Abstract

The technological improvement has been witnessed in many sectors, healthcare being the work of the industry which it has dominated. The healthcare practitioners like nurses and doctors play a significant in selecting an appropriate technological application in health care. Electronic Health Record (EHR) system is one healthcare technological application which has been so substantial in decision making. The EHR has many associated advantages that have been the reason for its widespread in many health care facilities. It also has associated challenges; however, proper planning and implementation are necessary for it to be useful. ERH also has associated implementation and maintenance costs which also need proper financial preparation. A good implementation selection and implementation process of the right EHR can bring a lot of benefits to the health care facility.

The Impact of Electronic Health Record (EHR) System in the decision-making process

Introduction

Decision making is an integral part and a natural process in any organization. In hospitals, for instance, decision-making is crucial because of the type of services offered to clients. Medical technology is essential in decision making in health care, especially in physician-patient interaction (Poulin, 2013). Three processes define the impact of technology in health care. First, decision making is diffused through the increased alternatives available. Second, the role of decision making is delegated to others in the health care system, and finally, some of the decision making processes in health care is shifted to the patient or the community. Electronic Health Record (EHR) system is one medical technology application that has gained much importance in healthcare (Gurtner, 2014).  Health care practitioners can use EHRs in checking the health history of their patients, their diagnoses, test results, and medications. This paper discusses the nursing role in identifying appropriate technology for practice and the EHR impact and its implications on quality decision making.

The Electronic Health Record (EHR) System for decision making in health care

The EHRs provides meaningful incentives in health care functions, and it has gained popularity over the years.  EHRs can be widely adopted if physicians realize more value it offers in the health care system to improve the entire system (Gurtner, 2014). The nurses, doctors and other medical practitioners can use EHRs in health care to help them in clinical decision making because it is easy to modify and update s as to meet the health care goals. The effectiveness of EHRs is realized when three it helps in achieving efficiency, quality, and healthcare safety.

However, there are some challenges that physicians face with the adoption of EHR. For instance, health care physicians take of poor usability as one challenge they face in using EHR. They also claim that data entry through EHR consumes time and it has complicated requirements on its regulation (Campanella et al. 2015). Besides, physicians also view HER as degrading the quality of clinical documentation and also results in an insufficient exchange of health information. However, EHR can help physicians in making informed healthcare decision if it is expertly designed within the system. The EHR vendors can make it more useful if they address some of the requests that physicians propose to improve its clinical usability and the overall functionality.

How Electronic Health Records contributes to quality decision making in health care

Healthcare can transform positively with the availability of EHR systems if they can be appropriately designed so that it will have accurate patients’ data. EHR can improve health care decision making by enhancing quality healthcare services, reduction of errors in medical practices, improving time efficiency and adherence to healthcare guidelines (Campanella et al. 2015). Also, EHR can also determine cost reduction related to medical errors, time inefficiency, and ADEs. The adherence to guideline also has a tremendous impact on the use and the reduction of healthcare cost, support the healthcare professionals in their clinical responsibilities by reducing the treatment ADEs and errors and also check on the unnecessary resource wastefulness. The appropriate utilization of EHR in healthcare delivery may also improve the efficiency in hospitals with its benefits being more than the cost of its adoption. With the improved efficiency, health care professionals can hence make informed decisions that will improve healthcare as a whole.

The process of selecting and Implementing EHR system

The selection and implementation of the EHR System is anessential process in any health care facility. In approximation, the complete identification and implementation of EHR type can take one year (Weathers & Esper, 2013). The time, however, depends on the organization. Some organizations can take slightly lesser time while some take longer to complete the implementation. The most important in the process are preparations made and the planning done. The following steps can be followed to ensure full implementation of the EHR:

1. Getting ready

Getting ready to move forward with the EHR system is the first step which will make the EHR availability a reality in an institution (Weathers & Esper, 2013). It requires a lot of effort on the side of the staff to prepare, to plan and to incorporate the application within the system. When the idea for implementing EHR comes in, the stakeholders should realize that the time to shift from the current system has reached. They should hence be ready, provide effort and allocate the staff for the implementation process.

