Internal Medicine Assignment
Internal Medicine Assignment Paper
Internal Medicine Assignment Paper
This benchmark assignment assesses the following programmatic competencies: 2.3: Develop leadership skills to collaborate on interprofessional teams in the provision of evidence-based, patient-centered care. 5.2: Apply professional, ethical, and regulatory standards of practice in the provision of safe, effective health care. One way informatics can be especially valuable is in capturing data to inspire improvements and quality change in practice. The Agency for Healthcare Research and Quality (AHRQ) collects data related to adverse events and safety concerns. If you are working within a practice setting to implement a new electronic health record (EHR) system, this is just one of the many considerations your team would need to plan for during the rollout process. In a paper of 1,250-1,500 words, address the following questions related to the advanced registered nurse\’s role during this type of scenario: What key information would be needed in the database that would allow you to track opportunities for care improvement? What role does informatics play in the ability to capture this data? Which systems and staff members would need to be involved in the design and implementation process and team? What professional, ethical, and regulatory standards must be incorporated into the design and implementation of the system? How would the EHR team ensure that all order sets are part of the new record? How would you communicate the changes, including any kind of transition plan? What measures and steps would you take to evaluate the success of the EHR implementation from a staff, setting, and patient perspective? What leadership skills and theories would facilitate collaboration with the interprofessional team and provide evidence-based, patient-centered care? You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance Internal Medicine Assignment Paper
Implementation of a New Electronic Health Record (EHR) System: Desirable System Architecture and the Role of the Implementation Team in Ensuring the System Enhances Healthcare Quality
The Electronic Health Record (EHR) can be defined as a digital record of a patient’s history, physical examination, laboratory tests, radiology results, and clinical management plan or treatment. The EHR has been touted as a means to improve quality of care, enhance access to a patient’s data, and lower healthcare delivery costs (Ozair et al., 2015). The pervasive use of the Electronic Health Record stems from the American Recovery and Reinvestment Act (ARRA) signed into law in 2009. This law includes the Health Information and Technology for Economic Clinical Health Act (HITECH). It is the HITECH that innovated the Meaningful Use (MU) program sheltered under the auspices of the Centres for Medicare and Medicaid Services (CMS). The MU program encourages healthcare providers to make use of EHRs by providing financial incentives to those who use them. It also has the mandate to impose penalties to those providers who stop using the EHR systems (Sweeney, 2017). This paper takes a look at the implementation of such an electronic healthcare record system and the factors surrounding the implementation.
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Crucial Information Needed in the Database to Facilitate Care Improvement
There are several important information pieces that should be included in the database of the new system. These are imperative to facilitate the tracking of information and provide a chance for care improvement. The following is some of the information that should be included in the new EHR system to achieve this goal. Internal Medicine Assignment Paper
Information on Drugs
This information should be included in the EHR as it will assist in the management of medications and prescriptions for all the patients. This has been shown to immensely improve patient outcomes (Hoover, 2016).
Information about Bar Code Scanning
This is an optional feature that can be integrated into the system at the design stage. It enables the nurse administering medication prescribed by a clinician to scan a unique number given to that medication at the time of prescribing. If she happens to scan the wrong medication, the system alerts her to this fact through a pop-up on the monitor. This has been shown to prevent a great number of hitherto rampant and costly medication errors (Hoover, 2016).
Information on Laboratory Values
When this information is included in the design of the EHR, the system will be able to notify all clinicians and other end-users of critical values as they are entered into the system. The system will also be capable of reminding the clinician on when to repeat the lab tests and other investigations. Moreover, this information in the design of the EHR system will also assist in preventing the duplication of tests and investigations. This saves the patient on healthcare costs and also improves efficiency on the part of the clinician (Hoover, 2016).
Information on Imaging Results
Including information on imaging results activates an important feature that greatly improves the effectiveness of the services of the clinicians. With this information in the EHR system, the clinician can view X-rays and other radiology results for any patient directly from the system. This he or she can do without having to physically go to the radiology department or calling the radiologist. They can also access the radiologist’s report directly from the EHR system at any time (Hoover, 2016).
The Role Played by Informatics
Informatics plays an important role in the capturing of the data around the information included in the system as described above. Informatics bridges the gap between the technology (the EHR system) and the process (workflow in the clinical area). Specifically, informatics brings skills that are crucial in understanding how data is not only collected, but also stored. Furthermore, informatics informs data extraction and opens up the minds of clinicians to appreciate the role of data in guiding practice. Informatics dictates the use of data collection devices such as vital sign machines and other data collection devices (Sweeney, 2017).
