be the lack of understanding on the part of nurses about how they can utilize information technology to improve the patient care services and how they can save time and generate vitally useful information in shortest time span. Nursing Informatics Nursing informatics is composed of theory and skills and it is a combination of nursing science, information science, and computers in which a nurse stands in the forefront duly supported by informatics and computers (Figure 1). According to the American Nurses Association (ANA), nursing informatics is "a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice . . . to support patients, nurses, and other providers in their decision-making . . . using information structures, information processes and information technology" (ANA, 2001, p. 46). FIGURE 1: The relationship of information technology, computer science and nursing. The main purpose of nursing informatics is to improve the health of individuals, families, and communities. This can be done by optimizing the management and communication of information to enhance the availability of patients' medical history and medicine records, promptly responding to any emergency and utilizing information system to deliver in time service to the healthcare management and patients. In this direction, computers can be used to manage and communicate data, information, and knowledge. It is very important that nurses are able to interpret data, utilize the information generated through the collection of data and put their knowledge to make the data meaningful and helpful for timely decision-making process which would enhance the healthcare services. The fundamental function of nursing informatics is that nurses should be able to use information in decision-making. As compared with the latest information technology, nurses used to relied on paper information in the past. The traditional paper based information process was comparatively slower, erroneous, and often resulted in prescription of wrong treatment and wrong diagnostics. However, the present use of computers in healthcare facilities has enabled more elaborate structures and processes. Thus, by adopting the healthcare informatics, nurses are able to deliver the right information to the right person at the right time. This process of timely delivery of information on the part of nurses is called an informatics solution. Key Clinical Informatics Issues There are many clinical informatics issues which the healthcare facilities often face and are a matter of concern for the authorities in decision-making. These issues include connectivity, electronic healthcare record, data standardization, and privacy and security and all these issues are vitally important and demand full attention because any lapse in these issues negatively impacts the healthcare services being provided to the patients. However, among these important issues, I would like to talk about the electronic health record (EHR) maintenance. Even the EHR can further be classified in accordance with the tools and equipments available, the database management system it uses to store etc., my main focus would be on prenatal EHR. Maintaining electronic health record is the sole responsibility of an advanced practicing nurse in order to maintain patients' health record and it is the most important step from which patients' treatment relies all the decision-making. Electronic Health Record Electronic health records (EHRs) significantly impact and improve the quality and safety of healthcare and has the potential to reduce the health care cost (Hillestad et. al., 2005). It facilitate the health providers by instantly letting them access to the authentic information of patients under their treatment including patient demographics, problems the patients have been facing, their progress notes, medications prescribed to them, and all the medical history and immunizations they were recommended . The Institute of Medicine (IOM) has also emphasized that the electronic health record (EHR) is the most important component of a national health network and its proper use improves healthcare quality, safety, and efficiency (IOM, 1999, 2001). These records are legible, complete, organized, and accessible by multiple users across networked sites of healthcare facilities. The data can be entered in real time at one point and documented in multiple settings to be accessed simultaneously. In order to enter data directly into the record, automated physiologic patient monitoring devices can be connected. This process eliminates the duplication of manual documentation and helps the nurses focusing on other assignments. The electronic patient record can be entered, stored, and organized in a database which can be retrieved and analyzed later on for improving the patient treatment. Due to flexibility and analytical capabilities of database systems, the electronic records can be coded and analyzed more elaborately and more efficiently as compared with the paper records. The EHR is a valuable facility that helps the health givers in creating required reports, forecasting, and measuring outcomes for quality improvement in the treatment of the patients. Thus, the EHR is the most powerful tool which improves the healthcare services significantly. However, there are some inherent issues pertaining to data storage, retrieval, and security of the data which pose potential threat to the EHR and undermine its value. Similarly, the use of EHR is comparatively limited. For example, in the ambulatory setting, only 5% of U.S. primary care providers are using EHRs (Bates, Ebell, Gotlieb, Zapp, & Mullins, 2003). The reason for EHRs limited use involves some potential barriers like inadequate funding, lack of support on the part of physicians, lack of technical knowledge, and the interference with routine workflow (Simon et. al. 2006). These limitations and barriers may be overcome by allocating more financial resources and enhancing technical skills amongst the advanced practicing nurses. Further, doctors' resistance can be eliminated by imparting awareness about the advantages and benefits of using EHRs. Recommended Tool Considering the importance of the electronic health record, it is recommended that in the facility I am being given a chance to serve, should have installed a prenatal EHR as a tool to improve prenatal surveillance and subsequent preventive care. There is the established evidence that the prenatal EHR can enhance the continuity of information and care from the office setting to the labor and delivery setting (Miller, 2003). Although prenatal systems are a stand-alone product. , there capabilities for interfacing with different network systems are increasing with the passage of time. Besides, the fully integrated electronic prenatal record, including electronic fetal heart monitor tracing, meets the same medical records standards as a paper record (McCartney, 2002). References Bates, D., Ebell, M., Gotlieb, E., Zapp, J., & Mullins, H. (2003). A proposal for electronic medical records in U.S. primary care. Journal of the American Medical Informatics Association, 10(1), 1-10. Institute of Medicine. (1999). To err is human: Building a safer health system. Washington, DC: National Academy Press. Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press. Hillestad, R., Bigelow, J., Bower, A., Girosi, F., Meili, R., Scoville, R. & Taylor, R. (2005) Can electronic medical record systems transform health care Potential health benefits, savings, and costs. Health Affairs , 24, 1103-1117. Luftman, J., & Brier, T. (1999). Achieving and sustaining business-IT alignment. California Management Review, 42 (1), 109-122. McCartney, P. (2002). Electronic fetal monitoring and the legal medical record. MCN: The American Journal of Maternal/Child Nursing, 27(4), 249. Miller, D. (2003). Prenatal care: A strategic first step toward EMR acceptance. Journal of Healthcare Information Management, 17(2), 47-50. Steven R. Simon; Madeline L. McCarthy; Rainu Kaushal; Chelsea A. Jenter (2006). Electronic health records: which practices have them, and how are clinicians using them Journal of Evaluation in Clinical Practices .45-46 Read More