Computerized Nursing Documentation System, Research Paper Example

Comparison of Two Articles on the Use of Electronic Health Records

Electronic health information is defined as “an electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared and controlled by the individual” (Thede, 2008, p.1).   Electronic health information has transformed the way healthcare is delivered in this country and around the world in recent times: it can make nurses and doctors more productive, increase ease of communication among members of the healthcare team and improve patient outcomes. However, it is still a relatively new technology and how it is integrated into current healthcare practice still needs to be assessed. Two recent articles, one published in the Journal of Medical Internet Research and one in Computers, Informatics, Nursing have attempted such assessments.

The Journal of Medical Internet Research Article

In this article, in an attempt to understand more about how the duties of a clinician related to the kind of electronic device that a clinician will prefer, researchers interviewed and observed 80 field staff, comprised of doctors and nurses, in regards to what their clinic role was on the wards and how they integrated electronic devices into their work.  The study found that for nurses, 91% of tasks and for rounding doctors 57% of tasks were performed on COWS (computers on wheels) and that both groups showed a strong preference for the COWS over other devices; however, when not rounding, it also showed that around 91% of computerized tasks performed by doctors were on stationary computers, usually in the doctor’s office. (Anderson. et. al., 2013, p.1). The study concluded that there is a strong link between the type of task a clinician is performing and the kind of computerized device that is preferred.

The Computers, Informatics, Nursing Article

This article focused on the revolutionary impact that electronic health records have had on the way healthcare is delivered and the way information is shared both with the patient, between doctors, and with other healthcare team members.  It noted, however, that a large part of the effectiveness of these electronic tools was based upon the ability of the clinicians to use them properly. For this, education is needed; the article noted that the basis of its project was to create a “conceptually sound, evidence-based, user-friendly and interactive e-learning approach to bring relevant EHR updates to nurses” (Topaz, 2013, p. 379). The article points out both the legal necessity to adapt to electronic health records due to recent healthcare-related legislation and also the potential to make serious or even fatal mistakes or breaches of confidentiality with healthcare information if technology is not properly used.

Support and Contradiction

These two studies support each other to a certain extent, in the sense that they both recognize that electronic health records are now a fixed part of the healthcare delivery and implementation in this country and around the world. They also both acknowledge that there is an ongoing need to integrate new technology into the way clinicians are now performing their tasks.  However, there does seem to be a difference in the viewpoint of the two articles on what is the best method or approach to this integration. The article from the Journal of Internet Medical Research seems to think that it is best to adapt the technology to the clinician: in other words, that the technology should dovetail with the clinician’s tasks and be accommodating to how the clinician’s work is performed.  On the other hand, the article from Computer, Informatics, Nursing seems to take just the opposite approach. The assumption seems to be here that the clinicians will have to adapt themselves and their work to the new technology and that in order to perform this gargantuan task, ongoing support and education about the devices is needed.

Contribution to the Use of Electronic Health Records

As previously discussed, the perspectives and approaches these articles take to the issue of electronic health records and how they should be integrated into current clinic practice differ somewhat. However, they both have important contributions to make to the ongoing body of research which is interested in studying the ways in which new technology transforms the task of healthcare and also ways in which healthcare workers in turn transform technology into something that will work for them as they seek to give care to their patients.  The relationship between the clinician and the technology he or she uses is thus a two-way street, and these two articles complement each other nicely on studying the two different aspects of this relationship. A knowledge of both these aspects is needed if new technology is going to be integrated into healthcare in a real and meaningful way.

Conclusion

Electronic health records are here to stay and are already changing drastically all levels and all areas of healthcare practice.  While they do have the potential to improve patient care and patient outcomes, as well as bring the healthcare team together in a more significant way and ease communication, there are drawbacks.  Technology is only as good as the people who wield it, so both finding the appropriate tools for the task at hand and making sure clinicians are supported in their use of EHR’s through ongoing education are both important to make sure that the impact which this technology has on clinical practice is a positive one.

References

Anderson, P., et. al. (2013). “Mobile and Fixed Computer Use by Doctors and Nurses on Hospital Wards: A Multi-Method Study on the Relationships between Clinician Role, Clinical Task and Device Choice.”  Journal of Medical Internet Research. 11(3).

Thede, L.  (2008). “Informatics, Electronic Patient Health Records: Nursing’s Role”. Online Journal of Issues in Nursing.  14 (1).

Topaz, M. (2013). “Educating Clinicians on New Elements Incorporated into the Electronic Health Record”.  Computers, Informatics, Nursing. 31(8) 375-379