Health information technology (HIT) has brought major changes in the delivery of health services in many healthcare centers today (Julien, S. P. (2014). The federal incentives and mandates of healthcare facilities to update their healthcare technologies have given birth to new technological trends in nursing and treatment that has increased safety, efficiency and lower costs in the delivery of health services. Physicians, patients, and even health care insurance agencies have great fruits to read through advancement in the HIT. Electronic health records (EHR) is one of these technologies that is being employed by many healthcare facilities.
In the given scenario, Electronic health records serve as one of the best technologies that the two merging healthcare centers can use to serve the targeted underserved population efficiently and effectively. With EHRs, the emerged health facilities will be able to provide their team of professionals within the remote settings the medical records of the medical records of the patients. EHR has been lauded to enable healthcare professionals to access previous medical data for their patients’ real time. This enables the physician to view the medical history of their patients, which helps in knowing the previous illnesses, current or recent medications, and tests that have been done. According to HealthIT.gov (2016), to the federal government, on EHRs, they should be able to improve the safety, efficiency, quality as well as reduce the health disparities in the healthcare delivery and improve the coordination of care, and the delivery of public health to the population. Therefore, with EHR, the remote health facility will be able to administer their services more efficiently as no duplicate tests are likely to be done and the patients’ medical histories will be available to them. Since the federal government’s record, the EHR technology to communicate with other facilities, the move by the merged health facility will also help the patients in future treatments in other health facilities since their records will be available. The tests done to the patients will not be repeated which lowers cost charges especially to patients and the medical insurance agencies.
Project Committee Description
- a) Project Members
The committee tasked to oversee the migration of the merged hospitals to a common health information system includes the following interdisciplinary team members.
- Informatics Nurse
- Physician representative
- Prescribing Clinician
- Facilities Engineer
- b) Roles of the Team Members
All the team members in the implementation of the project have different roles depending on their expertise and position in the healthcare system.
- Informatics Nurse
The informatics nurse will be the team leader in the project. She will coordinate all the activities of the other team members and ensure all are working together. The informatics nurse will also bring a team of experts from her departments who will be tasted to conduct training to other team members so that they are fully conversant with the system and the new technology and also get able to perform their duties in the committee properly. Additionally, she will also be tasked to engage other staff nurses on their needs and proposals on the new HIT system and communicate their feedback to the team.
- Facilities Engineer
The Facilities Engineer will be the assistant team leader in the committee. The major roles he/she will perform in the implementation of the project involve mobilizing the resources necessary to implement the project. He/she will perform the quantitative analysis of the project and prepare a budget to present to the health facility management system. The facility Engineer and his team will also do procurement of the necessary materials and equipment as well as organize the workforce from his/her department that will be used to install the necessary infrastructure in all the departments the technology will be employed. Additionally, the facilities engineer will liaise with the nursing informatics department to ensure enough personnel is trained on handling the technical issues related to the new technology.
The Physician representative will be required to report to other physicians in the medical facility on the progress made in the implementation process. He/she will also voice the needs and recommendation of the physicians to the project committee to ensure the physicians feel to be part of the project and consequently embrace the technology. Additionally, upon learning about the working of the new HIT, the physician representative will organize the training sessions for other physicians on the new system.
- Prescribing Clinician Representative
The Prescribing Clinician Representative will be required to report to other Prescribing Clinicians in the medical facility on the progress made in the implementation process. He/she will also voice the needs and recommendation of the physicians to the project committee to ensure the Prescribing Clinicians feel to be part of the project and consequently embrace the technology. Additionally, upon learning about the working of the new HIT, the Prescribing Clinician Representative will organize the training sessions for other Prescribing Clinicians on the new system.
- C) Expertise of the Committee Members
Informatics Nurse Specialist
The Informatics nurse specialist is an expert in health science, information technology, and computer science. This knowledge is used in helping healthcare organizations in storing and retrieving health data and information regarding patients. In the project, the specialist will use his/her skills to educate the different departments on the roles to do in the project. She/he will also teach the other team members on the benefits of the technology, expected challenges and the best practices in the implementation and use of the project. All training conducted by the use of the EHR upon completion will be conducted under his/her supervision.
