The EPIC ADT Application - Essay Example

? The EPIC ADT Application s s Use of computers in the healthcare department has been on the rise following the dynamic ties of technology. The hospital has the responsibility to adopt technology and information management systems and applications to support the documentation of the file and patient details. A California Pacific Medical Center hospital information system, one of the key applications adopted by the hospital is the ADT application. The application is technically based on documentation of the inpatient and outpatient admissions, discharge and transfer needs of the hospital. The application incorporates the use of both computer and information science technologies. The application provides a wide base of operation and ensures the use of practical dimension of the recent technology as prescribed by the nursing informatics principles. The application is used in the hospital and has brought efficiency in the operations of the hospital. Incorporation of the application has worked in hand with other information management application to ensure continued efficiency and effectiveness. Consequently, use of Information Management Application help organizations improves on the quality of service delivered to the hospital clients. The applications support the core values of the organization; quality, effectiveness, efficiency and integrity. Introduction The EPIC system is a series of computer related technologies adopted in the health sector to yield efficiency and effectiveness in the area of operation used for one. EPIC system interlinks various departments and units of an organization with the aim of facilitating functionality in the operations of the organization. The inpatient and outpatient admission-discharge-transfer application (ADT) focuses on building internal hospital efficiency. The EPIC ADT application integrated in California Pacific Medical Center has key components with features that support effective operation of the hospital (Armoni, 2002). The diversity of the EPIC system ranges from their functional ability to the nature of patient handling. Outpatients and inpatients possess different data packs to meet their specific objectives. The outpatient EPICADT component package allows a quick registry of the incoming patient, keeping a mark on the number of patients visiting and leaving the hospital. It also keeps the focus on clinical data management of the patients. This starts with creating an account for every patient and which act as the core tool for identity of the patient (Scaffzin, Prichard, Bisig, Gainor, Wolfe, Salon, Webster, & McCarthy, 2013). All the details of the patient are kept in that account and can easily be accessed through use of the patient user name or identification details. The system stores information and data relating to the individuals who visited the hospital (Saba, 2006). Such information includes a description of the health status of the patients. The areas visited by the patients are also included in the system and EPIC ensures keeping a record in every unit. For example, a patient visiting the consultancy department will have his or her name written in the system. If the patient visits another unit in the hospital, for example the laboratory department, the name of the patient will have to appear automatically since it was once used in the system. The EPIC system has a working scenario of “one client, one file”. Ambulatory services will also reflect on the system. The inpatient systems also have its category of packages available for the patients. It keeps a smooth and updated record on the admissions made in the hospital (Tan, 2011). As well, the system keeps information and data on the discharges and transfers made in the hospital. The importance of such information is articulated in the database of the hospital and aid easy retrieval and access to the information. Information on patients in a hospital is a crucial tool and a management aspect that aid smooth operations (Hewwet, 2002). Furthermore, ease of access of such information affects the effectiveness and efficiency of the involved parties. The system enables easy storage and access of information relating to surgery services, pharmacy and health information management. The EPIC system ADT application is structured to enable easy access to the information in the mainframe of the hospital database and for the staff. The ability to access the information is affected by the computer skills of the user (Brafman, 2011). Highly experienced users will have fewer struggles to get information from the database. Staffs with little knowledge will be able to get the information they want easily though will have to take considerably longer time compared to those experienced ones. The rate of usage of the system also affects the ease of use and efficiency of accessing the information as well (Johnson, Suominem, Basilakis, Dawson, Kelly, & Hanel, 2013). Lastly, the system is designed to have easy access to technical guidance and support. The system allows a 24 hour for 7 days technical support team which renders their service throughout to ensure user satisfaction and reduced delay and especially in the emergency department. The adoption of ADT application consequently comes with reduced data redundancy and incorporate technology in the operations of the hospital. Background Information Every organization, profit making or not aims at ensuring efficiency effectiveness, equity, integrity and quality service delivery as the key values (Rogers, 2013). The California Pacific Medical Center has its objective targeting efficiency and quality service delivery. In order to entail professionalism and patient satisfaction among the hospital patients, the firm had to incorporate a system that purported the staff