NR 599 Week 3 EHRs Benefits and Drawbacks

Sample Answer

1. As discussed in the lesson and assigned reading for this week, EHRs provide both benefits and drawbacks. Create a “Pros” versus “Cons” table and include at least 3 items for each list. Next to each item, provide a brief rationale as to why you selected to include it on the respective list.

PRO’s

• Improved patient-provider communication

EHRs have become an important part of nurse-patient interactions which includes both face-to-face and remote consultations (Aveyard, et al., 2022). EHRs allow the patient to connect with their provider from anywhere. Being able to connect at any time for any issue facilitates better communication and promotes better patient outcomes.

CONs

• Less patient interaction

The distraction that can be caused by the use of EHRs by providers has negative impacts on the patient-provider relationship (Bohsali, et al., 2018). Providers need to be cognoscente of time they are devoting to EHR documentation, especially in the presence of the patient, as not to distract of the patient-provider interaction (Bohsali, et al., 2018).

PRO’s

• Reduced costs

Advantages of EHRs are the shortening of the time to make a new medical record, the reduction of working hours for employees in the records department and other departments, increase of billing accuracy and income, and improvement in the quality of provider documentation (Adebowale, et al., 2022).

CONs

• Cost of operation/running

Long-term costs associated with running an HER includes software protection to protect against malware, system upgrades, and ransomware concerns (Adebowale, et al., 2022).

PRO’s

• Legible and complete documentation

EHRs support documentation which improves clinical outcomes and streamlines communication between professionals to improve patient safety, assess quality of care and maximize efficiency (Eltair, et al., 2018).

CONs

• Usability

“…poor EHR usability has been found to be a contributor to physician dissatisfaction, and many have hypothesized a direct relationship between EHR usability and physician burnout” (Dyrbye, et al., 2019, para. 6). Authors further point out that providers spend 1 to 2 hours time charting in the EHR for every 1 hour they spend with their patient on top of the 1 to 2 hours personal time they spend working in the EHR (Dyrbye, et al., 2019).

2. Refer to the Stage 3 objectives for Meaningful Use located in this week’s lesson under the heading Meaningful Use and the HITECH Act. Select two objectives to research further. In your own words, provide a brief discussion as to how the objective may impact your role as an APN in clinical practice.

Generate and transmit prescriptions electronically this objective strives to ensure all eligible hospitals and critical access hospitals use electronic health record technology to transmit prescriptions to patients (CMS, 2018). Under stage 2 controlled substances were excluded but under stage 3 e-prescribing of controlled substances is included in states where allowable (CMS, 2018).

As an Advanced Practice Provider, I will have to be knowledgeable about prescribing restrictions. For example, in my state of Wisconsin, there are restrictions on prescribing controlled substances (Board of Nursing, 2019). Regardless of eligibility under the objective, I will be unable to prescribe any schedule I controlled substance (Board of Nursing, 2019).

One of the factors in my ability to meet this objective is the training I receive. Proper training to ensure correct utilization of the organization’s EHR to e-prescribe will be vital. Beykloo, et al. states that use of the EHR for prescribing increases patient safety by reducing risk of errors, but can add to workflow thereby increasing provider frustration (The impact of electronic prescribing, 2019).

To decrease workload, reduce steps in the process, and decrease frustration, providers often use workarounds (Beykloo, et al., 2019). Although workarounds can save time, they are not best practice and can lead to adverse events or poor patient outcomes. Actively engage in public health this objective requires providers to show active engagement with public health agencies by meeting at least 2 of the 5 different public health measures (Forward Health, 2023).

These measures are immunization registry reporting, syndromic surveillance reporting, electronic case reporting, public health registry reporting, and clinical data registry reporting (Forward Health, 2023). Meeting these public health measures are vital in my future practice to promote the overall health of the community by focusing on the social, economic, and environmental factors that contribute to patient well-being (Bekemeier, et al., 2021).

