Essential EHR Components for Optimizing APN Patient Care
The Institute of Medicine (IOM) is focused on improving health through knowledge sharing. One of its areas of focus is the use of technology in healthcare settings at a time when digital health information systems such as electronic health records (EHRs) are becoming a norm in clinical practice. EHRs are impactful in clinical and nursing practice, especially in APN practice. The IOM has outlined nine essential components that act as the gold standards of EHR in nursing practice. These include administrative processes, communication and connectivity, decision support, dentistry and optometry, health information and data, order entry and management, results management, patient support, and population health management (Nelson & Staggers, 2018). All of the IOM’s essential components for EHR are important in supporting APNs in patient care. However, the top five most important components include administrative processes, communication and connectivity, decision support, health information and data, and patient support. This article discusses the top most 5 important essential components of EHR with a focus on how each component supports the APN or Nurse Leader role and how each component contributes to improving patient outcomes and effective patient care.
Administrative Processes
The administrative processes component focuses on the integration of EHR systems into the daily operations of a healthcare facility or a health system. The essential function of the administrative processes component of the EHR is the ability to support conducting all financial and administrative functions associated with institutional operations and patient engagement (Nelson & Staggers, 2018). An EHR system once implemented within a healthcare facility, especially in hospital settings acts as an integrated practice management system. Such an integrated practice management system acts as a repository for all information within the organization including patient information, staffing information, and appointment scheduling information, and helps with the management of the daily facility operations.
A nurse leader can utilize the system to improve the organization’s administrative processes in a number of ways, which can impact patient outcomes and the effectiveness of patient care. For instance, adopting EHR systems improves the ability of hospital leaders to keep track of staffing levels at any time, as well as identify the available staff against patient demands at any given time. This ensures that patients have timely access to healthcare professionals on demand, therefore, ensuring timeliness of care. Additionally, incorporating EHR into administrative operations can help in scheduling specific care activities, reducing conflicts and delays, as well as identifying priority cases for resource allocation, leading to improved patient outcomes and experiences with care.
Communication and Connectivity
A major and important component of EHR, as outlined by the IOM, is communication and connectivity. Incorporating electronic health records systems creates an electronic communication medium among healthcare professionals and between healthcare providers and patients (Nelson & Staggers, 2018). Communication and information flow is critical in healthcare settings. Such flow of information influences the timeliness of care and effectiveness of interdisciplinary collaborations. EHRs support the sharing and access of health data or patient information at any point in healthcare delivery. For an APN and a nurse leader, the adoption of EHR creates a system of electronic communication that impacts patient care delivery, leading to improved outcomes and effective care.
One way to utilize this component of EHR to improve patients as an APN would be to utilize the information-sharing capabilities of EHRs to collaborate with other healthcare providers in a team, whether within the same facility or remotely. EHR systems such as MedBloc have been found to provide secure platforms for sharing and accessing healthcare information, supporting real-time access to medical data and real-time remote collaboration (Huang et al., 2019). Another way to use this component is to utilize EHRs to coordinate care throughout the care continuum. For instance, an APN can make use of the communication and connectivity features of EHRs for timely communication and create an interdisciplinary care team that supports continuity of care during and after such transition of care.
There are various ways the communication and connectivity component of EHR contributes to improving patient outcomes and effective patient care. For instance, EHR supports and facilitates on-site and remote interprofessional collaboration in patient care delivery through its capacity to allow medical data sharing and accessibility as needed when needed (Huang et al., 2019; Vos et al., 2020). Interprofessional collaboration in real-time facilitated by EHR systems improves the quality of communication and timeliness of care, making it effective enough to improve patient outcomes. Additionally, interprofessional collaboration, especially among physicians, nurses, therapists, and other healthcare specialists, is a mediator for improved patient outcomes, as well as the satisfaction of healthcare providers, including nurses (Labrague DM et al., 2022). EHRs also support efficient care coordination as they improve the workflow in care settings (Pinevich et al., 2021). EHRs are also designed to have portals that allow patients to access their health information and other health education materials. Therefore, such systems can be used to improve patient engagement during the process of care delivery (Lyles et al., 2020). Both workflow and patient engagement improve the timeliness of care, continuity, and shared decision-making, leading to better care outcomes and patient experiences.
Decision Support
An essential function of EHRs is providing a system that helps create reminders, alerts, and links resources to improve decision-making during patient diagnosis and care (Nelson & Staggers, 2018). Healthcare decisions for effective care delivery need to be supported by the best available evidence. EHR systems are a major source of information that guides evidence-based practice (EBP) (Fossum et al., 2022). Besides providing data to guide the development of EBP, EHRs have integrated decision support systems that assist with making the best clinical decisions. As EHRs continue to develop, they have integrated clinical decision support systems that help with collecting, sorting, analyzing, and presenting patient data and information that improves patient care (Patterson et al., 2019).
