Opportunities and Challenges of Clinical Information Systems
Healthcare system is considered one of the busiest fields which require continuous upgradation in order to ensure optimum health benefits to the consumers (Kadhim et al., 2020). In this context, implication of new technology specifically the Electronic Health Record (EHR) has become highly essential. Clinical system strategies are usually developed by either by the nurse informaticists or the healthcare leaders (Strudwick et al., 2019). Since these methods are frequently dependent on technological developments, informaticists and others have profited from reading current studies to help them think through their options. Healthcare professionals especially, the nurses, who are relied for keeping the clinical records of their patients require in- depth knowledge and understanding on the processes so that they can use these technologies during their clinical practice in an efficient manner (Mutshatshi et al., 2018). The purpose of this paper is to review four existing and peer reviewed articles in order to understand the application of clinical systems in the field of nursing.
Islam, M. M., Poly, T. N., & Li, Y. C. J. (2018). Recent advancement of clinical information systems: Opportunities and challenges. Yearbook of medical informatics, 27(01), 083-090. https://dx.doi.org/10.1055%2Fs-0038-1667075
In this research article, the researchers systematically reviewed, synthesized as well as summarized available research articles which described the then stages of clinical information systems in order to assess identify potential challenges, benefits of the system and to understand the state of knowledge of the same. The researchers selected almost 23 papers from a collection of 1026 relevant abstracts for the review from reliable databases such as EMBASE and PubMed. However, only 20 articles could match all the criteria for the research. Three major aspects have been heighted by the researchers in this article and those included “Ambulatory and inpatients clinical information systems”, “Ancillary information systems” and “Specialty information systems”. It has been emphasized by the researchers that CIS might promote practices those are evidence-based and might improve the safety, efficacy and most importantly the quality of treatment for patients, its acceptance, acceptability, and adaptability have grown across the world. The researchers have also indicated that despite the fact that the need for CIS capability is growing exponentially, present CISs still face data integration issues and lack the ability to share patient data across all or portions of the healthcare system. Technical, human, and organizational constraints are to blame for these limits. The researchers spent significant amount to time to derive in their research and have concluded with the findings that clinical information system has a lot of potential for minimizing clinical mistakes including medical error and diagnostic mistakes, as well as promoting healthcare professionals by providing updated patient information. They claim to raise overall healthcare quality by improving workflow and care efficiency. For example, it has also been supported by Vaidotas et al. (2019) that medication errors have been reduced in emergency departments which have incorporated electronic medical records and thus have continued contributing to optimum patient safety.
Dykes, P. C., Rozenblum, R., Dalal, A., Massaro, A., Chang, F., Clements, M., … & Bates, D. W. (2017). Prospective evaluation of a multifaceted intervention to improve outcomes in intensive care: the promoting respect and ongoing safety through patient engagement communication and technology study. Critical care medicine, 45(8), e806-e813. https://doi.org/10.1097/CCM.0000000000002449
Evaluation of Multifaceted Interventions to Improve Outcomes in Intensive Care
There are few studies that evaluate treatments in ICUs to increase team communication and involve patients as well as the caregivers. The efficacy of a patient-centered care along with that engagement program that has been conducted in the medical ICU is investigated in this study. The researchers have included a prospective intervention study approach while conducting the research. In the ICU at a large tertiary care center the study set up had been established. Two thousand one hundred five patients undergoing admissions (1,030 patients before the intervention and 1,075 patients during application of the intervention) from the period of July 2013 up to the month May in 2014 and from July 2014 to up to May 2015 have been considered as the participants for this research. Web-based technology which included an ICU safety checklist, tools for developing shared care plans, as well as a messaging platform, enabling systematic patient-centered care and engagement training were taken as intervention for this study. Access to an online portal was given to the participants enabling patients and care partners to examine health information, engage in care plans, and interact with clinicians. The overall adverse event rate was the primary outcome. Patient and caregiver experience, care plan consistency, and resource use were included as the secondary outcomes. The researchers have concluded with the findings in the ICU, implementing a systematic communication and teamwork and patient engagement program was linked to fewer adverse events and higher treatment and healthcare partner satisfaction. It has been agreed by Prater et al. (2019) that patients with advanced cancer who were referred to hospice had fewer hospitalizations in the last 30 days of their lives when they had dedicated advanced care planning (ACP) documentation.