Systems and Staff Members Needed in Design and Implementation
To ensure success of the EHR system, its design and implementation has to include some specific persons with specific competencies and skills. The systems needed must also be appropriate for a healthcare setting. Some of these systems needed include scanners, bar code readers, and normal value codes for vital signs amongst others. On the part of team members, the following are four important team members that must be present for successful implementation of the system.
The Project Manager
This is the person tasked with managing the project and completing it within set timelines. This is the team member who co-ordinates all the phases of the project from planning all through to implementation and evaluation (Vant, 2017). He should preferably have a technical background especially in EHR implementation.
The Application Analyst
This team member consolidates the concepts and suggestions from the other stakeholders (departmental heads, top management, end-users and so on). He then puts this information into a technical form that can be easily incorporated into design by the developer. He should also preferably have a clinical background (Vant, 2017).Internal Medicine Assignment Paper
The Application Developer
His task is to design and implement the various applications as desired and which are part of the whole system. The applications are specific to departments, for instance, the Emergency department has different needs to the Intensive Care Unit. The application for each department customizes each departmental function for ease of use by that department’s end-users (Vant, 2017).
The Quality Assurance Test Engineer
The work of this team member begins proper after the application developer finishes his portion of the work and installs the system. He tests the EHR to see if it functions the way it is meant to function. He or she should have experience in the particular EHR system being implemented. He should also preferably have a clinical background (Vant, 2017).
Professional, Ethical, and Regulatory Standards in the EHR System
As much as the EHR is supposed to improve efficiency and cut costs, the matter of ethics, legality, and adherence to professional standards of care must be addressed. Some of the ethical, professional, and regulatory issues that it must address include that (Ozair et al., 2015; Sulmasy et al., 2017):
The system should only allow authorised access by using secure encrypted passwords for privacy and security.
Information should only be sharable with the team members directly caring for the patient to avoid breaching the ethical principle of autonomy.
It must at all times protect privacy and confidentiality.
The system must not allow loopholes for violation of the Health Insurance Portability and Accountability Act (HIPAA).
The new EHR system team will be able to ensure that all order sets are part of the new system by engaging fully the services of the application analyst and the application developer. Communication of the changes including any transition plan will be possible through a two-way communication channel that harnesses inter-professional communication (Foronda et al., 2016).
The measures and steps to be taken to evaluate the success of the system implementation from all the stakeholder perspectives will involve the use of tenets of inter-professional collaboration. This means that all perspectives will be considered through extensive consultations (Bosch & Mansell, 2015; O’Brien, 2019).
The leadership skills necessary for success in this project include computer literacy, good interpersonal relationship acumen, and emotional empathy amongst others. On the other hand, the leadership theories that can be helpful include contingency theories and participative theories.
Implementation of an EHR in the healthcare institution in the United States is becoming a crucial and almost mandatory requirement for success. It is becoming one of the measures that are used to gauge the efficiency, effectiveness, and general quality of the healthcare services delivered. Its importance is in the fact that the Affordable Care Act 2010 places a lot of emphasis on the quality as opposed to the volume of healthcare services. Internal Medicine Assignment Paper
Bosch, B. & Mansell, H. (2015). Interprofessional collaboration in health care. Canadian Pharmacists’ Journal (Ott), 148(4), 176–179. Doi:10.1177/1715163515588106
Foronda, C., MacWilliams, B. &McArthur, E. (2016). Interprofessional communication in healthcare: An integrative review. Nurse Education in Practice, 19, 36-40. Doi:https://doi.org/10.1016/j.nepr.2016.04.005
Hoover, R. (2016). Benefits of using an electronic health record. Nursing2016, 46(7), 21-22. Doi:10.1097/01.NURSE.0000484036.85939.06
O’Brien, J. (2019). The importance of interprofessional collaboration. Retrieved 4 February 2020 from https://www.rn.com/nursing-news/importance-of-interprofessional-collaboration/
Ozair, F.F., Jamshed, N., Sharma, A. & Aggarwal, P. (2015). Ethical issues in electronic health records: A general overview. Perspectives in Clinical Research, 6(2), 73–76. Doi: 10.4103/2229-3485.153997
Sulmasy, L.S., López, A.M. & Horwitch, C.A. (2017). Ethical implication of the electronic health record: In the service of the patient. Journal of General Internal Medicine, 32(8), 935-939. DOI: 10.1007/s11606-017-4030-1
Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics (OJNI), 21(1). https://www.himss.org/library/healthcare-informatics
Vant, A. (2017). Four crucial members of an EHR implementation team. EHR In Practice. Retrieved 4 February 2020 from https://www.ehrinpractice.com/four-crucial-members-of-an-ehr-implementation-team-154.html
Internal Medicine Assignment Paper