Healthcare Technology

Healthcare Technology

Identifying, selecting, implementing, and managing technology in clinical settings to achieve meaningful functionality is always complex. Today, with a range of options available to choose from and the changing healthcare environment, it is always important that healthcare managers in care facilities, such as hospitals and nursing homes, identify the challenges their institutions would wish to address and then choose the right technology that can match these shortcomings (Darvish et al., 2014). Involving healthcare workers, such as nurses, when mapping and building the technology is also necessary to ensure that the technologies being developed and rolled out meet global safety and quality standards and are within the technical specifications required to function effectively in clinical environments. Engaging nurses during the planning step ensures that all staff members are informed of the newly built technologies and applications, which can reduce medication errors or complexity of use. It guarantees that all workflows and processes used in a particular work environment are mapped out and tailored in the new application (Darvish et al., 2014).

It is essential to define what electronic healthcare records (EHRs) are, their impact on the quality of decision-making, the process of selecting and implementing them, their cost implications, and the role nurses play in selecting and evaluating these applications.

Technology App Used in Healthcare to Facilitate Decision-making – Electronic Healthcare Records

The term electronic health record (EHR), sometimes defined as an electronic medical record (EMR), refers to the digitized form of a patient’s paper-based chart. An electronic health record is a real-time digital record that makes patient data/information instantly available in a secure manner to authorized users, including nurses, doctors, pharmacists, laboratory technologies, researchers, and so on. A majority of healthcare professionals regard an EHR as one of the integral parts of the decision-making process in clinical settings because it contains a broader view of patient data with a click of a mouse. It carries a patient’s labs and test results, radiology images, allergies, immunization dates, treatment plans, medications, diagnoses, medical history, as well as demographics. EHRs enable providers to access evidence-based information that they can use to make critical patient care decisions and help streamline and automate provider workflow (HealthIT.gov, 2019).

The Application’s Impact on Quality of Decision-making

Electronic healthcare records are multifaceted digital tools that support a broad range of decision-making processes. When healthcare professionals – such as nurses and physicians – have access to accurate and complete patient data in real-time and instantly, they can deliver quality, safe, and better clinical care. Primarily, EHRs have been found to boost the ability of clinicians to make accurate and prompt decisions related to disease diagnosis – which have been associated with reduced medication errors, improved quality, reduced hospital stay, lower cost of care, and better patient outcomes.

Study findings have also indicated that adopting EHRs can improve the quality of care by improving liability prevention and risk management processes. This is because EHRs can provide clinical reminders and alerts, make it simpler to consider all areas of a patient’s condition, support the therapeutic and diagnostic decision-making process, allow evidence-based decisions at the point of care, prevent adverse effects through built-int safeguards, enable the collection of all relevant data in on place, and promote aggregation, evaluation, and communication of patient information. A study by Holt, Warsy, & Wright (2010) also found that EHRs significantly improved coding and documentation in clinical settings, such as an increase in the application of ICD code (by 11 percent).

The Process of Selecting and Implementing the Application

The process of implementing new technology in a clinical setting involves multiple steps and different individuals, from health IT developers to users of the technology, including nurses and physicians. The exact steps involved in the section and implementation often vary from expert to expert, with some splitting them into four, others seven, and others more than ten. For the sake of this assignment, the steps of making critical decisions about an EHR will be broken down into five broad categories: assessment, planning, acquisition, implementation, and management (Berkowitz & Swan, 1993).

The assessment step involves the creation of an advisory committee to evaluate and review the needs and requests for the EHR in a facility. The committee also serves an important role in reviewing the budget requests for the replacement of new technology and sets strategic and mission-based priorities. The second phase, planning, permits the healthcare facility to define and set short-term and long-term goals for the new EHR technology. This process often entails an audit of the present tools, examining technologies in other care facilities, and evaluating the EHR trends. An accurately defined plan will subsequently help in the purchase of the appropriate technology as well as its management. It gives the facility greater flexibility and an upper edge in budgeting for staff training, negotiating acquisition costs, and servicing, upgrades, and support. Before implementing or rolling out the technology, the IT team must choose the most appropriate way of launching the EHR, such as the “incremental” or “big bang.” The management step, sometimes known as the pre-implementation phase, involves monitoring the technology to assess its benefits or achievement of the pre-determined goals formed during the planning phase. This step involves gathering feedback and data for continual upgrades and improvement in the future.