Rao-Gupta, S., Kruger, D., Leak, L. D., Tieman, L. A., & Manworren, R. C. (2018). Leveraging interactive patient care technology to improve pain management engagement. Pain Management Nursing, 19(3), 212-221. https://doi.org/10.1016/j.pmn.2017.11.002
In hospitals, the majority of children endure pain, and their guardians are dissatisfied with the techniques by which the pain is managed. Involving patients and their families in the formulation and assessment of pain treatment regimens may enhance patients’ impressions of pain management and hospital visits. It has been objected by the researchers that involve patients and family in using patient care technology (interactive style) to manage the pain of hospitalized pediatric patients. The purpose was to get patients, parents, and health care providers talking regarding expectations related to pain management and views of care plan efficacy. The method of this study included Plan-Do-Study-Act approach was incorporated in this study. Designing, development, testing, and piloting new processes for integrating the participatory technology system related to patient care with the automatic medicine dispensing system and documenting activities from both systems in the electronic health record. Pain assessments, nonpharmacologic therapies, and therapy efficacy evaluations have all risen. From fiscal year 2014 to the year 2016, the percentage of positive family satisfaction answers for pain treatment rose dramatically. The researchers have conducted the research in an appropriate setting in order to obtain reliable data from the research. Patients and the respective family members were recruited to take an active initiative or play an important role in pain treatment planning as well as in evaluation of treatment outcomes by utilizing interactive patient care technology (McGonigle & Mastrian, 2017). Enhanced active communication and engagement with patients and family can help organizations improve their cultural aspects to be more sensitive to patients’ suffering and experiences in the hospital.
Leveraging Interactive Patient Care Technology to Improve Pain Management Engagement
Skiba, D. (2017). Evaluation tools to appraise social media and mobile applications. Informatics, 4(3), 32–40. https://doi.org/10.3390/informatics4030032
More people are using mobile applications and social media platforms to participate in their health care in a linked care environment. Given the increased use of digital tools in health care, it is critical for health care practitioners to acquire in- depth knowledge and abilities to assess and propose suitable digital technologies (HealthIT.gov., 2018). The goal of this literature is to define and assess criteria or the instrument for evaluating mobile applications and social media. The research will look at existing research as well as literature created by professional health care groups. This evaluation will make it easier for health care providers to evaluate mobile applications and social media technologies that may be useful to their patients. The evaluation will also identify techniques that a health-care system might employ to guide patients, family, and caregivers in the use of mobile applications and social media platforms. In conclusion, various techniques for analyzing health-related social media and mobile applications are currently accessible. The usage of changing online health information standards may be phased out when the validity and trustworthiness of these instruments is demonstrated. There are a lot of commonalities between the different tools. Standard criteria are usually given as usability metrics, though the scope and depth of the various measurements varies amongst program.
Conclusion
Hence it can be concluded that Clinical information systems (CISs) have provided healthcare professionals with the opportunities to substantially improve both workflow and patient care. However, there are still a few challenges which are faced by the users. All of the abovementioned articles have emphasized that incorporation of technology is beneficial in terms of enhancing healthcare facilities and ensuring optimum care to the patients. Hence clinical systems must be effectively implicated and upgraded in the clinical setting so that nurses or the direct carers of patients might get benefitted with this kind of practice by reducing medical errors and other practice related issues.
References
Dykes, P. C., Rozenblum, R., Dalal, A., Massaro, A., Chang, F., Clements, M., … & Bates, D. W. (2017). Prospective evaluation of a multifaceted intervention to improve outcomes in intensive care: the promoting respect and ongoing safety through patient engagement communication and technology study. Critical care medicine, 45(8), e806-e813. https://doi.org/10.1097/CCM.0000000000002449
HealthIT.gov. (2018c). What is an electronic health record (EHR)? Retrieved from https://www.healthit.gov/faq/what-electronic-health-record-ehr
Kadhim, K. T., Alsahlany, A. M., Wadi, S. M., & Kadhum, H. T. (2020). An Overview of Patient’s Health Status Monitoring System Based on Internet of Things (IoT). Wireless Personal Communications, 114(3).
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Mutshatshi, T. E., Mothiba, T. M., Mamogobo, P. M., & Mbombi, M. O. (2018). Record-keeping: Challenges experienced by nurses in selected public hospitals. Curationis, 41(1), 1-6. https://dx.doi.org/10.4102/curationis.v41i1.1931
Prater, L. C., Wickizer, T., Bower, J. K., & Bose-Brill, S. (2019). The impact of advance care planning on end-of-life care: Do the type and timing make a difference for patients with advanced cancer referred to hospice?. American Journal of Hospice and Palliative Medicine®, 36(12), 1089-1095. https://journals.sagepub.com/doi/abs/10.1177/1049909119848987
Rao-Gupta, S., Kruger, D., Leak, L. D., Tieman, L. A., & Manworren, R. C. (2018). Leveraging interactive patient care technology to improve pain management engagement. Pain Management Nursing, 19(3), 212-221. https://doi.org/10.1016/j.pmn.2017.11.002
Skiba, D. (2017). Evaluation tools to appraise social media and mobile applications. Informatics, 4(3), 32–40. https://doi.org/10.3390/informatics4030032
Strudwick, G., Nagle, L., Kassam, I., Pahwa, M., & Sequeira, L. (2019). Informatics competencies for nurse leaders: a scoping review. JONA: The Journal of Nursing Administration, 49(6), 323-330. https://dx.doi.org/10.1097/NNA.0000000000000760
Vaidotas, M., Yokota, P. K. O., Negrini, N. M. M., Leiderman, D. B. D., Souza, V. P. D., Santos, O. F. P. D., & Wolosker, N. (2019). Medication errors in emergency departments: is electronic medical record an effective barrier?. Einstein (São Paulo), 17. https://dx.doi.org/10.31744%2Feinstein_journal%2F2019GS4282
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