NURS 6051 Use of Clinical Systems to Improve Outcomes and Efficiencies Paper

NURS 6051 Use of Clinical Systems to Improve Outcomes and Efficiencies Paper

NURS 6051 Use of Clinical Systems to Improve Outcomes and Efficiencies Paper

Patient Portal and Effective Blood Pressure Control Walden University

NURS 5051/NURS 6051: Transforming Nursing and Healthcare through Technology January 24, 2021

Patient Portal and Effective Blood Pressure Control

Introduction

Technology continues to play integral roles in health care. This has led to the increasing relevance of informaticists within the care sphere. It is also important to note that research is fundamental to the activities, roles and decisions that are made by informaticists and health care leaders. Research is used to validate the development as well as implementation of specific clinical system strategies based on prevailing circumstances including existing technology trends. Examples of pertinent clinical systems in contemporary times include the Electronic Medical Records (EMR); Clinical Decision Support (CDS); Master Patient Index (MPI); Practice Management Software; Remote Patient Monitoring (RPM); and patient portals (Price-Haywood, Luo, & Monlezun, 2018).

The specific focus of this paper is to review existing research on the application of the patient portal clinical system, in regards to the enhanced blood pressure control/management. The study is formatted as an annotated bibliography and in line with this, 4 peer reviewed that are relevant to the study focus are selected and reviewed. After the review, the content of each of the peer reviewed articles is summarized in terms of their purpose, outcomes and lessons as pertains to application of patient portals to improve blood pressure control. Specific examples are offered to ascertain the relevance and soundness of the findings. Of note is that the articles are fairly recent having been published within the past 5 years (2016-2021). After the annotated bibliography, the conclusion synthesizes the core findings of the 4 peer reviewed articles.

Annotated Bibliography

Article 1

• Fleming, N. L., Cullen, D., & Luna, G. (2016). An Evaluation of Patient Web Portal Engagement: An Exploratory Study of Patients with Hypertension and Diabetes. Online Journal of Nursing Informatics, 19(3), 1–8. 10899758.

Improvement on the Outcomes

In their article, Fleming, Cullen, and Luna, (2016) focused on exploring the use of patient-centered health information technology like patient web portal (PWP) to improve the management of chronic diseases, more so through increased self-management. Fleming, Cullen, and Luna, (2016) present that the factors that fostered the focus of their study include that an

increasing number of American citizens live with chronic illnesses. For instance, the incidence of chronic disease in the United States (US) has increased by more than 23 million people between 1995 and 2014. Fleming, Cullen, and Luna, (2016) also present that the number amount of national cost spent on healthcare has tripled since 1960 with the management of chronic illnesses accounting for 84% of all healthcare spending. Chronic illness also accounts for 70% of all deaths in the US. Furthermore, within the clinical setting, chronic illness management consumes the highest volume of personnel and financial resources. This is a challenge given the rising number of patients and increasing shortage of nurses and primary care providers.

All of the above factors according to Fleming, Cullen, and Luna, (2016) have contributed to the imperative need of use of technology to improve care management whilst easing the pressure of shortage of nursing and primary care providers. Fleming, Cullen, and Luna, (2016) utilized primary research approach in their study. The conducted a retrospective analysis of patient web portals usage by 187 patients who had hypertension, diabetes, or both illnesses. This analysis was conducted over a one year period and the participants were patients at an outpatient family practice clinic in Indiana.

The clinical management of the patients was done by nurse practitioners and the researchers ensured that all relevant ethical considerations were observed. The statistical analytic tool that the researchers used to analyze their data is Statistical Package for Social Sciences (SPSS) software, and the data was organized into frequency tables, and Chi- Square calculations was conducted. Fundamentally, the research approach used by the authors, the period of research and sample size, were all relevant in terms of explaining the effective use of patient portal to enhance blood pressure control as well as diabetes management.

The article reveals that patient engagement with patient portals significantly improved the management of blood pressure. This is especially because it increased patient participation in their treatment plan. The patients become more involved and subsequently many of them tend to adopt healthier behaviors. Fleming, Cullen, and Luna, (2016 NURS 6051 Use of Clinical Systems to Improve Outcomes and Efficiencies Paper) emphasize that the PWP transform patients into committed partners with their health care teams.

The patient platforms are according to the authors used to manage communication, especially as pertains to managing medication refill’s communication of any relevant changes in health or treatment plan, and to request appointments. The increased engagement ensures that the hypertensive patients measure their blood pressure more effectively and adjust their lives to correlate with their health situations.

In the long run this translates to improved blood pressure control. The approach used as well as the findings of the article makes it an important source of evidence based practice as it can be used to encourage greater patient engagement through patient portals because the study revealed that a number of patients, especially males, are yet to utilize the platform.

