Health Information Exchange Discussion Paper
Excellent post! Your post provides an in-depth discussion of healthcare information systems. I agree that the first step in improving a healthcare organization’s information systems involves addressing a safe way to implement interoperability in health information exchange. I believe that we must embrace and integrate health information exchange (HIE) systems and electronic health records (EHRs) in order to accomplish interoperability in the healthcare system (Ohno-Machado, 2018) Health Information Exchange Discussion Paper.
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Healthcare professionals may only access their paper-based health records at a single place at a time, which was the case for most physicians and healthcare facilities until recently. I also strongly advocate for interoperability because when information is shared and utilized by authorized personnel from different places at the same time and in the same safe manner, this facilitates improved coordination of care (Kuziemsky, 2013). Above all, I can say that using healthcare information systems to structure activities, detect inefficiencies, and provide evidence-based, patient-centered decision-making at the point of care may significantly enhance the safety of medical care. In particular, new techniques that enhance customization while also gathering and sifting through tons of data to detect significant status changes and then notifying relevant people should prove to be very valuable Health Information Exchange Discussion Paper.
References
Kuziemsky, C. (2013). A multi-tiered perspective on healthcare interoperability. Advances in Healthcare Information Systems and Administration, 1-18. https://doi.org/10.4018/978-1-4666-3000-0.ch001
Ohno-Machado, L. (2018). Electronic health records and health information exchange. Journal of the American Medical Informatics Association, 25(6), 617-617. https://doi.org/10.1093/jamia/ocy057
I will be using the work environment of a Home Health agency in this comparison of information technology status with chapter 8 of the Handbook of Informatics for Nurses and Healthcare Professionals. I was able to view both the clinical information system (CIS) as a nurse in the field, as well as the administrative information system (AIS) as I also worked in the clinical administrative offices through Intake and as a Transitional Clinical Liaison. This gave me the opportunity to see the strengths and weakness of the information technology in my job in both CIS and AIS perspective. Overall, if I were to rate the information technology status of my organization on a scale of 0 (poor) to 10 (most successful), I would have to use a solid 5. Five is right in the middle as it balanced out the CIS and AIS weaknesses and strengths. There was great information technology potential within the organization, but though the electronic health record system was great within the organization, there was very little health information exchange with health partners. We may have received documents electronically and were able to scan them into our own medical data warehouse, we had to re-enter all information manually which presented opportunity for copy-error. Collecting data electronically instead of sharing information still contributes to silos of information. Hebda, Hunter, and Czar (2019) pointed out that silos of information lead to “. . . different versions of data, missing data, redundant data collection, and contributes to potentially dangerous errors and wasted resources” (p 97) Health Information Exchange Discussion Paper.
There was also poor transfer and communication of test results which led to valuable time spent tracking down data before going on home visits. The Electronic Medication Administration Record (EMAR) did not have a tracking system to notify when medications needed to be re-ordered to help the patient manage their medication supply. There was no system for financial tracking. All insurance information, including authorizations for home visits, were manually checked and entered, and communication between billing and nursing staff was time-consuming. However, the nursing and physician orders were viewed together, providing a great holistic view of patient goals and treatments. The EHR template’s, free text, and standardized language allowed for thorough documentation and easy tracking of clinical progress. The EMAR was great at implementing safety precautions and preventing duplication or drug-drug interaction errors. The organization implemented telehealth monitoring for at-risk patients with real-time data collection of physiological monitoring through a trained staff clinician. There was a great intake process of registering and scheduling patients, and scheduling staff for those visits. Risk Management and quality assurance was a high priority in this organization and it showed in documentation as well as measurable data shared with the staff in meetings. I would wish to improve this organizations information systems by first addressing a safe way to implement interoperability in health information exchange, especially with prominent healthcare partners. Next, I would want improved data management of test results, as well as financial status/requirements and tracking, built into the EHR Health Information Exchange Discussion Paper.
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This needs to be up-to-date and accessible for streamlined patient care. Last, but not least, the EMAR needs a tracking system for medications that need to be re-ordered so we can remind or assist patients to re-order important medications to avoid missing doses. In order to pursue these changes, I would need to first bring attention to the concerns in a professional way through the management pyramid, showing evidence to support the benefit of addressing these concerns . There needs to be a team of people in this organization that recognize and support the value of Healthcare information systems, as well as have or find the intelligence on how to organize it’s implementation. Hebda, Hunter, and Czar (2019) wrote it best by saying, “As patient advocate, the nurse is charged with protecting the health, safety, and rights of the patients. This protection extends to information and the use of systems that house patient information” (p 96). So it is the duty of a nurse to provide patient care in the best way possible, including through information technology. References: Hebda, T., Hunter, K., & Czar, P. (2019). Handbook of informatics for nurses and healthcare professionals (6th ed.). New York, NY: Prentice-Hall/Pearson Health Information Exchange Discussion Paper