and the nurses in the provision of such service (Wainwright, 1994). There was need to adopt a system that enabled easy access to patient information and easy management of the same information. There was a need for adopting a system simply structured for easy use by every employee in the firm. The organization also had an obligation to incorporate the recent computer technology in its daily operations. Technology is dynamic and inability to adopt technology to make a firm offer oblate product and or services. The daily running of the hospital needed a system that purported the external and internal needs of change. The EPIC firm then came with the ADT application and which targeted the inpatient and outpatient data recording, discharge and transfers. The three services form the basic operations of the firm. By so doing, the application was the best fit in the needs of the hospital (Armoni, 2002). Additionally, based on the requirement of the nursing informatics, the field of nursing aim at providing quality information management, and maximize efficiency at the lowest possible costs. The nursing informatics integrates the application of computer knowledge and skills to manage knowledge and data effectively so as to provide quality and quantitative health care for the patients. Conceptually, the field aims at facilitating beneficial and effective decision making in the line of health care services. In order to meet the needs and demands of the nursing informatics, the hospital has the obligation to incorporate the basics of computer and knowledge skills and technology in the operations of the firm (Tan, 2011). Nursing informatics aim to reduce the time, resource and human labor to be utilized in order to derive effective patients’ health care. The field accommodates utilization of systems and application, which have the capability to derive the effective operation and the desired output in the healthcare sector. Consequently, adoption of the ADT application had the same principles, geared to promote wellbeing of the patients and endorse effective data documentation. The arrival of the ADT application gave the hospital an opportunity to incorporate the technology into the actual activities of the hospital. ADT application met the computer requirements needed and was simple for almost every staff of the firm to use. On basis of nursing informatics, ADT application was a good application to implement. More than 75% of the management team purported the idea of implementing the application in the hospital database (Brafman, 2011). Conceptual Framework of ADT Application (a) Computer Science Concepts Utilization of the ADT application is based on all the computers in all the units and departments in the hospital (Saba, 2006). This calls for network management concept to be used so as to enhance continued access to the database of the hospital. The network concept may utilize the Wi-Fi computer knowledge or use of the local area network (LAN) as a strategy to access the hospital database. Software maintenance skills are also in demand by the technical support team to ensure the system operates normally throughout. The technical team needs to have a deep-set experience in computer skills and have a prior awareness of the operation of the application. The operators of the application, which is the employees of the hospital, need to possess data entry skill in order to run the application normally. This is the most basic concept requires to operate the application (Hewwet, 2002). At every level of use, the nurses/ the staff will be required to ‘feed’ some data into the computer so as to generate some information or retrieve any information. The data analysis concept is another skill the analytical staff needs to acquire. The application will require the data analysts to draw some meaning to information produced by the application after the processing process. The analysts need to possess the skill to decide based on the information provided by the application. What is more, the staff will need to have skills in data documentation. ADT is mainly concerned with proper data documentation. It might require the users to have skills in access, excel, and even internet for proper operation. The application also uses algorithms. This is a very important concept in the development of the application (Brafman, 2011). It ensures the detail and the hospital information does not ‘leak’ to the third parties. It offers the hospital and patients’ data security. (b) Information Science Concept Information science concepts are the skills and concepts involving data collection, documentation and dissemination of information to other users. The concept cuts across all the users of the application throughout the hospital. Users in the admission unit will receive the most basic patient information, and create accounts for them. Consequently, it allows data access by other units. The transfer department will need to access and affirm the patient details before the transfer is granted. In addition, the discharge department will have to clear with the patient before authorizing the discharge. This shows a continuous linkage of all the users of the application. The knowledge concepts used need to enable the users’ easy access and dissemination of information (Brafman, 2011). The data ought to be documented safely since it might have to be used as evidence or as a reference point in the future. Components of ADT Application The intensive application has a wide range of features and which facilitate effective operation and documentation of data in the area of use. Such include easy admission, emergency room admission, labor and delivery, ambulance emergency, transfer department and discharge components. In addition, surgery appointments, admissions, and re-admissions are