Promoting Safety and Quality Care Using Health Care IT Tools

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Excelsior University *

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445

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Health Science

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Dec 6, 2023

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1 Kathryn Cederlind Health Sciences, Excelsior University HSC445: Introduction to Healthcare Informatics Professor Barbara Carpenter November 26, 2023
2 Promoting Safety and Quality Care Using Health Care IT Tools There are countless health IT tools being utilized within the multitude of health care specialties and settings. All of which have the goal of improving care and streamlining all health care provider efforts towards safe, timely and effective patient outcomes. All systems, however, are not created equal. The systems to be discussed, and their functions, are within the specialty of elder care. In long term care and skilled nursing facilities, it is common to utilize all three of the following systems: Electronic Health Records (EHR), Computerized Physician Order Entry (CPOE) and Voice over Internet Protocol (VoIP) systems. These systems improve accuracy, speed and patient safety. Prior to the creation of Electronic Health Records, paper charts were used. The downfall of paper charting was accessibility (only one person may access/update it at a time), legibility of penmanship and inconsistency of documentation styles and formats. EHRs improve accuracy (sheets of paper are not being lost or damaged), accessibility (many health care providers can access and update the information, simultaneously) and security (users must be granted access and that access is traceable). Not only have EHRs improved accessibility and uniformity in charting, it assists the user in compiling complete data per encounter. “EMR is considered potentially one of the drivers for the transformation of healthcare. From a patient care perspective, EMR is expected to improve the accuracy of the information, support clinical decision-making and improve the accessibility
3 of information for continuity of care” (Honavar, S.G., 2020). This is done through alerts and suggestions within the system. One system widely used in the specialty of Dermatology is called EMA. EMA requires each step of the patient intake to be completed prior to the advancement to the next step. This prevents “gaps” in the information collected. EMA also functions as a Computer Automated Code Generating system (CACG) and in doing so, it makes suggestions in how to elevate the visit to a higher claim by suggesting actions that the provider should take – and requires the provider to take – in order to achieve the higher code. EMA also allows the user to ePrescribe. ePrescribe is akin to a Computerized Physician Order Entry in that it will only allow medications to be ordered that are directly linked to a diagnosis within the patient’s chart history. CPOE promotes accuracy through legibility (no scribbles to decipher!), checking for dosing accuracy, checking for potential drug interactions and/or drug allergies, checking preexisting orders for the same medication, etc. This system also prevents miscommunication with the pharmacist. Medications lists may also be “imported” from pharmacies that are linked and vice versa. The CPOE tool is precious to preventing medication errors because it is impossible to know every drug, every interaction and every potential dose adjustment needed for countless diagnoses. “Issues contributing to compromised patient safety in primary care settings include errors in diagnosis, prescription, communication breakdown, unsafe medication practices, fragmentation of care and error in clinical decision making” (Dhamanti, I. et.al., 2021). Pharmacists may also use their own computerized verification systems to “double-check” for
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4 allergies, interactions and incompatibilities of dose to diagnosis. Through this computerized system, not only is accuracy enhanced, but so is speed. In the realm of speed of response within long term care and skilled nursing, Voice over Internet Protocol (VoIP) systems can streamline response time to call-lights, doctors’ orders and emergencies. Workers can easily communicate with each other – and those from outside of the facility – from anywhere within the facility with mobile devices. “With VoIP, nursing homes can communicate with everyone via mobile devices. By centralizing communications with a mobile- friendly setup, nursing homes can eliminate communication roadblocks and focus entirely on patients” (Baker, K. 2022). Staff no longer is stuck with trying to listen to and answer voicemails, they can receive direct communication with their mobile devices. Combining a Voice over Internet Protocol system, with an Electronic Health Record system and a Computerized Physician Order Entry system results in increased speed, delivery, accuracy and safety within long term care and skilled nursing facilities. Health care providers are able to access up-to-date, accurate patient data; make informed decisions from this data and communicate effectively and quickly. These systems also prevent errors and miscommunication within the direct care team. Together, they also prevent miscommunication with outside care providers and specialists when coordinating patient care through access to charts, staff and medications.
5 References: Baker, Kari. “VoIP for Nursing Homes: All You Need to Know.” Dice Communications , 21 June 2022, dicecommunications.com/voip-for-nursing-homes. Dhamanti, I., Kurniawati, E., Zairina, E., Nurhaida, I., & Salsabila, S. (2021). Implementation of Computerized Physician Order Entry in Primary Care: A Scoping Review. Journal of multidisciplinary healthcare , 14 , 3441–3451. https://doi.org/10.2147/JMDH.S344781 Honavar S. G. (2020). Electronic medical records - The good, the bad and the ugly. Indian journal of ophthalmology , 68 (3), 417–418. https://doi.org/10.4103/ijo.IJO_278_20 Mastrian, Kathleen Garver, and Dee McGonigle. Informatics for Health Professionals . 2nd ed., Jones et Bartlett Learning, 2021.