Article 2

Manard, W., Scherrer, J. F., Salas, J., & Schneider, F. D. (2016). Patient Portal Use and Blood Pressure Control in Newly Diagnosed Hypertension. JOURNAL OF THE AMERICAN BOARD OF FAMILY MEDICINE, 29(4), 452–459. https://doi-org.ezp.waldenulibrary.org/10.3122/jabfm.2016.04.160008.

Improvement on the Outcomes

The focus that the authors had in this article is on getting to ascertain the relevance of utilizing patient portals in the management of blood pressure (BP). Manard, Scherrer, Salas, and Schneider, (2016) insist that evidence of the impact and benefit of patient portals on successful chronic disease management is inconclusive.

Manard, Scherrer, Salas, and Schneider, (2016) assert that at the time of conducting their study, they were not aware of any studies that focused on exploring the impact of patient portals on health outcomes of newly diagnosed hypertension. They explain further that few studies have explored the phenomena from the perspective of actual measure of portal use and also the comparison of use, against no-use of patient portals and other communication based technologies in regard to BP control. According to the authors most such studies have explored impact of the patient web portals of diabetic patients.

In their study, Manard, Scherrer, Salas, and Schneider, (2016) determine that it is important to conduct their investigation because approximately 70 million Americans were by 2015 hypertensive and the population is set to increase with the burgeoning of the aging population. Moreover, the growth of this number meant that the HealthyPeople 2010 goal (NHLBI) was not achieved. The effectiveness of the findings by Manard, Scherrer, Salas, and Schneider, (2016) is enhanced by the research approach used by the researchers.

The researchers had an initial target population of 33,661 patients visiting the Department of Family and Community Medicine’s Primary Care Patient Data Registry (PCPD) at Saint Louis University School of Family Medicine. This population was however limited through stringent inclusion and exclusion strategies, for instance, only patients with diagnosis of new-onset hypertension between 2008 and 2010, and patients with uncontrolled hypertension at their last visit before 2011, or have had at least one follow up visit the past year were included in the investigation.

All factors considered, the population size was reduced to 1571 patients with an incident hypertension diagnosis and aged 21 to 89 years. Manard, Scherrer, Salas, and Schneider, (2016) used Cox proportional hazard models to determine the link between portal use and BP control between 2011 and 2015 before and after adjusting for covariates. This helped ensure that the researchers were able to collect information explaining the lifestyle choices and behaviors of the participants and how this impacts on the health of patients. It also revealed impact of attributes like smoking, obesity and physical or mental health comorbidities on how often or effectively patients utilized patient portals and subsequently managed/controlled BP.

The findings in the article assert that antihypertensive medications and lifestyle modification are indeed effective when it comes to BP control. What the patient portals do according to the authors is that they increase consistency in lifestyle modification and adherence to medical interventions. Moreover, it directly increases communication between health providers and the patients resulting in better attainment of BP goals. Fundamentally, they assert that patient portal use increases effectiveness in control of BP by over 80% in comparison to the hypertensive patients that do not utilize the platform. In the clinical field, the findings advocates for the use of patient portals for newly diagnosed patients as well as those that had already been diagnosed with BP.

Article 3

Price-Haywood, E. G., Luo, Q., & Monlezun, D. (2018). Dose effect of patient-care team communication via secure portal messaging on glucose and blood pressure control. Journal of the American Medical Informatics Association : JAMIA, 25(6), 702–708. https://doi-org.ezp.waldenulibrary.org/10.1093/jamia/ocx161.

Improvement on the Outcomes

The purpose that Price-Haywood, Luo, and Monlezun, (2018) pursued is determining whether higher intensity of patient portal use translated to improved clinical outcomes for patients with chronic illnesses including Blood Pressure (BP). The authors present that the use of technology in health care has experienced unprecedented increase, especially in regards to technologies that facilitate enhanced communication. They therefore sought to determine whether enhanced communication via the technology improves patient outcomes.

The relevance and appropriateness of the study is significantly boosted by their study methods. In their research, Price-Haywood, Luo, and Monlezun, (2018) focused on retrospective observational cohort study. The study was done at the largest non-profit academic multispecialty care institution in Southeast Louisiana, Ochsner Health System.

Findings was collected from patients above 18 years of age and had at least 2 primary care visits between July 2012 and December 2014 and out of the 101 019 patients who visited the institutions clinical settings and had diabetes or hypertension, only 11 138 were active portal users. As part of the research methods, propensity score–adjusted multivariable fixed effects regression panel analysis was used. This was done to evaluate link between intensity of patient portal use and BP and glucose control.

The findings indicated that more female patients than male patients utilized the platform frequently and adhered to the information and advice that they received through the secure private medical messaging. According to Price-Haywood, Luo, and Monlezun, (2018) each portal visit corresponded to better dose response and control of glucose and BP. The authors concluded that portal users recorded better control outcomes compared to the non-portal users. Moreover, the more the portal use, the better the control and subsequent health outcomes.

