Impacts of Clinical Systems on Outcomes and Efficiencies

Impacts of Clinical Systems on Outcomes and Efficiencies

Technological advancements have yielded major positive milestones in the healthcare industry. The arrival of clinical information systems is one of the most recent developments in the industry. Clinical systems represent the single most transformative development in healthcare practice because they enhance quality patient care by supporting the clinical decision-making process. These systems offer a wide range of healthcare capabilities that are ultimately useful in improving patient outcomes. The majority of these functionalities result from the ability of clinical systems to record, store, process, and avail relevant information. Besides the potential for improvements in patient safety, the adoption of clinical systems will potentially result in widespread clinical task efficiencies, improved quality of care, and increased patient engagement.

The utilization of clinical information systems can potentially improve the efficiency and accuracy of clinical tasks. Scheitel et al. (2017) showed that the use of the clinical decision support (CDS) tool significantly improves the efficiency and accuracy of blood cholesterol management. In the study, a novel CDS was developed to facilitate the calculation of cardiovascular risk scores and provide relevant recommendations for management based on the risk scores. The tool derives data from an electronic health record system and automatically computes the risk score precluding the need for the provider to enter risk variable data manually. The efficiency and accuracy of risk calculation and subsequent treatment provision were compared for CDS-supported management and standard care among thirty-three clinicians. CDS utilization reduced the task completion time by 3 minutes and 38 seconds and reduced the number of clicks and keystrokes by 94 and 23, respectively. Similarly, task accuracy improved from less than 61% to 100%. In light of the increasing prevalence of chronic conditions, clinical information systems may, therefore, be crucial in fostering adherence to clinical guidelines and streamlining patient care tasks.

Similarly, the adoption of clinical information systems can result in improved medication safety. Balasuriya et al. (2017) showed that a dose range checking (DRC) system could significantly reduce the incidence of medication errors. In the study, an optimized DRC that integrated ‘soft” and “hard” alerts was developed and implemented in a pediatric intensive care unit in order to support and guide the prescribing decisions and behaviors of clinicians. The baseline rates and types of alerts were compared with similar variables following the implementation of the DRC. The findings showed an increase in the dose alert rates from 0.3% to 3.4%. Similarly, while all the alerts were soft alerts at baseline, hard alerts represented 32% of the post-DRC dose alerts. This indicates an increased rate of flagging potential dose errors. The rate of dose reconsideration following soft alerts increased from 10% to more than 24%. Additionally, nearly 28% of hard alerts elicited dose reduction, while 64% and 7.4% necessitated order cancellation and rewriting, respectively. Evidently, the implementation of the DRC resulted in increased flagging of potential medication errors at the clinical decision-making level, indicating the potential for clinical systems to reduce medication error rates.

Additionally, the adoption of clinical information systems has the potential to support tertiary prevention in the management of non-communicable diseases. Specifically, these systems provide capabilities for automated screening for complications of chronic medical conditions such as diabetes. Van Der Heijden et al. (2017) demonstrated the potential for automated screening for diabetic retinopathy and determining the need for specialist referral using a diabetes care system (DCS). An image-grading algorithm device was embedded into the Hoorn DCS. The retinal images of people with diabetes managed using the system were evaluated and graded using the algorithm, and the findings were compared with those obtained by a specialist using clinical guidelines to grade the same images. The grading sensitivity, specificity, and predictive values for the automated system were compared with the findings obtained through the use of clinical guidelines. In light of the current shortages in the healthcare workforce, the unavailability of specialists represents a major healthcare access barrier. Capabilities offered by clinical information systems, such as automated screening for referable retinal disease, may enable screening services to be offered at the primary care level, offsetting the pressure on specialists.

Furthermore, clinical systems can be useful in addressing patient safety concerns. Adverse events have a negative impact on the health outcomes of patients and are used as indicators of patient safety and quality of care. The implementation of a clinical information system has been linked to improvements in these patient safety metrics. According to Furukawa et al. (2020), acquiring a patient safety monitoring system (PSMS) can elicit a reduction in adverse events. In a retrospective study, the estimated risk of adverse events among 45,235 patients at risk for different types of sentinel events was compared with the actual incidence of these sentinel events in a clinical setting utilizing an electronic health record (EHR). The major sentinel events that were considered in the study included healthcare-associated infections, medication-related events, and post-procedure complications. The findings showed a 17-30% reduction in the incidence of sentinel events among cardiovascular, pneumonia, and surgical patients Furukawa et al. (2020). The potential for a significant reduction in patient safety concerns following the implementation of clinical systems may subsequently improve health outcomes in terms of mortality and length of hospital stay.

