Paperless Hospitals

Melanie Hood Mike Kramer Alyssa Grayson Sarah Smith Authors Melanie Hood Mike Kramer Alyssa Grayson Sarah Smith

Objectives Define and describe trend List and describe trend hardware and software Identify, describe and review trend information and system Describe advantages/disadvantages of using trend Examine legal and ethical issues related to the use of trend Describe technology - related competencies needed by the professional nurse working with trend Describe functions of the informatic nurse working with trend

What is a paperless hospital? A computer-based record containing health care information. This system will increase patient care and safety. It is the potential of electronic medical records to provide large-scale improvements in the efficiency, safety, and cost-effectiveness of health care  They will eliminate or substantially reduce medication related errors in the facility  This system will eliminate problems with legibility, ambiguous abriviations, and delays in order communication.   It will clinically benefit by automatically verifying orders by checking dose, drug to drug interations, and allergies.     (Russ, 2010)

HARDWARE

Wireless tablet PC's Scanners Printers Stylus Touch Screens Keyboards Available Hardware Wireless tablet PC's Scanners Printers Stylus  Touch Screens Keyboards Farcus, 2009. page 17.

Wireless PC A wireless PC is a computer that has the ability to become wireless and carried from patient room to room. (Ellison, & Evans, 2003)

Wireless PCs will have WiFi capability.

The PCs that the hospitals would be equipped with would have software with the ability to turn these hospitals paperless.

Available Software Billing Electronic prescriptions Physician's orders Nurse’s notes Laboratory results H&P Advanced directives Nutrition Non- physician orders Etc.

Electronic Prescriptions Increase patient safety and reduce pharmacy callbacks. Quick prescription refill processing Increases prescription accuracy Color-coded patient drug history maintains current, expired, ineffective, discontinued, and sample prescriptions. (Allscripts electronic prescribing, 2009)

Clinical Information System:   Accustat EMR:   Order entry system Manages transcription cycle & reduces errors & costs 24/7 Access to transcription Dictate, prioritize, and tracks jobs in real time Automatic attachment to patient EMR (www.acustatemr.net) -Manages transcription cycle from beginning to end by integrating voice recording, digital scripting, delivery of voice files to the medical transcriptionist, and final transcript receipt.

Who Uses and benefits from AccustatEMR?      Primarily used by Physicians   Benefits: Nurses Patients  Medical secretaries  -Physicians have multiple options for dictating -These include: 1. Toll free telephone number. Voice is recording and voice files are sent to medical transcriptionist for conversion. 2. Digital recording. The voice files can be uploaded to the Accustat server using desktop software. 3. PDA recording. Doctors can dictate and save files on a PDA. The PDA is synchronized with the PC and transmits the data.

AccustatEMR enables the physician to: Provide online billing Document test results and lab findings Document physician's progress notes and orders Prescribe new medications for patients -Reports are transcribed and delivered to the account within the turn around time that you deisgnate -This enables urgent reports to be as quick as 1 hour -Available 24/7 daily which allows convenience for physician

More About Accustat EMR... Configuration: Point of Service system Regularly exceeds the American Healthcare Association Integrity Standards (AHIMA) Routine audits by HIPAA compliance team The HIPAA compliance team guarentees that their employees respect your patient's information just as a member of your own staff would

Reasons we recommend Accustat EMR: Personalized to individual facility needs Physician and patient convenience Cost effectiveness Reduction in serious medical & prescription errors Easy access to edit, search, and view medical transcriptions -Great "all-inclusive" package. The company provide training, billing, networking, installation, scanning, and transcripting. -Fast turn around -Reduces errors caused by difficulty reading physician notes and orders

Personalized care More accurate patient billing Less med errors Legible physician orders Emailing of charts No way of wrong patient charting Personalized care More accurate patient billing Less med errors (Lamburg, 2008)

Disadvantages Cost Educating Staff Complete Cooperation Time Management (Lamburg, 2008)

Ethical/Legal Issues Paper-era state regulations that may not permit EHRs state regulation of medical records is based upon the rules of paper records HIPAA’s privacy and security regulations unrelated physicians of record sharing organizations can locate, request and obtain the medical records of patients (Shay, 2005)

Ethical/Legal Issues Anti-trust Laws  The laws prohibit anti-competitive behavior, including price fixing Sharing payment information could enable competing providers to collude on prices and violate the anti-trust laws. (Shay, 2005)  Creating a Legal Document  EMRs must be stored legally, if not they may be deemed invaild if they do not meet legal requirements, the payor can sometimes deny the claim

Competencies required to work in Paperless Hospitals: Ability to: Access and use emails Search databases and obtain information Navigate institution specific software regarding charting and administering meds Operate Windows applications (McGonigle, 2009) 

Functions and Responsibilities of the INS: Possess the knowledge and skills specific to paperless hospital software, hardware, and the clinical information system used by their facility Use critical thinking and computer skills to assist with hospital technology Teach and assist others with learning new information and technology Assist with implementation and evaluation of the Clinical Information System (McGonigle, 2009)

In conclusion: A paperless hospital will require new hardware/software There are many different software to choose from A customized software is needed for each area of healthcare This system will require all staff to transition to a different way of thinking The advantages out weigh the disadvantages A paperless hospital will change the way of nursing 

References Cucina, Russ. "Information Technology in Patient Care" (Chapter). McPhee SJ, Papadakis MA, Tierney LM, Jr.: CURRENT Medical Diagnosis & Treatment 2010: http://www.accessmedicine.com/content.aspx?aID=779189. Allscripts ( 2009, July). Electronic prescribing - TouchChart eRx. Retrieved [date] from MDS Medical website: http://www.mdsmedicalsoftware.com/allscripts/electronic-prescriptions.php Ellison, C., & Evans, D. (2003, October 14). Wireless networks. Retrieved from http://www.pcmag.com/article2/0,2817,1275533,00.asp Farcus, N. (2009). Introduction to computer hardware lecture. Nurs 457.

References: (2009). Accustat EMR. In Digital Medical ASP Transcription.                                    Retrieved December 1, 2009, from              http://accustatemr.net/default.aspx. McGonigle, D. & Mastrian, K. ( 2009). Nursing informatics and the            foundation of knowledge. Boston: Jones & Bartlett Publishers.  Lamburg, S.I. (2008, May 24). Paperless or less paper. Retrieved from http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B75K6-4SK9CWR-J&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=1121678625&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=795bc94818ea40d062fff6926535a25c Shay, Edward F., and Esq..(2005). "Legal barriers to electronic health records." Physicans News. N.p., n.d. Web. 4 Dec. 2009. <http://www.physiciansnews/law/505.html>.  "Legal Issues of the ELectronic Medical Record." Medical Practice Management Trends. N.p., n.d. Web. 4 Dec. 2009. <http://www.medicalpracticetrends.com/2009/07/19/emr-legal-issues/>.