An APN can utilize the decision support component of the EHR to review data on the patient, including medications and test results, and get alerts on current medications, prescribed medications, potential drug interactions, as well as reminders for patient appointments. The APN can also use this decision support component to keep track of routine tasks such as patient medication times and identify potential problems or complications in a patient’s health based on trends in their chart. The component can also provide data-backed suggestions to inform decisions about patient care.
The decision-support component of EHR has the potential to contribute to and improve patient outcomes and effective patient care in many ways. Studies show that EHR-integrated clinical decision support systems effectively change physician practice with significant process outcomes, including improved guideline adherence (Patterson et al., 2019). Adherence to practice guidelines has various benefits for patient care, including reducing medical errors, improving patient safety, and overall patient care outcomes (Audet et al., 2023). The decision support component also provides timely information to support patient care decisions, reducing delays in care provision and improving the effectiveness of provided patient care.
Health Information and Data
The main function of adopting EHR systems is to collect and manage clinical data (Luo, 2019). This function gives healthcare providers and other authorized users the ability to enter, store, and access key patient information when needed. This component of the EHR systems helps APNs update patient information from patient assessments in real time, track their progress, and identify and track trends in patient health regardless of their location.
AN APN can utilize this component to access the medical histories of a patient, test, and lab results, other patients’ reports from other departments, and current and previous medications all in the same place. The component of the EHRs can also be used to share patient information with other providers, as well as support remote collaboration to help a patient manage their health. Additionally, since the health information and data component allows access to the medical history of a patient and their current diagnoses, an APN can use this component to make data-informed decisions and tailor care plans to the patient’s needs. The component, therefore, supports improved access to patient health information as needed when needed, which can improve the safety of care and care outcomes due to the accuracy of data within the EHRs. Additionally, as EHR systems support patient file sharing and access, the component facilitates joint clinical decision-making, which further improves the quality and effectiveness of the care provided.
Patient Support
Patient support is an important component of EHR systems in care delivery that enables APNs to provide patient education and support remotely. Noting that EHRs allow patient access through integrated systems such as patient portals, the patient support component can provide tools that facilitate improved patient engagement in the care delivery process (Lyles et al., 2020). An APN can utilize EHR portals to provide easily accessible and comprehensive health information to patients. EHRs with telehealth capabilities can also be used by APNs to deliver care remotely, facilitate virtual remote consultations, promote adherence to care plans and promote patient self-monitoring and -management.
Noting that a majority of EHRs have integrated telehealth capabilities, the patient support component can be utilized to foster patient engagement and empowerment even in remote settings. The use of telehealth and telemedicine services has been found to help overcome major health access barriers such as geography and care costs (Hasselfield, 2022) and facilitate remote collaboration for at-home monitoring and care with better patient outcomes (Malasinghe et al., 2019).
Conclusion
In an age of technological advancements in healthcare, health information, and data management have become critical in improving the effectiveness of patient care and patient outcomes. The nine components of the EHR systems, as outlined by the IOM, facilitate access to timely and relevant patient health information and related resources to support clinical decision-making and promote interdisciplinary collaboration and better coordination during care transition while improving patient engagement in care. As APNs are at the center of the digital transformation in healthcare delivery, leveraging the components of EHRs significantly improves the capacity of nurses to deliver effective patient care with enhanced patient outcomes.
References
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Fossum, M., Opsal, A., & Ehrenberg, A. (2022). Nurses’ sources of information to inform clinical practice: An integrative review to guide evidence-based practice. Worldviews on Evidence-Based Nursing, 19(5), 372–379. https://doi.org/10.1111/WVN.12569
Hasselfield, W. B. (2022). Benefits of Telemedicine. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/benefits-of-telemedicine
Huang, J., Qi, Y. W., Asghar, M. R., Meads, A., & Tu, Y. C. (2019). MedBloc: A blockchain-based secure EHR system for sharing and accessing medical data. Proceedings – 2019 18th IEEE International Conference on Trust, Security and Privacy in Computing and Communications/13th IEEE International Conference on Big Data Science and Engineering, TrustCom/BigDataSE 2019, 594–601. https://doi.org/10.1109/TRUSTCOM/BIGDATASE.2019.00085
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Question 
Using the list below of 9 essential components prescribed by the IOM as the gold standards of an EHR, select 5 components you believe are the most important to support APN patient care. For each selection:
Essential EHR Components for Optimizing APN Patient Care
— In an ideal environment, how would the component support your role as an APN or Nurse Leader (Provide examples of how you would use the component in your role)
–Explain how each chosen component contributes to improving patient outcomes and effective patient care.
include peer reviewed references and follow all 7th edition APA Professional Paper formatting.