Article 4

Reed, M.E., Huang, J., Brand, R.J., Neugebauer R., Graetz I, Hsu J, et al. (2019) Patients with complex chronic conditions: Health care use and clinical events associated with access to a patient portal. PLoS ONE 14(6): e0217636. https://doi.org/10.1371/journal.pone.0217636

Improvement on the Outcomes

According to Reed, et al., (2019) many studies allude that patient portal has considerable associations with better management of chronic conditions. This is especially in regards to promoting better self-management and enhancing coordination of health care services whilst reducing in-person health care visits. The authors sought to explore the accuracy and relevance of this position through investigating impact of portal access on outpatient, and emergency visits and overall trends of preventable hospitalization.

Reed, et al., (2019) focused on observational research where they compared the visit rates of patients that used patient portals, and the ones that did not. They used marginal structural modeling with inverse probability weighting estimates to explain potential bias, especially because some patients were likely to drop out of the treatment plans over the 1 year period when they conducted the study.

After rigorous inclusion and exclusion criteria, the researchers endedup examining 165,447 patients with comorbid illnesses, including hypertension. They determined that the patients with hypertensive comorbidity had higher frequency of utilizing the patient portals. The researchers effectively observed rates of emergency room visits and outpatient office visits, as well as preventable hospitalization.

In their findings, Reed, et al., (2019) were able to confirm that use of patient portals directly and profoundly improved health outcomes of patients. The patient portals ultimately reduced the number of in-person health facility visits. Moreover, it significantly reduced number of hospitalization with most in-person visits being of diagnostic or consultative nature. This was evidence that the effective use of patient portals directly resulted in better control or management of chronic illnesses, and in this case the specific illness is diabetes and hypertension.

Conclusion

It is important to take note that all of the 4 studies confirm that patient portals directly enhances BP control. All of the studies present that the benefits of patient portal include ensuring that patients maintain consistency in adherence to medication interventions and lifestyle choices and behaviors. Moreover, they significantly reduce number of hospital visits while ensuring that the patients maintain constant communication with their care providers.

Fleming, Cullen, and Luna, (2016) considers that this is a significant benefit because the number of patients with chronic illnesses continues to rise each day. This is as the shortage of nurses and primary care providers becomes chronic. Reed, et al., (2019) support this by asserting the patient portals are effective in reducing hospitalization rates, as well as emergency cases.

Manard, Scherrer, Salas, and Schneider, (2016) and Price-Haywood, Luo, and Monlezun, (2018) present that it is important to note that despite the effectiveness and relevance of patient portals, a number of patients with chronic illnesses, more so BP, are yet to embrace the technology. They advocate for encouraging the patients to embrace the technology, especially male patients because their findings provide that more female patients than male patients utilize the technology.

NURS 6051 Use of Clinical Systems to Improve Outcomes and Efficiencies Paper References

• Fleming, N. L., Cullen, D., & Luna, G. (2016). An Evaluation of Patient Web Portal Engagement: An Exploratory Study of Patients with Hypertension and Diabetes. Online Journal of Nursing Informatics, 19(3), 1–8. 10899758.
• Manard, W., Scherrer, J. F., Salas, J., & Schneider, F. D. (2016). Patient Portal Use and Blood Pressure Control in Newly Diagnosed Hypertension. JOURNAL OF THE AMERICAN BOARD OF FAMILY MEDICINE, 29(4), 452–459. https://doi-org.ezp.waldenulibrary.org/10.3122/jabfm.2016.04.160008.
• Price-Haywood, E. G., Luo, Q., & Monlezun, D. (2018). Dose effect of patient-care team communication via secure portal messaging on glucose and blood pressure control. Journal of the American Medical Informatics Association : JAMIA, 25(6), 702–708. https://doi-org.ezp.waldenulibrary.org/10.1093/jamia/ocx161.
• Reed, M.E., Huang, J., Brand, R.J., Neugebauer R., Graetz I, Hsu J, et al. (2019) Patients with complex chronic conditions: Health care use and clinical events associated with access to a patient portal. PLoS ONE 14(6): e0217636. https://doi.org/10.1371/journal.pone.0217636

The Use of Clinical Systems to Improve Outcomes and Efficiencies NURS 5051

Healthcare systems around the world continue to improve various aspects of the provision of care to meet the needs of the patients and ensure improved health outcomes and patient satisfaction (Manias, 2019). Enhancing the quality of care requires the incorporation of efforts from healthcare providers as well as all stakeholders involved in care. One way of improving patient care is through active engagement of patients and their relatives in care through coordinated care and clear communication. The engagement of patients in care affects treatment adherence, satisfaction, healthcare cost, and self-management.