2. Planning

Planning is an integral factor in EHR implementation. A project manager selected for the task should be tech-savvy and the key to lead the entire program. The project manager will ensure that the program schedule is kept, the staff should be up to date with the progress, and they should know the right EHR system at the right time (Weathers & Esper, 2013). First of all, the planning team should understand the need and shortage to ensure that the right system is put in place before selecting the EHR. For instance, they should know the answers to the questions such as whether there will need to connect the health information exchange between facilities, whether there will need to synchronize the system with other software available, and kind of they will need.

3. EHR System selection

The implementation team should have a choice among the top three vendors of the EHR system. Organize demos in which all staff attends and ask the vendors similar questions and note their responses (Weathers & Esper, 2013). The management can then use a decision matrix to select the best vendor. The system should not be expensive and should not also be cheap. The cheapest may fail in the long run; hence more cost will come in. The most important factor is to assess the efficiency of the system.

4. System preparation and Training

The users should, therefore, be subjected to on-site and online training to improve their knowledge and skills on their use. After training the critical data can then be incorporated within the new EHR system.

5. Implementation

The system can hence be allowed to go live and become operational. The vendor can still be onsite and ready to handle unforeseen challenges that may come up in the initial implementation period enabling the staff to familiarize with the system.

6. Continuous Quality Improvement

Regular meetings by the users should be organized occasionally to fine tune the EHR system with the organizational needs. The constant workflow adjustments will also be necessary for peak performance and best alignment.

The Costs associated with the EHR system

The implementation and maintenance of the EHR system come with a set of associated costs. A healthcare facility, therefore, requires sufficient preparation to facilitate its implementation and maintenance. According to Palabindala et al. (2017), hospitals and other health care facilities pay fees of about $500,000 for application and $1,200 for annual maintenance. The associated yearly and monthly recurring costs associated with the EHR system, therefore, requires proper preparation in hospitals and other health care facilities. There are also other associated hidden costs such as server updates, eligibility check services, and electronic prescribing functionalities. The EHR is, therefore, an essential application due to its related benefits. It, however, requires proper planning so that the healthcare facilities and health care stakeholders to realize its benefits.

The role of nursing in identifying appropriate technology

The modern technologies in healthcare are a significant factor required for nursing advancement. The physicians, especially nurses believe in the importance of healthcare technology (Morilla et al. 2017). The nurses with experience in using a particular technology in their services are more open to the implementation of new forms of appropriate technology that can aid in decision making because they have many benefits which outweigh the apparent shortcomings and difficulties (Morilla et al. 2017). The nurses in most cases recommend the funding and implementation of appropriate technology, especially the ones who can improve the patient-nurse interactions. There are various nursing responsibilities which require the use of modern technology, and hence nurses need technology to be incorporated at their workplace just the same way they have integrated technology in their lives. For instance, the Electronic Health Record system has proved to be very useful in helping health care practitioners in decision making. They can use it to check o patients’ test results and decide the form of medication that can be appropriate to the patients.

References

Campanella, P., Lovato, E., Marone, C., Fallacara, L., Mancuso, A., Ricciardi, W., & Specchia, M. L. (2015). The impact of electronic health records on healthcare quality: a systematic review and meta-analysis. The European Journal of Public Health, 26(1), 60-64.

Gurtner, S. (2014). Making the right decisions about new technologies: a perspective on criteria and preferences in hospitals. Health care management review, 39(3), 245-254

Morilla, M. D. R., Sans, M., Casasa, A., & Giménez, N. (2017). Implementing technology in healthcare: insights from physicians. BMC medical informatics and decision making, 17(1), 92.

Palabindala, V., Pamarthy, A., & Jonnalagadda, N. R. (2016). Adoption of electronic health records and barriers. Journal of community hospital internal medicine perspectives, 6(5), 32643.

Poulin, P., Austen, L., Scott, C. M., Poulin, M., Gall, N., Seidel, J., & Lafrenière, R. (2013). Introduction of new technologies and decision-making processes: a framework to adopt a local health technology decision support program for other local settings. Medical devices (Auckland, NZ), 6, 185.

Weathers, A. L., & Esper, G. J. (2013). How to select and implement an electronic health record in neurology practice. Neurology: Clinical Practice, 3(2), 141-148.

 
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