Finally, a clinical information system may be beneficial in increasing patient satisfaction and engagement in their care. Patient satisfaction is crucial in their engagement in the management plan. Clinical information systems offer capabilities for enhancing the patient’s engagement in their care. In a focus group-based qualitative study conducted to explore the experiences and perceptions of patients with an active patient health record (PHR) system, patients cited perceived benefits such as improved patient-provider communication, increased care partnership, and greater engagement levels in self-management (Rief et al., 201). Traditionally, active PHR systems have experienced low popularity due to the influence of these systems on the patient-provider relationship dynamic since these systems grant the patient greater autonomy while increasing the provider’s accountability. Active PHR allows patients to enjoy individualized contact with the provider, which includes personalized reminders and alerts and secure messaging capabilities (Rief et al., 201). The number of patients on long-term care and self-management plans is currently because of the rise in chronic health conditions. Active PHR may provide a modality for maintaining individualized patient follow-up.

Indeed, clinical information systems have created significant opportunities for improving various aspects of patient care. The effectiveness of various types of clinical systems in improving the efficiency of the patient care process, promoting medication safety, supporting prevention efforts, reducing patient safety concerns, and increasing patient engagement makes these resources invaluable additions to patient care. Although providers still grapple with the challenges that accompany the implementation of clinical systems, such as workflow perturbations and the associated cost implications, their potential to positively transform the quality of patients is undoubted.

References

Balasuriya, L., Vyles, D., Bakerman, P., Holton, V., Vaidya, V., Garcia-Filion, P., … & Kurz, R. (2017). Computerized dose range checking using hard and soft stop alerts reduces prescribing errors in a pediatric intensive care unit. Journal of patient safety, 13(3), 144-148.

Furukawa, M. F., Eldridge, N., Wang, Y., & Metersky, M. (2020). Electronic health record adoption and rates of in-hospital adverse events. Journal of Patient Safety, 16(2), 137-142.

Rief, J. J., Hamm, M. E., Zickmund, S. L., Nikolajski, C., Lesky, D., Hess, R., … & Roberts, M. S. (2017). Using health information technology to foster engagement: Patients’ experiences with an active patient health record. Health communication, 32(3), 310-319.

Scheitel, M. R., Kessler, M. E., Shellum, J. L., Peters, S. G., Milliner, D. S., Liu, H., … & Hankey, R. A. (2017). Effect of a novel clinical decision support tool on the efficiency and accuracy of treatment recommendations for cholesterol management. Applied clinical informatics, 8(1), 124.

Van Der Heijden, A. A., Abramoff, M. D., Verbraak, F., van Hecke, M. V., Liem, A., & Nijpels, G. (2018). Validation of automated screening for referable diabetic retinopathy with the IDx‐DR device in the Hoorn Diabetes Care System. Acta ophthalmologica, 96(1), 63-68.

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Impacts of Clinical Systems on Outcomes and Efficiencies

Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of a positive impact on outcomes or efficiencies.

Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists, and others have then benefited from consulting existing research to inform their thinking.

In this Assignment, you will review existing research focused on applying clinical systems. After reviewing, you will summarize your findings.

To Prepare:

• Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
• Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to
  

  Impacts of Clinical Systems on Outcomes and Efficiencies

  improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”

• Identify and select 5 peer-reviewed articles from your research.

The Assignment: (4-5 pages)

• In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:
• Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
• Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.

Grading Rubric

• The responses accurately and clearly identify 5 peer-reviewed research articles for the Assignment.
• The responses accurately and thoroughly summarize in detail each study reviewed, explaining in detail the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described.
• Specific, accurate, and detailed examples are provided which fully support the responses.
• Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
• Uses correct grammar, spelling, and punctuation with no errors.
• Uses correct APA format with no errors.