Electronic Medical Records Systems
EMMER systems are composed to create improvement in the quality of care for our patients. The US Department of Health and Human Services lists several ways that EMMER systems are improving quality of care on their website. It talks about the dangers of paper records that we are avoiding by using EMMER systems which include handwriting that is difficult to translate, providers for one patient not communicating with each other, and new and increasing amounts of information regarding treatments and drugs that are not being utilized (Medical Informatics for Better and Safer Healthcare, Issue 6, 2013).
Patients with chronic disease sometimes have to be diligent in monitoring their condition at home. An example would be a patient with congestive heart failure that monitors their weight and blood pressure or a patient with diabetes that monitors their blood sugar and insulin use multiple times per day. With an effective EMMER system patient would be able to input these values and physicians and healthcare personnel would be able to use these values to evaluate the effectiveness of current treatment and to uses these values as a basis for any adjustments or changes in treatment.
These values could also e used to stave off potential dangerous medical situations. For example if a physician notices that a CHEF patient’s weight has been trending up and they have gained 14 pound in three days they could call this patient and try see if the patient has been voiding regularly, if the patient has been taking all prescribed medications, or to see if anything has changed in the patient diet or lifestyle and adjustments could be made before a condition is life threatening.
This feature is also a benefit to patients who are frequently on the road or who are on vacation when a health issue arises. The physician at he facility they are at has information regarding their medications and their health history in trending format. Like stated above switching to EMMER systems will eliminate the potential danger of misinterpreting a written doctor order. These systems will also be equipped with the capability to be continuously current with all medical and drug information.
This will enable us as healthcare providers to be up to date and current with the latest clinical information and research and will also lead to an increase in the quality of care we provide. Another great benefit to using the EMMER system is that we will e utilizing Patient ID bands with a barded specific to that patient. It has been found that using a patient id band with barded technology as well as medication with barded technology greatly reduces medication errors (Goodman, 2009). EMMER systems are becoming a standard in the healthcare industry as they make what we do more efficient, effective, and safe.
And by doing these things they assist us in increasing the quality of care that we deliver to our patients. Active Nursing Involvement When deciding upon and implementing change to a new EMMER system active involvement from the facility s nursing staff is very important. Nurses are a critical element in the management of a healthcare record. Nurses are the ones charting on the patients. They are the ones that use the barded scanners to safely administer the medication that the doctors order.
They are the ones identifying needs and writing care plans for these patients. I found it interesting that in an article written on how IT and nursing connect that a nurse specializing in informatics suggested that any hospital considering selecting a new EMMER system should first get to know how the nurses on the lour conduct their daily duties (Runny, 2013). It goes on to state that the nurses are the ones providing direct patient care and that these individuals input would be useful in that they will be the ones using the system the most intensively.
Their knowledge of what does and does not work on the floor will be insight that other members of the EMMER selection committee Will not be able to lend. For example the daily workflow and duties including patient care, charting, order entry, etc. Will guide developers to how best to make these systems go to work for us. Without this input from the floor nurse the aerogramme may fail to include something that is crucial in daily care delivery while including something that is rarely used. They will also be able to format the EMMER chart in a logical format to promote the nursing process.
If we can simplify and make efficient their use of the system then they will have more time and ability to give more direct patient care. Handheld Devices Handheld devices are a new trend as EMMER systems are becoming more widely used. With the fact that phones and other smart phones are commonplace and tablets are becoming more and more frequently used we can see that Hess could have great potential changes on how we deliver, record, and research for the care we give. Many healthcare providers are already using handheld devise at the bedside.
These devices can offer benefits to patients and providers alike. One benefit to patient and provider is that the device would offer more quality time from nurses by removing the need to go to a desk and chart. The nurse could simply chart on the patient at bedside while assessing and taking with the patient. It would also benefit both parties in the area of communication. Nurses would have access at bedside to access Hispanic progress notes and past nursing assessments without having to leave the bedside to access these things.
This will save time for nurses and will promote confidence in care by having information for our patients constantly at the tip our fingers. Along with being able to chart and see trends in charting and being able to educate the patient while treating the patient you would also have access to any order changes the doctor might be remotely inputting into the system. This will allow for expediency in executing treatment plans and changes and will also help the patient know that everyone is on the top of their game.
These handheld devices could help healthcare personnel from different specialties provide effective, current, and expedient care and will help us to improve the quality of the care we provide. Security Standards HIPPO, the Health Insurance Portability and Accountability Act, is a federal law that was enacted to protect the privacy of all patients. All EMMER systems must be in compliance with this act as well as making sure that these records are protected from any breech of information.
