NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

In 2011, Mason General Hospital was named one of America’s most connected hospitals by Hospitals & Health Networks magazine. What makes this especially important is the fact that Mason General is a small, 25-bed rural hospital in Washington State. The success is credited to Nurse Eileen Lansomer, Director of Clinical Informatics. Under her leadership, the hospital has introduced innovations such as her Visual Her Smart Board, where real-time patient information is always available.

According to the journal, hospitals named “Most Wired” “show better results in patient satisfaction, risk-adjusted mortality, and other important quality measures through the use of information technology (IT).” (Mason General Hospital and Family of Clinics, 2012).

Developments in information technology have enabled patients and health care providers to collaborate for quality improvement at an unprecedented level, and nurses have consistently been at the forefront of these efforts. This week you focus on the IOM report “To Err Is Human” and consider how health information technology has helped to address the issues of patient safety and quality health care. NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

Clinical transformation: Blending people, process, and technology

Together with all of the healthcare reform efforts being considered, the massive adoption of electronic health records (EHRs) nationwide is expanding the focus on reducing costs and improving quality. Many healthcare organizations are embracing the concept of clinical transformation to achieve these goals, but they still require the tools and capabilities to make data available in real time and reduce the burden on scarce resources. These are among the key findings from the HIMSS 2011 Clinical Transformation Survey.1

This is the HIMSS organization’s first industry survey to measure clinical transformation. To ensure respondents had a level foundation for their responses, the following definition was developed: NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

Clinical Transformation:This involves assessing and continually improving the way patient care is delivered at all levels in a care delivery organization. It occurs when an organization rejects existing practice patterns that deliver inefficient or less effective results and embraces a common goal of patient safety, clinical outcomes and quality care through process redesign and IT implementation. By effectively blending people, processes and technology, clinical transformation occurs across facilities, departments and clinical fields of expertise.

Approximately 175 respondents assessed the degree of clinical transformation within their organizations in terms of measurement, governance and leadership, organizational behavior and data access. Among the key findings: NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

* Clinical priorities: Nearly half of respondents indicated that their organization was presently focused on ensuring that a fully operational EHR is in place.

* Key drivers for addressing quality metrics: While meaningful use/ARRA is the influence driving which quality metrics to address, the choices made by healthcare organizations are also driven by other federal efforts, The Joint Commission, and other quality initiatives.

* Improved outcomes: Organizations aren’t only using the analysis of clinical and financial data to improve quality and efficiency of care, but to control costs and improve revenue, as well. NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

* Barriers: Respondents identified the fact that data aren’t captured in discrete fields or defined consistently as key barriers to the capture and use of clinical data for quality metrics.

* Clinical transformation teams: While nurses and physicians are well represented on clinical transformation teams, one-third of respondents noted that these teams were lead by a member of the executive office.

* Organizational changes: As organizations are evaluating how to use IT to effectively implement clinical and quality improvement efforts, more than 80% are evaluating clinical workflow and process.

* Addressing change management: Three-quarters of respondents rely on education and training to address change management issues.NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

According to the survey findings, there are numerous improvements that organizations can make to enhance their ability to use clinical and financial data to improve patient outcomes. For instance, data isn’t always available in a way that facilitates easy access and reporting. Only 35% of respondents presently import data into a data warehouse, and nearly half of respondents noted that they rely on interfaces to assist with integration. Since not all data is available in an electronic fashion with discrete data elements, reviewing charts by hand is still a key means for measuring clinical quality.

Having the correct resources in place to improve reporting capability is also an issue. Nearly two-thirds of respondents noted that their organization needs additional resources in order to report appropriately on quality measures. NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

Although there’s organizational support for clinical transformation, there are gaps and barriers to being able to accomplish goals and objectives in this area. Specifically, nearly three-quarters of respondents noted that they needed additional IT resources to report on quality measures. This was closely followed by additional staff (61%) and more money (58%).

Only 4% of respondents indicated that they don’t need additional resources. In addition, two-thirds of respondents directly noted that while they had staff qualified to report on quality measures, the staff simply didn’t have the time needed to create reports. Other respondents (43%) noted that their organization’s priorities were focused elsewhere. NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

The role of clinical informatics, including nurse informatics, continues to be a much valued and necessary position in today’s healthcare organization because these experts are essential to the success of quality initiatives, participating in the executive clinical team that analyzes clinical data. Survey results indicate that these human resources are necessary to ensure that clinical transformation efforts benefit from appropriate access to clinical data that is derived from the EHR. NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

The recently published IOM report on The Future of Nursing asserts the U.S. healthcare system has the opportunity to transform itself, and envisions nurses as active leaders in this transformation.2 Nurses have already taken a leadership role in embracing technology as a necessary tool to innovate the delivery of healthcare. The report recommends that nurses take on leadership roles to improve safety and efficiency, bring evidence for decision making to the point of care, and empower patients to be involved partners. NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

Also recognizing the vital leadership role of nurses in providing quality patient care, the HIMSS Board of Directors approved a position statement this summer describing how to transform nursing practice through technology and informatics.3 Leaders from the HIMSS Nursing Informatics Community, representing over 2,900 members who not only serve the nursing profession, but also, the broader healthcare industry and HIMSS membership at large, developed the following position statement.