 

Consequently, there is improvement in the quality of care, safety, and delivery of care provided, as well as reducing the cost of care. Information technology and clinical systems have enhanced patient-centered care in various settings through improved technology (Manias, 2019). Patient Engagement Communication and Technology (PROSPECT) is an example clinical system that can be used to improve patient-centered care.

The components of the program include electronic health records, checklist tools, patient portals, and messaging platform (Dykes et al., 2017). This paper is a literature review organized in an annotated bibliography that aims to address the impact of using patient-centered care using various components of the PROSPECT to improve the health outcomes of patients with chronic conditions.

Dykes, P. C., Rozenblum, R., Dalal, A., Massaro, A., Chang, F., Clements, M., Collins, S., Donze, J., Fagan, M., Gazarian, P., Hanna, J., Lehmann, L., Leone, K., Lipsitz, S., McNally, K., Morrison, C., Samal, L., Mlaver, E., Schnock, K., … 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

The article by Dykes et al. (2017) highlights the importance of patient-centered care in the ICU setting. The article argues that despite most ICU patients being critically ill and unresponsive, engaging their family members in looking after them is also a form of engaging patients. Accordingly, these engagements aim to improve partnerships and the quality and safety of care. The study examined the effectiveness of patient-centered care and engagement program in the medical ICU.

The intervention includes a patient-centered care and engagement training program and web-based technology that involves a safety checklist, messaging platform, and tools developed to share care plans. Patients and care partners use online portals to access health information and participate in care plans while communicating with providers (Dykes et al., 2017). The findings from the study encouraged the implementation of patient-centered care based on the benefits realized.

The intervention led to a reduction in adverse events while markedly improving patient satisfaction (Dykes et al., 2017). The findings of this article are relevant and encourage the implantation of patient-centered care through adopting effective communication strategies to involve patients and family members to improve overall care. Patients feel motivated and appreciated if they understand whatever is happening to them, as discussed by their healthcare providers.

Penedo, F. J., Oswald, L. B., Kronenfeld, J. P., Garcia, S. F., Cella, D., & Yanez, B. (2020). The increasing value of eHealth in the delivery of patient-centered cancer care. The Lancet Oncology, 21(5), e240–e251. https://doi.org/10.1016/S1470-2045(20)30021-8

This article review presents summarized evidence-based information regarding the impact of eHealth in the care of cancer patients. They argue that the evolution of eHealth ushered in a new era of managing patients with various chronic conditions by improving patient-centered care (Penedo et al., 2020). Through eHealth, traditional in-person care with the adoption of real-time care that is dynamic with improved assessment and delivery of interventions.

The review provided a narrative of peer-reviewed articles published within the last 10 years. From the review, using eHealth to achieve patient-centered care is an acceptable practice due to its benefits. eHealth enhances the care of patients through improved diagnosis, planning of care, surveillance, and monitoring of patients.

Improved communication enhanced the assessment of toxicity, improved management, and optimized patient engagement throughout care (Penedo et al., 2020). The article’s findings are important to adding knowledge on the importance of using technology in long-term follow-up of patients. Engaging patients through eHealth can improve various aspects of their life, including improving their quality of life by addressing their symptoms (Manias, 2019). Healthcare organizations should incorporate and implement the use of eHealth to offer care for individuals with chronic conditions such as cancer.

Tebeje, T. H., & Klein, J. (2021). Applications of e-health to support person-centered health care at the time of the COVID-19 pandemic. Telemedicine Journal and E-Health: The Official Journal of the American Telemedicine Association, 27(2), 150–158. https://doi.org/10.1089/tmj.2020.0201

The surge of Covid-19 got many people unaware, including the healthcare department. The rapid spread of the virus, with associated mortality and morbidity, shook the whole world. Prevention of covid-19 requires the implementation of various measures, including hand hygiene, avoiding social gatherings, and working from home. Restrictions on social gatherings meant that a limited number of people could access healthcare at the same time.

Limited access to healthcare, especially for patients with chronic disease, meant their health was in danger as they often required close monitoring. To close the gap in care access while reducing exposure to infections, healthcare departments embraced telehealth, an eHealth technology to help improve patient-centered care to meet patient needs. Telehealth allows for the remote clinician and patient interaction without exposure to Covid-19 (Tebeje & Klein, 2021). This literature review aimed at assessing the effects of telehealth on patient care and outcome during the covid-19 pandemic.

Literature was systematically searched from publications dated January 1 and May 20, with eight studies out of the 60 articles included in the study. The study findings revealed the importance of telehealth and mobile health in improving patient engagement and access to care while at home (Tebeje & Klein, 2021). The quality of care and personalized experience and satisfaction improved while using telehealth.

This article is relevant to this literature review and adds more knowledge on the effects pandemics can have on healthcare, as well as providing alternative methods of overcoming the problems. Improving patient-centered care through telehealth is a promising way through which care can be offered in the future to manage chronic conditions, especially for patients in remote settings with a disability who have limited access to care (Lyles et al., 2020).

