Electronic Health Records Abigail Noble RN James Madison University NSG 462

Electronic health records Overview Recent topic of discussion among health care facilities Financial incentives are pressuring health care facilities to switch to Electronic Health Records (EHRs) and will be penalized if not Positives and negatives exist (Poon 2012) Affects patients outcomes and increases patient safety Nurses play a large role in the implementation of EHRs (Stonham 2012)

Why do we need EHRs? Over a persons lifetime, things are continuously added to a patients medical records in several different locations, there is no sharing between facilities Repetitive treatments are given and money is wasted Care would be more efficient if all medical history was known to the MD at time of treatment People forget parts of their medical history (Thede 2010)

The push for EHRs American Recovery and Reinvestment Act (ARRA) Health Information Technology for Economic and Clinical Health Act (HITECH) Medicare EHR Incentive Program that health care providers can receive a maximum of $44,000 over five years in a row Medicaid EHR Incentive Program they can receive a maximum of $63,750 for those five years Time limit set on EHR adoption. The last year to start the process of EHRs is in 2014 and If a facility is unable to prove meaningful use of their EHRs, then the Medicare reimbursements starting in 2015 will have reductions by 1 percent and will increase each year up to 5 percent (Knudson 2012).

Benefits Patient data easily being shared between health care providers Patient’s personal accessibility to their medical records Increased data organization and readability Potential decreases in cost Potential increases in efficiency of care (Knudson 2012)

Negatives System errors like computer crashes or other technological errors Decreased amount of time spent with a patient while the physician is working on data entry Privacy is harder to control EHRs require a lot financially to initially start Positive financial return on investments is unclear at this time (Knudson 2012) Maintenance costs and amount of money to keep IT staff is high Benefits from EHRs do not go to the health care facility that initially paid for the EHRs, but it goes to the providers or payers (Ginn 2011

Does every facility need EHRs? There is a lack of data at this point really showing the need for EHRs in certain areas Most of the data is skewed because it was based of large institutions that already have a lot of experience and financial and technical resources Small health care facilities have been left out of studies and do not have the same need In a study completed by Linder, it was found that there was no significant increase in quality indicators on fourteen out of seventeen practices Garrido study showed that “intermediate measures of quality of health care remained unchanged or increased slightly” (Poon 2010).

Nurse’s role Huge role in the productivity and implementation of EHRs Nurses spend a lot of time documenting which can either slow down or increase the efficiency of their time (Thede 2008) Front line of documentation on patients and collecting data and creating outcomes Important regarding the Commission for Quality and Innovation (CQUIN) dashboards

Overall Implementation of EHRs will continue to grow and become mandated Depending on the health care agency, EHRs can have varying results of effectiveness, but have the potential to improve patient safety and outcomes, as well as workload for health care staff Nurses need to take responsibility in their role of EHRs and keep their charting “accurate, detailed, reusable, readable, and clinically relevant,” as well as stay current on technology so they can contribute efficiently (Stonham 2012).

Work Cited   Abbass, I., Helton, J., Mhatre, S., & Sansgiry, S. (2012). Impact of electronic health records on nurses' productivity. CIN: Computers, Informatics, Nursing, 30(5), 237-241. Abramson, E. L., McGinnis, S., Edwards, A., Maniccia, D. M., Moore, J., & Kaushal, R. (2012). Electronic health record adoption and health information exchange among hospitals in New York State. Journal Of Evaluation In Clinical Practice, 18(6), 1156-1162. doi:http://dx.doi.org/10.1111/j.1365-2753.2011.01755.x Ginn, G. O., Shen, J. J., & Moseley, C. B. (2011). Hospital Financial Position and the Adoption of Electronic Health Records. Journal Of Healthcare Management, 56(5), 337-350. Knudson, L. (2012). Adoption of electronic health records gaining ground. AORN Journal, 96(5), C1-9. Poon, E., Wright, A., Simon, S., Jenter, C., Kaushal, R., Volk, L., & ... Bates, D. (2010). Relationship between use of electronic health record features and health care quality: results of a statewide survey. Medical Care, 48(3), 203-209. Schreiber, J. A. (2013). Electronic Health Records: Current Issues in Oncology. Oncology Nursing Forum, 40(1), 14-16. Stonham, G., Heyes, B., Owen, A., & Povey, E. (2012). Measuring the nursing contribution using electronic records. Nursing Management - UK, 19(8), 28-32. Thede, L., & Jeanne , S. (2010). Informatics and nursing: Competencies and applications. (3rd ed., pp. 233-234). Philadelphia, PA: Lippincott Williams & Wilkins. Thede, L., (Aug 18, 2008) "The Electronic Health Record: Will Nursing Be on Board When the Ship Leaves?" OJIN: The Online Journal of Issues in Nursing Vol. 13 No. 3. Topaz, M., & Bowles, K. H. (2012). Electronic Health Records and Quality of Care: Mixed Results and Emerging Debates. Online Journal Of Nursing Informatics, 16(1), 21-24.