Position Statement:Nurses are key leaders in developing the infrastructure for effective and efficient health information technology that transforms the delivery of care. Nurse informatics play a crucial role in advocating both for patients and fellow nurses who are often the key stakeholders and recipients of these evolving solutions.

Nursing informatics professionals are the liaisons to successful interactions with technology in healthcare. As clinicians who focus on transforming information into knowledge, nurse informatics cultivate a new time and place of care through their facilitation efforts to integrate technology with patient care. Technology will continue to be a fundamental enabler of future care delivery models and nursing informatics leaders will be essential to transforming nursing practice through technology. NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

In addition to the need for knowledgeable and available leaders, nearly all survey respondents (87%) indicated that their organization leverages technology to standardize and automate practices, such as the format of a discharge summary, to enable additional focus on new quality initiatives. Survey respondents were also asked if they were leveraging data from diverse information sources to measure quality. Approximately half of respondents (53%) noted that they’ve created interfaces to support integration.

A third (35%) noted that their organization imports all data into a repository-warehouse. Only 12% reported that the tools they use are fully integrated into their EHR. 55% reported that these tools are partially integrated, and 13% reported that these tools aren’t automated with organizational EHRs. NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

One organizational leader in this area, Catholic Health East (CHE), has launched a massive, multi-year initiative to move forward with the development and implementation of a system-wide evidence-based care/clinical transformation initiative.4 This new delivery model, the ACT (Advancing Clinical Transformation) initiative, was developed in 2008 and introduced throughout CHE in early 2009. The initiative is focused on ensuring excellence in quality and patient safety outcomes-every person, every place, every time.

Evidence-based care has been established throughout CHE using core measures, technology assessments, standardized documentation, order sets and computerized provider order entry. CHE will also leverage existing information systems and introduce new system capabilities and industry standard clinical terminology to provide patients with their personal health information and exchange key clinical information with authorized entities and public health agencies. NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

New Nursing Technologies and Trends

Nursing technology has transformed the way nurses work and continues to evolve, along with the roles that nurses play in today’s health care arena. According to various studies and surveys, technology in the nursing world has increased patient satisfaction and overall outcomes, reduced clinical errors and decreased the amount of paperwork that nurses were once required to perform.

The outlook for new technology in nursing remains robust, as new devices, computers and robots aim to transform the future of health care. The following technologies are just a few that have made headlines recently as they ease and streamline each nurse’s workload to help them focus on what matters most–their patients. NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

Point-of-Care Technology

Accessing patient records, X-rays, medication information and even obtaining a second opinion from another health care professional, can all be done directly from the bedside thanks to new advances in point-of-care technology. Utilizing a wireless network and computer, nurses in many hospitals can now access and receive a wide array of information right from the patient’s room.

Computer and software companies are working to further advance point-of-care technology to include wireless and mobile applications that will enable nurses to have the information they need directly at their fingertips. NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

Electronic Health Records

Electronic Health Records (EHR) have been a hot topic lately as policymakers work towards establishing a Nationwide Healthcare Information Network (NHIN) that would standardize EHRs. Although paperless health records have been utilized for years, a new Harvard research study showed that fewer than 1 in 5 nurses are using EHRs, although computerized documentation was linked to nursing excellence and better patient outcomes.

As more hospitals began to implement EHRs, experts predict that there will likely be fewer medical errors, an increase in quality care and satisfaction, and an overall increase in accuracy. NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

Electronic Lift Systems, Smart Beds and Computerized Staff Schedules

Many of the health care technologies we see today have been put in place to make a nurse’s everyday routine safer and more efficient. Electronic lift systems operated by remote control and other wireless technologies have greatly reduced injury and stress for both patients and nurses.

Smart beds and computerized staff scheduling systems have also improved general nursing efficiency. Smart beds, such as those developed by Hill-Rom, work in conjunction with other point-of-care technology to obtain and analyze patient information such as weight, temperature and head and neck elevation. New staff scheduling systems improve efficiency by enabling nurses to set up coverage and even schedule their shifts remotely. NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

Patient and Staff Identification Systems

Patient and staff identifiers in the hospital setting have become increasingly important in light of patient mix-ups and unauthorized people entering a facility or accessing patient records. Bar codes, wristbands and radio frequency identification (RFID), all work to track and identify patients in an effort to reduce errors while also keeping the hospital population safe.