Downes, E., Horigan, A., & Teixeira, P. (2019). The transformation of health care for patients: Information and communication technology, digiceuticals, and digitally enabled care. Journal of the American Association of Nurse Practitioners, 31(3), 156–161. https://doi.org/10.1097/JXX.0000000000000109

Downes et al. (2019) provide an insight into the role of information and communication technology (ICT) in transforming healthcare systems. The presence of innovative technology such as wearable technology, patient portals, remote monitoring, mobile applications, and new services such as virtual visits and telemedicine. The literature review aimed at preventing the use of digitally enabled tools and ICT in patient care. By applying the aforementioned technology in patient care, the quality of care and patient experience improved.

ICT helps in improving communication while enhancing patient engagement in their care. Patient-centered care improves health outcomes, curtails care costs, and enhances patient experience (Downes et al., 2019) e. Understanding the various ICT options is important when determining which type to adopt to enhance patient-centered care (Manias, 2019). This article is relevant in educating healthcare providers about the different ICT options and how to apply these technologies in improving effectiveness and efficiency in patient care.

Conclusion

Technology is an integral aspect of patient care, as proven by the evidence. Using technology to improve patient-centered care is associated with various benefits in improving health outcomes, reducing the cost of care, improving the patient experience, as well as patient satisfaction. Enhanced communication and engaging patient in making decisions increases treatment adherence and improve self-management. Therefore, healthcare providers should adopt appropriate information technology that positively impacts patients` outcomes.

NURS 6051 Use of Clinical Systems to Improve Outcomes and Efficiencies Paper References

Downes, E., Horigan, A., & Teixeira, P. (2019). The transformation of health care for patients: Information and communication technology, digiceuticals, and digitally enabled care. Journal of the American Association of Nurse Practitioners, 31(3), 156–161. https://doi.org/10.1097/JXX.0000000000000109

Dykes, P. C., Rozenblum, R., Dalal, A., Massaro, A., Chang, F., Clements, M., Collins, S., Donze, J., Fagan, M., Gazarian, P., Hanna, J., Lehmann, L., Leone, K., Lipsitz, S., McNally, K., Morrison, C., Samal, L., Mlaver, E., Schnock, K., … 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

Lyles, C. R., Nelson, E. C., Frampton, S., Dykes, P. C., Cemballi, A. G., & Sarkar, U. (2020). Using electronic health record portals to improve patient engagement: Research priorities and best practices. Annals of Internal Medicine, 172(11 Suppl), S123–S129. https://doi.org/10.7326/M19-0876

Manias, E. (2019). A patient-centered care and engagement program in intensive care reduces adverse events and improves patient and care partner satisfaction. Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses, 32(2), 179–181. https://doi.org/10.1016/j.aucc.2018.10.001

Penedo, F. J., Oswald, L. B., Kronenfeld, J. P., Garcia, S. F., Cella, D., & Yanez, B. (2020). The increasing value of eHealth in the delivery of patient-centered cancer care. The Lancet Oncology, 21(5), e240–e251. https://doi.org/10.1016/S1470-2045(20)30021-8

Tebeje, T. H., & Klein, J. (2021). Applications of e-health to support person-centered health care at the time of the COVID-19 pandemic. Telemedicine Journal and E-Health: The Official Journal of the American Telemedicine Association, 27(2), 150–158. https://doi.org/10.1089/tmj.2020.0201

NURS 6051 Use of Clinical Systems to Improve Outcomes and Efficiencies Paper Example 3

Inpatient Electronic Health Records Clinical System

Clinical systems play a vital role in strengthening healthcare delivery throughout the world. All healthcare organizations and professionals must try and adopt the various clinical systems in their organizations. The development of clinical systems and other information technologies in healthcare are related to improved patient outcomes and efficiencies.

They are crucial to delivering patient-centered and evidence-based care, decreasing medical errors, boosting the quality of care, increasing legibility, and reducing healthcare costs (Islam et al., 2018). In-patient electronic health records are a clinical system known to enhance access to healthcare and improve patient outcomes.

The electronic health record is used in hospitals to store and retrieve various patient information so that healthcare practitioners can use it in patient care. This paper seeks to elaborate on how electronic health records have improved outcomes and efficiencies in healthcare by critiquing various research articles.

The study’s main aim was to examine the physician’s perspective on the contribution of the electronic health records systems in managing chronic diseases in primary healthcare centers. The study design used was qualitative, mainly involving semi-structured interviews among physicians who work in the primary healthcare centers with experience of at least one year. Convenience and purposive sampling were applied when the participants were selected. The sample obtained was 22 physicians who work in chronic diseases clinics.