key components of the application. The components of the application take into consideration both the outpatient and the inpatient clients. The diversity of the application components considers most of the documenting aspects of the hospital and allows easy and effective documentation. The admission component is mandatory for all the hospital clients. It involves the creation of client accounts. The hospital and the ADT application advocate one client one account principle and which embrace integrity, effectiveness and efficiency. The creation of the patient account can take into consideration the patient either using an identification tool like the national identity cards or equitable tools or use of I.P. addresses. The patient account is used to document the patient details and which include names, type of service, and the file number. The file number is the key patient identity number applicable to all patients. Moreover, the components allow management and control over the number of patients to bring in based on the bed space, free bed space, and the occupied bed space. The component allows making adjustments when the hospital has met its maximum holding capacity. Emergency room component is meant to take care of the intensive care unit situation. The component offers special consideration for the patients in great and urgent need for the medical attention. The emergency room services may include patients from the accident related nature or any other situation considered relevant and equitable to the same. The casualty department is also included in the emergency room services. The component enhances management and control over the data relating to the demands of the unit. It also aids in managerial decision making in matters of service provision. The labor and delivery department form another component of the ADT component. This is crucial for pregnant women, to whom the service may call for urgent need. The component provides advanced and special attention to the special need aroused by the patients in the department. The ease of access of the component also includes the maternity section. This avails quick documentation of the patient details and guarantees safety in the delivery process. The component also minimizes the delay in the section and hence allow effective offer of the service. The ambulance department also has its component in the application. Ambulance department is considered as an emergency service in the hospital. Hospital ambulances are used to avail the patients to the hospital or facilitate transfers. The efficiency of the department is very crucial to the wellbeing of the patients and the quality of the service to be offered. In order to ensure efficiency, patients with the need for the ambulance services utilize the component and do not have to utilize the normal admission component. The transfer component offer efficiency in times of demand when arises. Patient transfer may be from one unit to another or from one hospital to another. The reason behind the transfer may be a matter of urgency and in demand for special attention. The application also offers a discharge component to ease the release of patients of the hospital and may as well give feedback on the quality of service rendered. The transfer has to be incorporated with other application components in data management to allow facilitation of the bed control mechanisms. The various components of the application require other hardware and software supporting components in order to enhance the effective functioning (Tan, 2011). The computer setup is one of the basic supporting components. This allows access to the application software. The application software is the driving component for the application. The software includes the documenting facilities like bed allocation system, inpatient admission files, transfer files, discharge files, ambulance and emergency files, in-patient assistance, inpatient deaths and files relating to financial efforts of the patient like the bad debt sheets. The software component enhances effective interface among many units and sections of the component. Hence, it has to be technologically updated. The interface may be complex or simple based on the area and zone of operation of the firm. The hardware and the software part of the ADT application is important to the operation and functioning of the hospital (Tan, 2011). The management ought to embrace continuum updates on them. Continuous maintenance facilitates effective operation and ease of use of the various application components. ADT Application Evaluation IMA Summary Form Name of Application EPIC is the vendor firm for the ATD application. The EPIC firm specializes in making computer related applications that aid in enhancing quality and improvement of service delivery. It embraces the principles of informatics nursing to incorporate computer knowledge and technology in the documentation and management process. Description of Application: The application has a variety of components and features; Admissions Readmissions Discharge Transfer Inpatient and outpatient Data documentation Inpatient deaths Ambulatory surgery Emergency rooms Information management applications A clinical component Clinical toolbars Laboratory testing Application Vendor EPIC Systems Application Systems Architecture - system is built on a central platform that designated servers support from a mainframe location in Sacramento. Servers are added to support the mainframe depending on how many users need to access the system. PC Based/Client Server/Mainframe The system application is designed to incorporate all the servers inclusive of PC, client server and the mainframe server. The application accommodates usage of the application resources in all dimensions. Description of Organization The