New palm vein technology, eye scans and microchips have also been introduced as a way to identify both patients and healthcare professionals, and to cut down on unauthorized access to patient files.

As new technologies continue to emerge, nurses’ roles will continue to evolve, with each advance, bringing a safer and healthier future for both nurses and the patients in their care. NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

Technology in Nursing

The technology involved in nursing today would likely surprise even the most devoted gadget freak. Nurses must increasingly master a host of complex technologies, from “smart” medical devices to tablet PCs.

“There’s no way to get around it,” says Carol Bickford, PhD, RN, BC, a senior policy fellow in the department of nursing practice and policy at the American Nurses Association. “You need to know the tools, and new ones are coming in right and left.”

Nursing Tech Types

The technology nurses encounter on the job falls into two broad categories — clinical and other information systems, and smart medical devices, often with integrated computer chips and screens. Specific technologies include: NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

Clinical Information Systems: These systems bring together an organization’s patient records, lab results, pharmaceutical data, medical research resources and other information, providing nurses and other caregivers with integrated, PC-based tools to help them input and retrieve information.
Electronic Health Records: Patient records in this format provide instant access to a patient’s medical history, improve communication between caregivers and offer flags and alerts to prevent conflicts over prescriptions and tests.
Drug Retrieval-and-Delivery Systems: These utilize several technologies, including bar codes and automated dispensing machines, to ensure patients receive the correct medications and dosages.
Tablet Computers, Wall-Mounted PCs and Mobile Carts: These computer-based tools allow nurses to enter and retrieve information housed in a facility’s information system without leaving the bedside. The systems can operate wireless and connect to databases containing care guidelines and other clinical resources. NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper
Medical Devices: Devices such as infusion delivery systems and ventilators often have “brains built into them,” says Joyce Ramsey-Coleman, vice president of nursing and patient-care services at Children’s Healthcare of Atlanta. These electronic brains assist nurses by flagging problems and helping to avoid errors.
Personal Digital Assistants: PDAs with add-on software can help nurses research conditions and check medication doses.

Furthermore, wireless tech integrates information from disparate sources and delivers data faster, so nurses don’t need to be tied to a specific workstation to get the necessary information.

Boon and Burden

While nurses acknowledge the advantages of using technology, they also say training is sometimes inadequate, IT systems occasionally force them to rethink how they do their jobs, and technological snafus can impede their work. NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

But without a doubt, the introduction of new technologies may bring considerable changes to nurses’ day-to-day work. Consider the experience of Texas’s Baylor Medical Center at Achievable after touch-screen computers were installed in the emergency department. The system has helped improve efficiency and patient care in a number of ways, says Mike Beaning, RN, the emergency department’s day supervisor. With the system in place:

Nurses don’t have to find a doctor to get a patient’s chart.
Charts are easier to read, minimizing potential errors.
Lab results are available in real time.
Various departments communicate better.

“Because of the time that is saved by using this system, it gives the nurses more time for more personalized care,” Behning says.

But new technologies don’t always result in more time for patients. Bar-code scanning, Bickford notes, can serve as part of a check-and-balance system for catching errors, but the bar-code systems aren’t always convenient and can take up nurses’ time. The same goes for automated medication systems, which may be designed more for the convenience of the pharmacy than for use during nurses’ daily duties, she says.

“Many times the technologies are imposed on nurses,” Bickford explains. “There has not been thoughtful consideration about the work processes or the business processes.” NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

Bickford expresses concern about losing the “sounds and touch” of nursing when dealing with screens and nursing equipment. While technology can improve patient care, she acknowledges that “sometimes it’s burdensome.”

Common Uses of Healthcare Information Technology

Health IT has been used sporadically for decades in the form of electronic medical records (EMRs), which are digital versions of patient charts and medical histories from a single provider. In 2014, the federal government disbursed more than $19 billion in incentives for hospitals to use EMRs. Since then, the number of providers using EMRs skyrocketed.

As of 2016 (the most recent data), more than 95 percent of all eligible hospitals have demonstrated “meaningful use of certified health IT,” the HHS’s Office of the National Coordinator for Health Information Technology (ONC) said.

In addition to EMRs, health IT is commonly used in other areas of healthcare:

Electronic health records (EHR)

EHRs have a similar function to EMRs but EHRs refer to records kept on the patient’s overall health from a multitude of providers. The ONC said EHRs “go beyond standard clinical data collected in the provider’s office and are inclusive of a broader view on a patient’s care.”