The physicians reported that the application of the health information systems in their clinics has positively influenced patients with chronic diseases. It has resulted in more efficient patient care because the patient’s records and results are always available in the systems.

The presence of the patient information allows the physicians to come up with diagnoses, treatments, and follow up effectively and, therefore, improve patient outcomes. They also reported that EHR enhances accurate patient documentation, which is very rare in handwritten documentation. It also enhances early screening of non-communicable chronic diseases and, therefore, early detection and treatment of comorbidities. Through electronic health records, physicians can easily manage patients by prescribing medications and facilitating referrals.

The research shows that using EHR in primary healthcare centers is associated with various positive benefits. It is vital to allow patients with non-communicable chronic diseases to access the EHR systems to manage chronic diseases. Electronic health records are a clinical system that has greatly supported positive patient outcomes and effectiveness among patients with chronic illnesses. Linking the HER to other government and private facilities can enhance communication and patient care integration, leading to improved patient outcomes.

The article mainly focused on how the use of electronic health records is associated with quality care and outcomes among patients with heart failure. There has been an increase in the adoption of electronic health records worldwide.

However, no studies have been conducted to assess whether it improves outcomes among patients with heart failure. The sample was obtained from patients admitted in 2008 in Get With The guidelines -HF registry. The researchers obtained detailed patient information and also the various hospital-level characteristics. A longitudinal study design was used during the research. The statistical analysis mainly involved a cross-sectional and survival analysis.

Selvaraj et al. (2018) explain that through electronic health records, there can be improved care coordination, resulting in improved efficiency. The findings in the study indicated that the application of electronic records among patients with heart failure is not associated with improved quality of care based on the in-patient outcomes, predefined metrics, and other post-discharge events.

Electronic health records can have unintended adverse effects like; medication errors, increased mortality, and provider dissatisfaction. Although some of the findings indicated that electronic health records could be associated with less frequent length of stay and higher rates of discharge, it is also associated with a poor achievement rate of some measures such as smoking cessation counseling.

According to the article, using electronic health records alone among heart failure patients may not help improve patient outcomes and efficiency. It is therefore vital to set in place other interventions in addition to EHR to help improve the quality of care among those patients. It is essential to ensure increased optimization of EHR in this era because of the increased adoption of technology because there are many theoretical benefits related to its use.

The study aimed to find out clinicians’ experiences in assessing the contributions of EHR in enhancing safety and improving the quality of care in healthcare. The study design used was qualitative. Semi-structured interviews were used among various healthcare practitioners in California and Nevada in the U.S.

There were 20 participants in the study, and they included individuals from different organizations, including; medical clinics, small hospitals, trauma hospitals, hoke health centers, and academic medical centers with different job roles including; nurse practitioners, physicians, patient safety officers, hospitalists and nurses.

The findings indicated that EHR makes communication between patients and clinicians more efficient. The clinician can be able to access past patient procedures and other histories. Through clear communication, electronic health records enhance clear understanding among the nurses, physicians, and therapists, and therefore informed decisions can be made, resulting in improved patient care outcomes.

Electronic health records are a critical factor in improving the quality of care. EHR has enabled the nurses to mitigate the risk of medical errors because they can clarify the interactions or side effects of medications before administering them. Patient safety can be enhanced because electronic health record provides notifications, reminders, and alerts. The results also indicated that EHR enables the healthcare providers always to set informed decisions that can play a role in improving patient outcomes.

Evidently, electronic health records help clinicians make informed decisions, reduce medical errors, and enhance safety, which is essential in improving patient outcomes and effectiveness of care. Electronic health records contain all the patient information.

They can be easily accessed by the various healthcare practitioners working together as a team, such as nurses, and physicians’ therapists, among others, in providing patient care. EHR enhances accurate documentation of data which is related to effective patient safety. From the research, it is vital to train various healthcare practitioners on using electronic health records in case of any change or advancement because it greatly affects the quality of care.

The research aims to summarize the value of electronic medical records. The method adopted from this research was from various literature reviews, and it involved a literature search of Edline; the keyword used was “Medical Record, system, Computerized .”The evaluation of data sources mainly involved a qualitative assessment of the medical records of publications, description of sources of data, and scoring of quality of studies. There were 1345 literature references to be reviewed by the authors, and in the end, they chose 23 studies that were relevant for the research. A semiquantitative study evaluation was applied in the research.

All the 23 articles demonstrated a positive effect of electronic health records on the quality of care provided in all the healthcare organizations. 9 out of 16 of the secondary sources demonstrated decreased costs. At the same time, 14 of 18 studies indicated an increase in the quality of care. The EHR has greatly helped in reducing time for documentation and reducing various medication errors.

The decrease in medication errors is related to improved patient safety and, therefore, better health outcomes. There was no relationship found between mortality and the use of electronic health records. The introduction of electronic medical records is related to the various technological processes, and its introduction has resulted in many clinical benefits.