The facilities engineer in a medical hospital is skilled in carrying out various tasks that include implementation of designs and projects, installation of new systems, repair and maintenance of all various engineering equipment and apparatus in the facility and coordination with all department to ensure that their computer and medical engineering systems are functioning properly and up to date. In the committee, this expertise will be used in the installation of the necessary infrastructures in the process of implementation. The facilities engineer will form the team that will be trained on how to trouble the health informatics systems problems and attends to them in case of a breakdown of the system.
The physicians are expert in diagnosing and treating chronic diseases or specialized cases. To perform their duties effectively, they require the medical history of the patient which will be made available by the EHRs. Therefore, the physician representative offers enough advice on the requirements that other physicians will require to deliver excellent service. Additionally, the physicians need to feel part of the project to ensure it is fully embraced.
The prescribing clinician is an expert in performing patient examinations, diagnosis and treatment of illnesses, injuries and prescribes medications to patients. In the implementation of the HIT, which is the Electronic Health Records in this facility, he/she offer enough advice on the requirements that other prescribing clinicians will require to deliver excellent service. The prescribing clinicians are also the main users of the EHRs; the committee has to ensure they feel part of the project for them to embrace which will help in the success of the implementation process.
Importance of Interoperability in Healthcare
Interoperability refers to the way information captured in one medical organization is shared within the organization and also among other organizations (Iroju et al.,. 2013). The stored data in the EHR from different organizations in departments should be accessible and easy to be interpreted by other users in the network.
Interoperability in the healthcare is vital since data shared in the EHR system is vital and obtained from important sources in the delivery of healthcare such as laboratories, pharmacies, hospitals and clinics among others. The following are the major benefits of interoperability in medical care;
- It improves efficiency: When data transmitted from one source to recipient in a manner that it is easily understood a lot of time is an accurate conclusion are made.
- It cost saving: When the data of particular tests in readily available to all practitioners, they can easily proceed with the treatment without doing the tests again. This saves the costs used in redoing the tests again.
- It ensures safer treatments: Medical data is very crucial in the administering the treatment to a patient. Previous medications and illnesses help the physicians make the right decisions on how to treat a patient. If that data cannot be retrieved due to the format or software challenges, then a wrong conclusion by a physician can result which dangerous for a patient.
Importance of Using Nursing Standard Terminology
The healthcare environment today demands a safer cost-effective and quality care to patients in medical facilities (Doenges, Moorhouse, & Murr, 2016). To achieve this contribution by other players in the profession is necessary. The use of the EHR system in many healthcare facilities has led to the need for a universal language in nursing to ensure all players in the profession understand communication.
There are many advantages of using a standardized language in the in the nursing profession and some of them include:
- Enable easier communication with other nurses and health professionals in the field.
- It facilitates the collection of the data that is shared to improve the provision of healthcare at the local level and nationally.
- A universal language enables evaluation of community healthcare activities through measuring their outcomes.
- The nurses can give better visibility of their work when a standardized mode of communication is used.
Recent federal regulatory requirements that support health information technology
The health information system technology has received a major boost due to the recent federal regulatory requirements. One of these requirements is the Electronic Health Records incentive programs provided by the CMS. The program ensures that there are incentives that are provided to healthcare professionals and facilities that are ready to adopt and use the HIT systems in their systems to ensure safety, cost efficiency and quality of the healthcare provider.
Secondly, the HITECH Act, (Health Information Technology for Economic and Clinical Health Act) signed by the federal government ensured that the healthcare facilities had adopted the use of EHRs in the delivery of healthcare services (Washington et al., 2017). The act aimed to ensure adoption of the HIT into the healthcare through incentives and penalties. The regulation required demonstration of using HIT systems by health professionals and facilities such as ‘computerized physician-order entry system for professional or using ONS certified HIT system in the recording and sharing of patients data.
Components of the EHR System that Meet Regulatory Requirements
1) Cost efficiency: The EHR system was designed to reduce costs in the healthcare, which is one of the major requirements, by CMS and the HITECH Act. The system is fed with all the data about a patient on all the visits he/she does to any medical facility that has the system. If a patient had done a particular test recently such sugar levels or prostate screening, the physician can easily see it on the records and does not to test the patient again for a similar test that had been done recently. This reduces the costs used to perform similar tests on a single patient especially on expensive and complicated procedures.
2) Quality care: The quality of care provided by the medical facilities is one of the points of focus by the federal regulations on the use of HIT systems. The EHRs enables the physician to deliver quality care by providing the background of a certain ailment. A patient may be suffering from a certain condition, which may be as a resultant of other condition previously. When the health professionals understand the medical history of a patient, they can easily administer correct medication. Additionally, the EHRs prevent helps in identification of errors, if previous medical professionals who reduce the risks in the administration of care previously made a poor diagnosis.