agency is a provider of both inpatient and outpatient services. This makes the firm have undefiled use of the application and maximize for the services of the application. Apart from the ADT application, the hospital uses other information management applications. They include; Hospital Administration’ Out and In Patient Management, Emergency Patient control, Laboratory Test, Radiology Test, Patients’ History, Daily check Up, Medicine Prescriptions, Billings and radiology and image taking. User Friendliness Novice computer user – 2 Experienced computer user – 4 By observing nurses go through their day to day encounter with EPIC, the novice users takes slightly a little longer to navigate the system, but they are able to find what they are looking for easily. The system gets easier to use with exposure every day. I see nurses less anxious before the start of their shift. Technical Support for Users Organization system - 4 End users – 4 Tech support is 24/7 and very good at getting back to the person with a question right away. Many from different departments are on constant rounds to see if anyone needs help. Adequacy of Staff Training Program to Use the IMA Training – 2. I would say this is where the numbers drop, due to the way that the classes were done. Nurse end – users went to 3, 8 hour classes. These classes consisted of nurses sitting in front of the computer for that time and pretty much following a module. There were instructors to answer questions, but most do not have clinical backgrounds and they were not able to answer their questions properly. The end users felt like they did not learn anything from the classes. The only time they started feeling more comfortable about learning the system was when they sat with one of the quality champions to learn it one on one. IMA Development Involvement of end –users – 4 The informaticists formed groups for the different campuses within CPMC. They then solicited feedback from Frontline staff starting a year before rolling out. They created domains to address workflows for ICU/MED-Surg, periop, Peds, OB, NICU, ED, SNF, and acute rehab. Objectives for IMA Clearly Stated Clearly stated – 4 When the hospital first talked about rolling out an EHR for our patients about a year ago, they clearly stated the EHR is for patient safety. It is also for easier integration. Their motto was 1 patient, 1 record. In addition, to this day, they remind us this is the reason we transitioned to EPIC. Objectives Met Objectives met – 3 I only give it a 3 for now because I have seen nurses go around certain things, such as using the barcode system incorrectly. If the nurses used this the way it’s supposed to be used, it would help tremendously with patient safety. Personal Response The ADT application plays a vital role in the incorporation of computer science and information science technologies in the healthcare sector and aid in the provision of quality services. By embracing the doctrines of nursing informatics, the application takes lead in enhancing effective documentation of the patients and in the general management of the hospital. Use of the application in hospital aids in reducing data redundancy in the hospital`s filing system. Such an advantage reduces the inspection time of patients’ files and offers a better opportunity of maintaining data security. Furthermore, the application allows effective and efficient address for matters of urgency by creating special attention to the emergencies in the hospital. The application also aids in decision-making and especially in the field of transfers and discharges. Effective decision-making allows the emergence of a suitable environment for work and embrace the employee motivation to continue working for the organization. The application has given me the expertise necessary for availing nursing services to the clients. It has given me a new experience in the digital world and opened many opportunities for learning. This is through the staff training programs offered by the hospital. However, the implementation of the application has been faced with a variety of challenges including poor training methodologies and long training hours. These factors affect the efficiency and proper utilization of the ADT application services. References Armoni, A. (2002). Effective healthcare information systems. Hershey, PA: IRM Press. Bekey, G. A., & Schwartz, M. D. (1972).Hospital information systems. New York: M. Dekker. Brafman, R. I. (2011). Algorithmic decision theory second international conference, ADT 2011, Piscataway, NJ, USA, October 26-28, 2011 : proceedings. Berlin: Springer. Hewett, W. G., & Druitt, G. (2002).The case for selective ICT outsourcing South West Alliance of Rural Hospitals. Melbourne: Deakin University School of Information Systems. Johnson, M. S., Suominem, H., Basilakis, J., Dawson, L., Kelly, B. & Hanel, L. (2013). Comparing nursing handover and documatnation: forming one set of patient information. Int Nurse Rev. retrieved from http://www.ncbi.nlm.nih.gov/pubmed?term=A+Nursing+Documentation+system Saba, V. K., & McCormick, K. A. (2006).Essentials of nursing informatics (4th Ed.). New York: McGraw-Hill, Medical Pub. Scaffzin, J. K., Prichard, H., Bisig, J., Gainor, P., Wolfe, K., Salon, L. G., Webster, L., & McCathy, J. J. (2013). A collaborative system to improve compartment syndrome recognition. Pediatrics, 132(6), 1672-9 Rogers, C. (2013). Improving the process to capture and present on admission pressure ulcers. Adv Skin Wound Care. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed?term=A+Nursing+Documentation+system Tan, J. K. (2011). Developments in healthcare information systems and technologies models and methods. Hershey, Pa.: IGI Global Wainwright, P. (1994). Nursing informatics. 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