This article shows that the application of electronic medical records in-hospital care is related to reduced medical errors and improved quality of care. Therefore, EHR can facilitate safe continuity of care and improve patient outcomes and efficiency. From the various articles assessed, since the adoption of EHR, the various processes in healthcare have been made easy and faster.

Conclusion

To sum up, clinical systems are essential in the healthcare setting. Electronic health records is one of the clinical system known to improve patient outcomes and enhance effectiveness and efficiency in the healthcare setting. All four pieces of research indicated the various ways the electronic health record reduces medication errors, enhances coordinated care among the care practitioners, and enhances accurate documentation, resulting in improved patient outcomes.

The efficiency is evident in electronic health records because of the teamwork and collaboration among the care practitioners, including the nurses, physicians, therapists, and lab technicians. The studies have also elaborated on how the EHR reduces healthcare costs and saves time used to deliver healthcare. The use of electronic healthcare records among in-patients is therefore essential, and the healthcare facilities should try to adopt it and make improvements for it to function effectively.

NURS 6051 Use of Clinical Systems to Improve Outcomes and Efficiencies Paper References

• Hazazi, A., & Wilson, A. (2021). Leveraging electronic health records to improve management of non-communicable diseases at primary healthcare centers in Saudi Arabia: a qualitative study. BMC Family Practice, 22(1). https://doi.org/10.1186/s12875-021-01456-2
• Islam, M., Poly, T. N., & Li, Y.-C. J. (2018). Recent Advancement of Clinical Information Systems: Opportunities and Challenges. Yearbook of Medical Informatics, 27(1), 83–90. https://doi.org/10.1055/s-0038-1667075
• Selvaraj, S., Fonarow, G. C., Sheng, S., Matsouaka, R. A., DeVore, A. D., Heidenreich, P. A., Hernandez, A. F., Yancy, C. W., & Bhatt, D. L. (2018). Association of Electronic Health Record Use With Quality of Care and Outcomes in Heart Failure: An Analysis of Get With The Guidelines—Heart Failure. Journal of the American Heart Association, 7(7). https://doi.org/10.1161/jaha.117.008158
• Upadhyay, S., & Hu, H. (2022). A Qualitative Analysis of the Impact of Electronic Health Records (EHR) on Healthcare Quality and Safety: Clinicians’ Lived Experiences. Health Services Insights, 15, 117863292110707. https://doi.org/10.1177/11786329211070722
• Uslu, A., & Stausberg, J. (2021). Value of the Electronic Medical Record for Hospital Care: Update From the Literature. Journal of Medical Internet Research, 23(12), e26323. https://doi.org/10.2196/26323

Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies Example 4

The application and implementation of new healthcare technology require support from current literature. The literature may shed light on the benefits of using different clinical systems and the challenges encountered before, thus helping avoid similar challenges.

In addition, research informs the selection of the best types of clinical systems. It provides results of related efficiencies and outcomes, assisting informaticists and healthcare institutions in trying different clinical systems (Atasoy et al., 2019). One of the commonly used clinical systems is remote patient monitoring technology. There are different technologies and devices used in remote patient monitoring.

Therefore, research literature can be used to identify the best, based on previous studies and outcomes or efficiencies. This essay presents the literature review in an annotated bibliography form, focusing on the role of patient monitoring systems in improving the outcomes of diabetes patients and improving the efficiency of diabetes care.

Annotated Bibliography

The study focuses on assessing the importance of patient activation and engagement with remote patient monitoring technology in diabetes management among type 2 diabetes patients. Su et al. (2019) note that despite the research results on the effectiveness of telemedicine, and remote patient monitoring, a clear report is needed to identify the effectiveness in patient outcomes. Therefore, the study measured the improvement of care outcomes among type 2 diabetes patients using changes in HbA1c levels.

A sample of 1354 type 2 diabetes patients used remote monitoring technology for three months. The study found that most patients embraced remote patient monitoring technology and devices and had improved their self-monitoring skills over time. At the end of the study, the patients showed reduced HbA1c levels, thus indicating proper glycemic control, which can be translated as desirable diabetes care outcomes.

The lessons learned from applying remote patient monitoring systems in diabetes management are that it improves patient outcomes. According to Su et al. (2019), patients are more likely to take keen initiative when monitoring themselves remotely, thus promoting better health outcomes by preventing complications and unnecessary healthcare expenses.

The focus of this study is to identify the different factors facilitating the acquisition, management, and use of diabetes technology and telehealth in diabetes management. According to Johnson and Miller (2022), remote patient monitoring technology would be ineffective without being complemented by telehealth, which enables the patient to communicate with the care provider and upload their progress so that the care provider can access them and give feedback.

