June 12th, 2012
By Jennifer Olin, BSN, RN
The reality is electronic health records (EHRs) are here to stay. Just a few months back the office of Health and Human Services (HHS) announced that the number of hospitals using health information technology (HIT) has more than doubled in the last two years, from 16 to 35 percent. Now, a new study suggests that the implementation of a basic EHR may result in improved and more efficient nursing care, better care coordination, and patient safety.
What that really means is, if you are a nurse in all likelihood you are either already charting in an EHR, or at this rate of growth in the next couple of years you will be.
EHR Pluses and Minuses
Of course there are benefits and drawbacks to everything and when you are in a science oriented field (nursing, medicine, technology) you can find studies to support whatever side of an argument you choose to take. Therefore there are studies that say EHRs are better for nurses because they do everything from eliminate bad handwriting to having every bit of health info on a patient available right at the bedside.
These studies also show that, generally, such systems improve nursing documentation, reduce medication errors, and make nurses feel more satisfied with their work environments.
Disadvantages to implementing EHR systems include the start up costs of putting such a system in and also from the cost analysis side, training everyone to use such a system.
These studies have basically focused on the healthcare providers and their interactions with EHRs. But what about patients?
EHRs Can Build Safer Patient Care
Just a couple of weeks ago the federal Agency for Healthcare Research and Quality (AHRQ) shared with the public the results of a study that the AHRQ funded. It says EHRs make for better patient safety and better quality of care. Until now few large-scale studies have examined how adoption of EHRs may be associated with quality of care.
University of Pennsylvania researchers surveyed 16,362 nurses working in 316 hospitals in four states (California, Florida, New Jersey, and Pennsylvania). Nurses were asked about their workload and patient outcomes, as well as their hospital's patient safety culture using items from the AHRQ Hospital Survey on Patient Safety Culture. Of the 316 hospitals, only seven percent had a basic EHR system functioning on all patient care units.
The federal government has defined a complete EHR system as containing four basic functions:
According to the study, nurses working in hospitals with basic EHRs consistently reported that poor patient safety and other quality outcomes occurred less frequently than reported by nurses working in hospitals without an EHR. Nurses reported few medication errors occurring and a higher quality of patient safety and care provided. These nurses also had a 14 percent decrease in the odds of reporting that "things fell between the cracks" when patients were transferred between units.
These same nurses were also less likely to report that patient safety is a low priority for hospital management. With all of this improvement it’s hard to imagine a hospital wouldn’t want to put an EHR system into play despite the costs.
“EMR’s are definitely the wave of the future,” Dr. Marcus Pantalion, D.H.Ed. told me during an interview about training personnel to use EHR systems. “…clinicians can run queries of their entire patient database to locate individuals with a certain diagnosis. Additionally, an EMR can help reduce workloads; allowing more time for a provider or clinician to focus on patient care.” And, isn’t that really the goal? The biggest complaint many nurses have is they spend too much time on paperwork and don’t have enough time to spend at the bedside.
So, despite the hesitation of some healthcare systems to implement EHRs because of the startup and training costs and despite the lack of enthusiasm displayed by some healthcare providers when change is imminent, it seems that EHRs aren’t just the wave of the future, they are the best way we have today to provide greater patient safety and continuity of care.