Potential Threats to Electronic Health Records
Advance in technology is increasingly creating positive impacts on health care especially in electronic recording of information. However, just like manual or paper recording, the electronic method has threats that affect its credibility. Such threats include:
Hacking: this is access to electronic information by unauthorized person exposing out such that it is no longer safe. Hacking may lead to patients’ data being compromised with.
Inaccurate patient records: this mainly occurs when the information is not updated on time resulting in inaccurate data.
Virus attack: this where stored electronic information is destroyed such that it can no longer be retrieved. This may lead to vital patients information getting lost hence make it difficult to give the best care to the patient.
Poor or lack of training: lack of training to the staff on the maintenance of electronic health records may lead to exposure or interference of patients’ information.
- Two essential system features designed to ensure the protection of patient privacy
The increased number of threats affecting electronic health records has brought about different ways of protecting health information. Two of the main solutions that are implemented in minimizing these threats are:
Improved administrative control
This ensures that all electronic health records are protected by a password, and patients’ data is shared in encryption form. Further, this information is availed to limited staff members who need it (Fernández-Alemán et al., 2013). Additionally, the electronic health record systems have dashboards that ensure that they can only be accessed by administrative authority hence keep information safer.
Frequent Monitoring of the System
Constant monitoring access of the electronic record system ensures that any unauthorized access of data is detected and dealt with. It also helps in determining the information that should be easily accessed by the staff members and which needs improved security. Further, it allows frequent updating is hence leading to enhanced patient care.
- b) Industry standards for protecting data integrity and for mitigating risks that safeguard health information systems
Various standards are being employed in the maintenance of the integrity of health information. The integrity of this information is mainly interfered with during transfer or exchange of information. In this case, health industries have improved their health information exchange (HIE) models to ensure advanced data protection (Bahga & Madisetti, 2013). HIE models are usually divided into:
- Centralized model in which the organization’s patients’ information is transmitted to a shared repository.
- Federated model where patient’s information is maintained in independent databases in the organization.
- A hybrid model, which uses both federated and centralized models.
HIEs have policies that ensure maintenance of high level of health data integrity .further, a committee that governs HIEs in the organization ensures that proper measures are taken in mitigating any risks that may be encountered or may affect healthcare information systems.
Nonclinical emerging technology designed to support the assessment and delivery of patient care in remote satellite facilities
Several nonclinical emerging technologies are used in the healthcare environment. Some of them include:
- Social media
Social media technology in medicine is the process of using social platforms to access or provide information about health issues. Many healthcare organizations are using social media platforms to give information to their clients on health matters and tips (Hoffman, 2016). New products or packages offered in healthcare facilities are also being communicated through social media. Many individuals have turned to social media to seek information on certain ailments and how they can be treated. Health tips such as healthy ways to lose weight or healthy eating habits are some of the examples of health information people are seeking through social media. Additionally, an outbreak of certain diseases in certain places is widely shared through social media today so that it can reach more people in remote areas.
Smartphones have revolutionized many sectors of life including healthcare. Patients and healthcare providers have many uses for this technology. Patients can use their smartphones to make appointments with healthcare facilities using web portals, view medical information on the internet or find healthcare facilities (Hoffman, 2016). On the other hand, the healthcare professionals can use the smartphones to access patient’s information, capture procedures and codes of diseases, and connect to the health facility medical records among other uses while in the remote places.
Clinical applications of emerging technology designed to support the assessment and delivery of patient care in remote satellite facilities
Clinical Decision Support (CDS)
Clinical decisions support is a function of health information technology that provides health care personnel with intelligently filtered information based on the medical history of the patients entered in the HER. The CDs help in making decisions and avoid errors by basing their clinical suggestions based on facts and procedures rather than opinions. CDs can identify possible risks on some practices and give appropriate warning to the healthcare provider. Medical practitioners in remote places where there are no adequate resources to measure certain conditions can rely on CDs for tips especially in the cases of emergency.
The use of electronic communication is one of the modern technologies that are being used today, especially in remote applications. Health professionals can send some results from remote places where they can be analyzed by the equipment’s in the health facility and sent back (Hoffman, 2016). Prescription of certain medicine or explanation of certain procedure is also done using electronic transmission today.