Therefore, it is vital to identify the facilitating factors, to avoid missing out or making preventable mistakes. The diabetes care remote monitoring systems assessed in the study included insulin pumps, health apps and personal digital devices, smart insulin pens and pen caps, connected glucose meters, and continuous glucose monitoring systems. These devices led to improved diabetes care outcomes since lower HbA1c levels and self-monitoring behavior were noted among patients using them (Johnson & Miller, 2022). The lessons learned from applying these systems is that it is vital to consider other facilitating factors, such as patients’ knowledge and confidence in using remote patient monitoring technology to produce the desired patient outcomes.

This study aimed to evaluate a virtual diabetes clinic, comparing it with regular primary care clinics, to determine whether diabetes remote care technologies such as remote patient monitoring devices increase efficiency in diabetes care. Al-Badri and Hamdy (2021) state that diabetes is a condition that requires continuous management, so remote patient monitoring technologies would increase efficiency and thus improve patient care outcomes. To validate the notion, the study assessed a complete virtual diabetes clinic. The must-have technologies for patients getting care services in the clinic include remote patient monitoring devices, patient portals/online records and mobile phones/computers to facilitate telehealth (Al-Badri & Hamdy, 2021).

The study further shows that incorporating these technologies and services in diabetes care is attributed to successful patient engagement in diabetes management, proper glycemic control, improved quality of life, and reduced diabetes complications and related healthcare costs. Remote patient monitoring also improves diabetes care efficiency since providers can provide services to more patients at a reduced cost (Al-Badri & Hamdy, 2021). The lessons learned from this study include the importance of shifting physical diabetes care to virtual care in reducing costs and thus improving care efficiencies. Additionally, remote patient monitoring improves self-management behavior, improving care outcomes.

This study aimed to assess the effectiveness of remote patient monitoring systems in controlling glycosylated hemoglobin in type 2 diabetes patients compared to usual care. The study searched and reviewed other published studies from the most important electronic databases, whereby the main outcome was HbA1c levels.

The review results showed that studies that employed remote patient monitoring systems and technologies had controlled glycosylated hemoglobin (Salehi et al., 2020). In addition, Salehi et al. (2020) note that patients who used remote patient monitoring technologies had better HbA1c levels than those who used routine patient care. The lessons learned from this study include the importance of assessing the efficacy of clinical systems before implementing them. These assessments can also be done by reviewing related research.

Summary

The essence of using clinical information systems in care is mainly improving outcomes and increasing care efficiency. Diabetes care is one of the areas that have adopted the use of clinical systems, especially remote patient monitoring systems. The literature reviewed above has justified improving patient outcomes and care efficiencies in diabetes care while using remote patient monitoring systems.

The future of diabetes care depends on technology (Al-Badiri & Hamdy, 2021); however, it is essential to educate patients on how to acquire, manage and use data from remote monitoring systems (Jonhson & Miller,2022; Su et al., 2019), to lead to improved patient outcomes and care efficiencies. Therefore, remote patient monitoring increases patient outcomes and efficiency in diabetes care.

NURS 6051 Use of Clinical Systems to Improve Outcomes and Efficiencies Paper References

• Al-Badri, M., & Hamdy, O. (2021). Diabetes clinic reinvented: will technology change the future of Diabetes care? Therapeutic Advances in Endocrinology and Metabolism, 12, 2042018821995368. https://doi.org/10.1177/2042018821995368
• Atasoy, H., Greenwood, B. N., & McCullough, J. S. (2019). The Digitization of Patient Care: A Review of the Effects of Electronic Health Records on Health Care Quality and Utilization. Annual Review of Public Health, pp. 40, 487–500. https://doi.org/10.1146/annurev-publhealth-040218-044206
• Johnson, E. L., & Miller, E. (2022). Remote patient monitoring in diabetes: how to acquire, manage, and use all of the data. Diabetes Spectrum, 35(1), 43-56. https://doi.org/10.2337/dsi21-0015
• Salehi, S., Olyaeemanesh, A., Mobinizadeh, M., Nasli-Esfahani, E., & Riazi, H. (2020). Assessment of remote patient monitoring (RPM) systems for patients with type 2 diabetes: a systematic review and meta-analysis. Journal of Diabetes & Metabolic Disorders, 19, 115-127. https://doi.org/10.1007/s40200-019-00482-3
• Su, D., Michaud, T. L., Estabrooks, P., Schwab, R. J., Eiland, L. A., Hansen, G., DeVany, M., Zhang, D., Li, Y., Pagán, J. A., & Siahpush, M. (2019). Diabetes Management Through Remote Patient Monitoring: The Importance of Patient Activation and Engagement with the Technology. Telemedicine Journal and E-health: The Official Journal of the American Telemedicine Association, 25(10), 952–959. https://doi.org/10.1089/tmj.2018.0205

Also Read: SOCW 6500 Week 1 Assignment Paper