The Costs Associated with the Application

Planning, purchasing, and implementing an EHR framework in a healthcare facility is both labor-intensive and costly. The costs can be categorized into installation, training, software, hardware, hosting, software licensing, and so on. The total practice cost is $220,500, while the average cost per physician is $44,100. The following table breaks down the first-year EHR installation and management costs for a 5-physician practice setting.

Expenditures	1-Year Costs
Vendor costs (training, interface, and software)	$50,500
Hardware costs (printers, desktop computers, database server)	$60,000
Other costs (surge protectors, remodelling, wiring, hosting, etc.)	$10,000
Project manager (half-day for nine months)	$30,000
Project team	$60,000
Training time (staff)	$10,000
Total per practice	$220,500
Total per physician	$44,100

Nurses’ Roles in Selecting and Evaluating the Application

Nurses, as frontline workers or end-users of electronic healthcare records, play a fundamental role in selecting and evaluating the technology’s efficacy and effectiveness. In terms of selection, nurses provide clues that define the exact workflows and processes that the technology will be built for based on their work environment and skills, as well as the programming language that will be used, including the terms and abbreviations. The technology will specifically be tailored to match the specific and unique work environments of nurses and their capabilities to achieve maximum implementation. For technologies already built, nurses help select applications that match their work environment’s specific needs and skillsets. It is also important to note that nurses understand the shortcomings of the existing patient data recording and sharing platform and are, therefore, in a better position to guide the technology developers or vendors on what needs to be done to achieve maximum results in their work environment.

Finally, in terms of evaluating the technology, nurses serve an integral role in giving project managers and vendors feedback (including technology shortcomings) related to the efficiency and effectiveness of the technology. These clichés are often needed to determine improvement areas and make relevant upgrades (Patricia, 2015).

Conclusion

In a nutshell, it can be argued that technology implementation for decision-making purposes in healthcare settings is often a complex and multifaceted process. An electronic healthcare record (EHR) is a classic example of health IT archetypes that have been standardizing the recording and sharing of patient data in clinical environments, replacing paper-based records. EHRs have improved the quality of patient care by improving communication among healthcare providers, ensuring that nurses, pharmacists, and physicians share accurate patient information in real time. EHRs have also played an important part in ensuring care providers make informed and accurate diagnosis and treatment decisions. Implementing an EHR system can be broken down into five broad phases, including assessment, planning, acquisition, implementation, and management. Finally, it is important to note that nurses play a vital role in not only selecting but evaluating the efficacy and effectiveness of healthcare technology, such as EHR.

References

Berkowitz, D. A., & Swan, N. M. (1993). Technology decision making: A constructive approach to planning and acquisition will require a paradigm shift. Health Progress, 74(1), 42-47.

Darvish, A., et al. (2014). The role of nursing informatics in promoting quality of health care and the need for appropriate education. Global Journal of Health Science, 6(6), 11-18. doi: 10.5539/gjhs.v6n6p11

HealthIT.gov. (2019). What is an electronic health record (EHR)? Retrieved from https://www.healthit.gov/faq/what-electronic-health-record-ehr

Holt, J., Warsy, A., & Wright, P. (2010). Medical decision making: a guide to improved CPT coding, Southern Medical Journal, 103(4), 316-322. doi: 10.1097/SMJ.0b013e3181d2f19b.

Patricia, D. (2015). Clinical nurses lead the charge with EHR. Nursing, 45(10), 25-26. doi: 10.1097/01.NURSE.0000471426.47075.d2

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