Electronic health record adoption stages and patient safety outcomes in hospitals

Hessels, A. Flynn, L. Cimiotti, J.P. Bakken, S. and Gershon, R. (2015). Impact of Heath Information Technology on the Quality of Patient Care. Online J. Nurs Inform; 19.

Give A Few Overviews About Health Information Technology and Healthcare (Give Some Legislation Associated with It)

Consumer concern regarding healthcare has become a major issue that involves covering the high costs of the patients who cannot afford it. The Affordable Care Act (ACA) 2010 was established to propose the Hospital Value-Based Purchasing program which rewards acute care hospitals with incentive payments for the quality of the care that is provided. This program places two percent of the reimbursements at risk by outcomes, quality metrics and care experiences. In order to further support the improvement, the American Recovery and Reinvestment Act (ARRA) 2009 was established; it involves information technology to bring reforms in health care.

Background/Significance of the Article Provided

Several healthcare programs have started incentive programs and also receive EHR incentive payments that begin with two million dollar foundation payment and over five billion dollars paid till today. Several acts have also been established like ARRA (2009) and ACA (2010) that have increased the use of IT in healthcare; evidence also suggests that the use of technology enhances decision-making and communication and has a positive impact on the performance and outcomes. However, despite the funding and attention, several gaps still exist in the evidence that involves the influence of EHRs around several organizational climates.

Method

A secondary analysis of the cross sectional data was done in the research that included (i) adverse patient events and PSIs by using PSI algorithm from Healthcare Cost and Utilization Project, State inpatient database; (ii) survey data of patient satisfaction of Hospital Consumer Assessment of healthcare providers and systems, (iii) EHR adoption stage by using EMR adoption model scale from healthcare information and management systems society; and (iv) nurse practice environment scores using Practice Environment Scale Nursing work index. The years selected were 2006 through 2007 and were merged using hospital level identifiers. The design included adult patients from New Jersey hospitals and nurses.

Findings

Findings from this study propose that a converse relationship exists between adoption stage of EHR and the patient results of PLOS and readmissions. The findings of this study did not propose that expanded EHR selection stages are identified with diminished antagonistic results of PSIs results or expanded patient satisfaction. Extra investigation was done to determine if the solid connections among the nursing workplace, missed nursing care and patient satisfaction were puzzling the impact of EHR on patient satisfaction results. Remarkably, in the last balanced models\' one and only satisfaction result, the patient reaction of \"being given discharge information,\" achieved the level of measurable centrality. This relationship, in any case, was the other way of that conjectured.

Implication for Advanced Practice Nurse

Imperatively, accomplishing EMRAM arrange 3, including nursing documentation which is the essential instrument of electronic correspondence, is crucial for safe moves of care. As such, results that are more delicate to great correspondence and care moves, for example, readmissions, PLOS, and patient reports of \"yes, given release data,\" may possibly be early pointers of the effect of cutting edge EHR reception. Suggestions for hospital administration and nursing practice are obvious and consistent with best practice rules, recommending the engagement of nursing staff in the improvement, utilize, and progressing input of documentation frameworks and designation of assets for progressing preparing and frameworks assessment and change are important to advance the framework

Recommendation for Further Study/Action

This study was cross-sectional and correlations, connections, and relationship between factors of intrigue were inspected, however causality couldn\'t be determined. The accuracy of the PSI information was reliant on the documentation in the record and coding connected via prepared restorative coders; along these lines, inconsistencies in information and exactness could have existed at the healing center level. Methodologically, quiet reactions can\'t be connected transiently to particular doctor\'s facility EHR.