Healthcare providers and workers as well as IT professionals should always have most concern regarding peeping these records safe and protected from non-authorized individuals. IT helps us do this by installing firewalls, encryption of information, and protected servers. How we all help protect this information is by using secure networks. Each authorized person has a login ID and postcode. This ID and postcode will allow you to access the information that you need for your job to be successful. For example a nurse may have more access to the system than a secretary.
How we assist in keeping this server secure is by protecting out ID and postcode and not sharing it with anyone. Information access can be audited to assess if information has been accessed in an unauthorized manner and if so this can lead to training improvement, additional education regarding HIPPO, or sometimes corrective action. An article in the New York Times regarding Epic Systems, an EMMER system being audited, the CEO talks about the extensive firewall and security systems present to prevent unauthorized parties from gaining access to private health information (Freudianism, 2013).
Just like when paper charting was used nurses will still be responsible to guard who has access to the patient’s chart. Computer monitors need to be black when left so that no unauthorized viewing of patient data occurs. The use of handheld devices must be considered in this security discussion as well. Access to the system where patient data is located will be permitted (with personal ID and postcode) but no data will be stored on these handheld devices to help prevent misuse of data if any of our handheld devices go missing or are stolen.
Cost An effective EMMER system will save the facility not only time and worry about patient safety but is can also benefit the facility financially. The Department of Health and Human Services published a paper stating that the significant savings from converting to an EMMER system are projected to outweigh the costs of converting and investing in the EMMER system. However it also admits that the anticipated time it will take to break even to begin the period of savings is variable ranging anywhere from around 3-5 years to all the way to almost 15 years (Costs and Benefits of Health Information Technology, 2006).
Costs of implementation with the various EMMER systems vary greatly. A company called Practicalities offers a free EMMER program online. There are o charges to use this technology. It states on its website that Practicalities offers e-prescribing, medical charting, online booking, scheduling, EMMER for pad, referrals, billing, labs & imaging, and patient health record applications (Free, Web-based Electronic Health Records). Practicalities does use various ads to be able to render these services for free but as a user you can pay $100 per month to avoid seeing these ads.
Epic Systems is another provider of EMMER systems. Unlike Practicalities which is free Epic Systems offers Its services to large hospitals and is much more financially draining. One of these hospitals estimated that it would end up spending around four billion dollars on the software, equipment, and training of employees (Freudianism, 2013). In addition you have to consider continued training time, cost of upkeep, and new updates, and training/education of IT employees. Now with Medicare & Medicaid Services new Meaningful Use the EMMER system can also help with costs in a new way. Meaningful use is the set of standards defined by the Centers for Medicare & Medicaid Services (SMS) Incentive Programs that governs the use of electronic health records and allows eligible providers and capitals to earn incentive payments by meeting specific criteria” (Policymaking, Regulation, & Strategy: Meaningful Use, 2013). These incentive payments earned by the appropriate use of the EMMER systems can help offset the cost of implementation and even help earn the hospital money once implementation costs have been offset by profit.
Benefits to Care There are many benefits to patient care that are a result Of converting to an EMMER system. Patient safety is increased. We do this by increasing the safety of medication administration and decreasing medication errors. This is also one by seeing new physician orders in real-time. We can also see this in a full and easy to navigate medical record that is easy to access all parts of including medication allergies and adverse medication reactions.
Using a system like this will also enable providers to have instant access to the most current research and evidence-based practice articles to help promote the most current and research based results-driven care. Expedient care and communication is also a component of having such access to physician orders and medical records. Not only that but because care is expedited we eave more time to spend with our patients developing a relationship and delivering quality care. Communication is easier between healthcare team members.
Nurses are able to better communicate with physicians and will have quicker access to information to assist the physicians in making the best decisions for patient with all of the data needed. And physicians can more easily communicate with other physicians and have access to each other’s progress notes. Transcription errors of written physician orders are abolished by getting rid of written orders all together. “The federal government is intriguing to the recent growth of Epic and similar firms by offering financial incentives to health providers who switch to electronic records.
It sees these records as a way to improve patient care and reduce inappropriate costs like those for duplicated tests” (Freudianism, 2013). Even the US government is encouraging the conversion to EMMER systems by necessitating meeting certain criteria with the EMMER system. Recommendation audited Practicalities and Epic Systems which are on both sides of the cost spectrum. It is difficult to compare these programs. Epic has been working on evolving a leading EMMER system since 1979 and has won various awards for its system. It boasts a stellar reputation with the healthcare industry.
While the cost is intimidating when you look at the implementation at a large hospital the cost would be significantly less to implement at our 100 bed hospital due to training less people and needing less implementation staff. And we would still be using an EMMER system that is used throughout the industry. It also comes with a great support system for implementation where the Practicalities does not offer as thorough of a support system. Price will also add up if we want to avoid ads on the Practicalities site and need to pay $100 dollars per user.