Wednesday, June 20, 2012

Nursing And Computers: The obvious Move Towards Electronic health Records (Ehr)

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Nursing and computers have not always been a excellent mix. Typically, nurses try to get away from new computer systems as much as possible. However, it is an confident workflow evolution in today's hospitals.

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"It was so easy before when all I had to do was give it (orders) to the clerk."

"This new computer ideas is such a mess. Why can't we keep our old system?"

"It takes time away from my patient care."

"This is never going to work."

As an Rn working on the informatics side of healthcare, such comments are commonplace when I trip on site to separate facilities.

Why I wanted to do it

With billions of dollars allotted to deploy this scheme to manifold facilities nationwide, I wanted to be a part of it. "It's never been done before in this scale," stated Vicki Levario, the Director of ideas Solutions & Deployment at Kaiser Permanente Southern California Region. When I was offered this job, I didn't hesitate. Here was a marriage of two things I feel comfortable with - clinical content and computers.

The magnitude of this scheme can be appreciated when you take into consideration the 8 million Kaiser members it will affect. By 2007, all 12,000 physicians and 150,000 employees in the Kaiser organization are anticipated to be fully trained and use the software in their workflows. After a few weeks of involvement in this project, I began to see what a Herculean undertaking this will be.

Resistance

"Good luck with that job. They're just wasting their money. It's never going to happen, " a physician said to me one day.

Healthcare automation is an confident progression, but not met with resistance. There are those who are so unyielding to the change that they would rather retire than work under these conditions.

This sentiment is not unique to this organization. Cedars-Sinai medical center in Los Angeles met with such resistance from physicians that the implementation phase failed despite the ideas being two-thirds online.

I can understand where the overtone of paranoia comes from. Working on the units to retain the software, I observed some users who are obviously using the computer for the first time. I saw them having mystery using the mouse and typing their user names and passwords with painfully slow pecking style.

I try to encourage users by showing them the confident side. With the nation's healthcare trend of medical narrative automation, this will make health care givers more marketable as electronic health narrative (Ehr) experienced professionals. And, in time they will devotee the system, and their workflows will be more efficient.

Safer Practice

The issue of electronic ideas workflows in the healthcare setting adversely affecting patient care has also been a concern. However, the opposite is true. According to the produce of medicine (Iom) in a narrative called To Err Is Human: building a Safer health ideas (2000), "98,000 Americans die in hospitals each year as a consequent of medical errors. Even when using the lower estimate, deaths in hospitals due to preventable adverse events exceed the amount attributable to the 8th-leading cause of death. Deaths due to preventable adverse events exceed the deaths attributable to motor vehicle accidents (43,458), breast cancer (42,297) or Aids.

In her report, Key Capabilities of an Electronic health narrative ideas July 31, 2003, Dr. Carolyn Clancy, Director, branch for Healthcare study and potential stated, "There is a great deal of interest within both the public and secret sectors in encouraging all health care providers to migrate from paper-based health records to a ideas that stores health facts electronically and employs computer-aided decision retain systems. In part, this interest is due to a growing recognition that a stronger facts technology (It) infrastructure is integral to addressing such national concerns as the need to heighten the security and potential of health care."

National Mandate

Automation of records in healthcare is not only a step in modernization, but a national mandate. The following is excerpted from the United States branch of health Services.

Mission statement:

"... To guide the nationwide implementation of interoperable health facts technology in both the public and secret health care sectors that will cut medical errors, heighten quality, and produce greater value for health care expenditures, and coordinates outreach and consultation by the relevant administrative subject agencies with the public and secret sectors."

Vision:

"...Clinicians will have a patient's perfect medical history, computerized ordering systems, and electronic reminder."

The implementation of electronic health records (Ehr) is integral to this national mandate and it's just a matter of time when all hospitals in the Us will be fully electronic in their workflow systems.

With this daunting task ahead, I'm reminded of the words of the National Coordinator for health facts Technology National Coordinator, David J. Brailer, Md, PhD when he addressed the ideas Solutions and Deployment personnel. "All eyes are on you." As an Rn and healthcare provider, it's spectacular, to see straight through the telescope to look beyond the horizon and be part of the mission.

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