Discussion Board Post for Healthcare Informatics Course

February 3, 2023

Prompt:

1. Do you feel electronic health records (EHRs) help meet the goals and expectations of the
organizations in relation to the quality of care? Patient safety? Unexpected outcomes?
Other issues?
2. What recommendations would you suggest to improve the exchange of health
information and interoperability of patient records?
Response:
I will contextualize my consideration of the readings in my area of practice: outpatient
hematology/oncology (hem/onc) nursing.
I feel that electronic health records (EHRs) do in many ways help meet my organization’s
(Sentara Martha Jefferson Hospital, or SMJH) goals/expectations for quality of care. For
example, EHRs create alerts so that physicians, nurses, and other members of the care team are
alerted of duplicate or erroneous tests, potential drug interactions, and other potential issues in
patient care. Catching such errors before they occur helps to promote patient safety and cost
effectiveness. However, when a patient is able to see lab or imaging results before they have
been interpreted by the provider, this can create a sense of anxiety that is bad for the patient
and places a strain on their relationship with their care team. Where unexpected outcomes are
understood as the unfortunate consequences resulting from any human activity (Colicchio,
Cimino, & Del Fiol, 2019), I believe that the pros of the EHR in my area of practice outweigh the
cons. I can think of hardly any instances of damaging unexpected outcomes that stem from
EHRs, and on a daily basis I witness the many benefits: a repository of information across
providers within our system, easy-to-understand longitudinal comparisons of vital sign and lab
data trends, and the patient portal enables the patients and their loved ones to be well-
informed about their treatment and health status. In two focus groups with hem/onc nurses at
an outpatient clinic in Texas (Gerber et al., 2017), nurses also noted merits and demerits
affiliated with patient portals and EHRs, including the mixed blessings of patients immediately
receiving results and the usefulness of being able to answer patient questions in writing so that
there is no ambiguity about medical recommendations.
To improve the exchange of health information and interoperability of patient records, I would
recommend recruiting more and wider variety of nurses and patients to user test EHRs and
HIEs. Based on the American Nurses Association's assertion that nurses should be active
participants in developing EHR technology (ANA, 2017), health institutions and/or HIT
companies should incentivize RNs to quality test their products in order to develop and refine
EHRs so that they best support patient safety and quality of care. These incentives could be
monetary, or the product-testing could count towards continuing education credits, as
community service, or as an expectation for membership in professional organizations. Also
based on the ANA’s (2017) recommendations, nurses should assist in developing standards for
EHRs that will help to overcome the innovation vacuum and improve the user friendliness and
effectiveness of these systems. Patients, too, ought to be encouraged to pilot and provide
feedback on EHR’s, to ensure that these key stakeholders are satisfied with their interface.
Most importantly, patients can provide feedback about whether the EHR improves the quality
of their care and whether they feel that it supports rather than hampers their right to privacy.
Reading these articles has raised my awareness of the complex, rich infrastructure of EHRs and
HIEs that is already deeply ingrained in how I practice healthcare. This module leaves me eager
to seek opportunities to better wield HIT in my nursing practice.
 References
American Nurses Association. (2009, December 11). Electronic health records: ANA position
statement. https://www.nursingworld.org/practice-policy/nursing-excellence/official-
position-statements/id/electronic-health-record/ Links to an external site.
Colicchio, T. K., Cimino, J. J., & Del Fiol, G. (2019). Unintended Consequences of Nationwide
Electronic Health Record Adoption: Challenges and Opportunities in the Post-
Meaningful Use Era. Journal of medical Internet research, 21(6), e13313.
https://doi.org/10.2196/13313 Links to an external site.
Gerber, D. E., Beg, M. S., Duncan, T., Gill, M., & Lee, S. J. C. (2017). Oncology Nursing
Perceptions of Patient Electronic Portal Use: A Qualitative Analysis. Oncology Nursing
Forum, 44(2), 165–170. https://doi.org/10.1188/17.ONF.165-170