Patient portals

Patient portals allow patients to access their EMRs, EHRs and other pertinent information such as lab results, immunization records, prescription records and information about recent medical visits. Some portals also allow patients to download information and request new prescriptions or prescription refills. NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

E-prescribing

Electronic prescribing, or e-prescribing, allows providers to use electronic tools to write and submit prescriptions. When used in conjunction with EMRs and EHRs, providers can better determine the best prescriptions for treatments. One study linked e-prescriptions to better health outcomes in diabetic patients.

Patient scheduling

Patient scheduling is considered an essential step in providing care, but studies show effective scheduling is lacking. A 2016 survey by the AHRQ found 10 percent of adults said they frequently have difficulties getting timely appointments with providers.

DNPs and Healthcare Leaders Using Health Information Technology

While nursing leaders are increasingly using health IT in clinical practice, a lot remains to be accomplished. Barriers that include capital costs, inadequate staff training and unfamiliarity of the benefits of health IT have hindered progress in some areas, the AHRQ said. To increase the use of IT for quality improvements, the AHRQ made the following recommendations:

Share samples of exemplary use of health IT to inspire staff
Develop and refine high-functioning IT tools
Empower staff with the knowledge, guidance and tools to maximize the use of IT
Expand the availability of financial incentives for IT use.NURS 6051 – Transforming Nursing and Healthcare Through Technology Essay Paper

Healthcare leaders say DNP-prepared nurses can take on advanced roles in IT through a DNP curriculum that examines and evaluates the importance of technology in nursing leadership. In 2012, Jason T. Shuffitt, DNP FNP-BC, recommended that DNP education programs develop “innovative and creative ways of integrating healthcare informatics throughout the curriculum.” His recommendations resonate today.

“These clinicians are on the front line of care delivery and must have not only the knowledge and skills necessary to provide competent and quality clinical care but also the ability to manage care effectively in an information-centric and ever evolving complex healthcare system,” he said in the Online Journal of Nursing Informatics. NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

APRNs considering advancing their careers with a DNP degree have an opportunity to utilize a DNP curriculum that includes coursework in healthcare information systems, leadership and safety initiatives. Duquesne University’s online DNP program allows APRNs to delve into health IT and other topics for a well-rounded education.

The health care industry is facing the third evolutionary wave of IT digital technologies with implications so profound analysts believe it is a new era of global computing. Indeed, for all organizations, digital transformation will be galvanized by foundational technologies such as mobility, Internet of Things (IoT), Web 3.0, PaaS/SaaS, Big Data and Unified Communications (UC).

During the next 10 years, a “digital thread” will unleash a seamless flow of data ranging from health care records and systems to patients interacting with care teams at any time and from anywhere. With the advent of the Internet as the bulwark of our modern economy, and mobile usage growing exponentially, all industries, including health care, are poised to benefit from the ubiquitous and real-time access to contextual information facilitated by the new technologies that are driving the digital transformation narrative.

What is the promise of digital transformation? It can transform operations, reduce costs and improve the quality of patient services and care. Health care organizations that leverage mobility, Big Data, UC and IoT will enhance the entire health care service-delivery chain from diagnosis to post-care while improving the relationship between patients, caregivers and other leveraged partners. Processes will be more automated, efficient – and mobile. NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

The Impact of dIgital HEALTHCARE AND CUSTOMER EXPERIENCE

Why are the mandates of digital transformation so vital to the health care industry? The short answer is that this digital revolution will impact how health care providers diagnose, monitor, manage and track patient health. But how? What are the elements at work that have caused, and will cause, such quantum shifts that will impact an entire industry?

The essential purpose of digital transformation is to provide “agility” that will enhance and refine operational processes, and improve patient experience while reducing costs. The digital services so integral to health care include electronic medical records (EMR), electronic health records (EHR) and enterprise resource planning (ERP) systems. Also, Oracle^® databases, Microsoft Exchange^® email services, UC, bring-your-own-device (BYOD) initiatives and Voice over IP (VoIP) coupled with telemedicine are indispensable as well and are taxing networks, servers and databases like never before. NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

These digital services are inextricably linked in the health care service-delivery chain. Everything from portable medical imaging to wellness to portable diagnostic tools to crowd-sourcing, genomic applications like decoding one’s DNA on a portable device – are revolutionizing the industry. The end result will ultimately be better patient care.

Digital transformation velocity and its myriad number of digital services are driving health care, but risk is everywhere from infrastructure and application integration to disaster recovery and provisioning of services. As such, improving network visibility and understanding the interrelationships of service delivery components with actionable intelligence are vital. NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper

Moreover, maintaining an evolving service delivery infrastructure is important but service performance issues can extend mean time to knowledge (MTTK) and mean time to repair (MTTR), potentially costing millions. NURS 6051 Transforming Nursing and Healthcare Through Technology Essay Paper