As Advanced Practice Providers, we have the capacity to work in diverse settings such as health departments, nonprofits, and complex care systems in our community. Being able and willing to engage the fore-mentioned public health measures will guide us to provide better care to the patients we serve in our future practice (Bekemeier, et al., 2021).

• Aveyard, H., Butcher, D. & Forde-Johnston, C. (2022). An integrative review exploring the impact of electronic health records (HER) on the quality of nurse-patient interactions and communication. JAN, 79(1), 48-67. Retrieved on 03/19/2023 from https //onlinelibrary.wiley.com/doi/full/10.1111/jan.15484Links to an external site.
• Adebowale, A., Amanullah, S. & Gopidasan, B. (2022). Electronic medical records – a review of cost-effectiveness, efficiency, quality of care, and usability. Journal of Psychiatry Spectrum, 1(2), 76-79. DOI 10.4103/jopsys.jopsys_17_22. Retrieved on 03/19/2023 from https //journals.lww.com/jops/Fulltext/2022/07000/Electronic_Medical_Records___A_Review_of.2.aspxLinks to an external site.
• Bekemeier, B., Johnson, K., Kaneshiro, J., Kuehnert, P., Swider, S. & Zahner, S. (2021). A critical gap advanced practice nurses focused on the public’s health. Elsevier Public Health Emergency Collection, 69(5), 865-874. doi 10.1016/j.outlook.2021.03.023. Retrieved on 03/19/2023 from https //www.ncbi.nlm.nih.gov/pmc/articles/PMC8092811/Links to an external site.
• Beykloo, M., Blandford, A., Franklin, B., Furniss, D., Ma, T., McLeod, M. & Mohsin-Shaikh, S. (2019). The impact of electronic prescribing systems on healthcare professionals’ working practices in the hospital setting a systematic review and narrative synthesis. BMC Health Services Research, 19. Retrieved on 03/19/2023 from https //www.ncbi.nlm.nih.gov/pmc/articles/PMC6806498/Links to an external site.
• Board of Nursing (2019). Chapter N8. Wisconsin Legislature. Retrieved on 03/18/2023 from https //docs.legis.wisconsin.gov/code/admin_code/n/8.pdfLinks to an external site.
• Bohsali, F., Chisolm, M. & Wolfe, L. (2018). Clinically excellent use of the electronic health record review. JMIR Human Factors, 5(4). doi 10.2196/10426. Retrieved on 03/18/2023 from https //humanfactors.jmir.org/2018/4/e10426/Links to an external site.
• CMS (2018). Medicare promoting interoperability program stage 3 eligible hospitals, critical access hospitals, and dual-eligible hospitals attesting to CMS objectives and measures for 2018. Department of Health and Human Services. Retrieved on 03/18/2023 from https //www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/MedicareEHStage3_Obj2.pdfLinks to an external site.
• Dyrbye, L., Melnick, E., Nedelec, L., Shanafelt, T., Sinsky, C., Trockel, M., Tutty, M. & West, C. (2019). The association between perceived electronic health record usability and professional burnout among US physicians. Mayo Clinic Proceedings, 95(3), 476-487. Retrieved on 03/18/2023 from https //www.clinicalkey.com/#!/content/playContent/1-s2.0-S0025619619308365?returnurl=https %2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0025619619308365%3Fshowall%3Dtrue&referrerLinks to an external site.=
• Eltair, S., Faber, K. & Pagulayan, J. (2018). Use the nursing process to take advantage of EHR’s capabilities and optimize patient care. The American Nurse Journal. Retrieved on 03/18/2023 from https //www.myamericannurse.com/documentation-electronic-health-record/Links to an external site.
• Forward Health (2023). Promoting interoperability program meaningful use of certified EHR technology. Department of Health Services. Retrieved on 03/19/2023 from https //www.forwardhealth.wi.gov/WIPortal/Subsystem/KW/Print.aspx?ia=1&p=1&sa=15&s=11&c=637&ntLinks to an external site.=