The role of nurses in selecting computerized healthcare management systems

Computerized management systems truly represent the future of healthcare. The benefits of computerized systems should be obvious: they streamline efficiency, minimize mistakes and generally make the delivery of care faster and safer. The reduction of medical mistakes is nothing to underestimate: if computerized management systems can create a scenario where there are fewer medication errors or dosing errors, that would be a tremendous win for the entire healthcare industry. This is particularly important to pay attention to, as the implementation of computerized management systems generally represent a formidable investment. There's the cost of software not to mention the time required to spend training members of staff on how to use it properly. Though this investment of time and money should not deter members of the healthcare arena from implementing computerized medical records. This is a result of the fact that study after study has documented concerns about the quality of U.S. health care, particularly the occurrence of adverse events, such as injuries sustained by patients as a result of their care -- the most of which are attributable to mistake from medication or medial errors (Doolan & Bates, 2002). Thus, the benefits of computerized management systems should be overwhelming.

However, when it comes to selecting a particular computerized management system, hospitals definitely have a wealth of choices. As one healthcare professional as commented, "Big hospital selections nearly always involve Cerner and Epic as finalists. In most cases I've heard of lately, Epic wins. Few would have expected that back in 2002 or so, when Epic suddenly roared out of the ambulatory systems market with a vengeance, much like Cerner exploded out of its lab system roots to dominate the world (at least just behind Meditech" (HIStalk, 2007). Such commentary is just an opinion; many people would wager just the opposite, that Cerner beats Epic. Regardless, what such remarks reflect is just how close these two systems come, and how truly neck and neck they are when it comes to preference and domination in the healthcare arena.

B. Necessity of Nurse Involvement

Given the rivalry between the two dominant systems (Epic and Cerner) and given the sheer volume of choices available to those in the medical field, it truly is crucial that nurses play an active role in the planning, choice and implementation of such computerized systems. One of the most obvious reasons for the necessity of the involvement of nurses is connected to the fact that nurses are on the front lines of patient care. Nurses have the most accurate snapshot of the most pertinent needs of patients and the most pertinent information they as nurses need to have at their fingertips. Thus nurses are truly crucial people in the planning and selection process. Nurses have the most relevant idea as to what type of program would be the most beneficial to them.

Furthermore, the bulk of what such systems are capable of doing generally orbit around the needs of the nurse. For example, nurses are so heavily involved in the information processing and communication of patient care (as are all clinicians, though nurses more so). Nurses are the ones who are responsible for obtaining and recording information about patients, communicating with other clinicians, finding relevant medical literature, choosing particular diagnostic processes, viewing lab results and gathering clinical research data (Kaminski, 2010). The right computerized management system allows one to harness technology to speed up all these tasks and make them error-free by providing a digitally stored pile of appropriate literature along with statistics and relevant data to help nurses assist in decisions and to offer a language for nurses to engage in recording and planning individual client care (Kaminski, 2010).

C. Nurses and Handheld Devices

One simply cannot underestimate the sheer benefit of handheld devices to nursing work. Such devices allow a wealth of information to be reached easily to a nurse's fingertips. For instance, patients lists are uploaded to these handheld gadgets, providing the nurse with the opportunity to choose a patient from a drop-down menu, rather than search from a list (Birz, 2006). Vital labs are spotlighted, bringing a nurse's attention to the results and other critical information (Birz, 2006). Data from the facility's patient information is uploaded, along with tools like a neonatal drug database, and drug interaction data (Birz, 2006). Many of these devices also come equipped with dose calculators so that the nurse can triple check the doses prescribed by the doctor and pharmacist (Birz, 2006). All of these devices also have access to the Internet, affording the nurse the ability to read information and nursing webpages regarding questions and the latest research; some PDAs can even send information to one another (Birz, 2006). Fundamentally, this breaks down to a higher level of patient care. "Having the patient data available at the bedside allows the nurses to have more rapid access to the results… McCleery shared a recent experience. One of the babies she was treating had a head ultrasound. The baby's mom was understandably anxious to get the results. McCleery was able to use her PDA to access the results from the bedside and immediately provide the results to the mom" (Birz, 2006). PDAs allow nurses to be more effective at their jobs by ensuring that nurses don't spend a lot time looking for results or research: there's simply more time to spend with patients, which generally translates to a higher level of care received and more satisfied patients.

E. New Systems Healthcare Cost

Those who are not well acquainted with the tremendous benefits that computerized health systems can provide the field see them simply as costly investments. One must not mistake: these systems are indeed costly and for many healthcare facilities they represent a costly investment. However, looking at the long-term picture, one sees that they pay for themselves and they end up being worth every penny. This is apparent even just by looking at the most basic studies. One study funded by the AHRQ examined the impact of something simple: an antibiotic consultant program (ahrq.gov). This program "…recommended the appropriate medication regimen for hospitalized patients 94% of the time, compared with the 77-percent success rate for physicians. The average cost for 1 day of therapy selected by the antibiotic consultant was $41.08 per patient, compared to $51.93 for the antibiotics prescribed by physicians. The majority of physicians who used the antibiotic consultant said they would recommend it to other physicians (88%), felt that it helped them select the proper antibiotics (85%), and believed that it improved patient care (81%)" (ahrq.gov). A short-sighted individual would simply look at the overall cost of the program and see it as something which was fundamentally raising the cost of healthcare. However, someone who was more attuned to the potential long-term benefits can clearly see that such a program lowers the cost of healthcare for everyone because it helps to prevent costly mistakes which ultimately end up making healthcare more expensive.

F. Benefits of the New Systems

The benefits to patient care that these new systems can offer truly are unparalleled. Patient care improves when nurses are truly empowered to do their best work. Computerized systems can help nurses to do their jobs even better, cutting out tedious work, allowing them to access information more efficiently and giving them the ability to make strong decisions based on cutting-edge information. Improvements in the level of care, the level of safety, the facility's efficiency, the access to data and reduced cost all happen when clinicians can make "timely, accurate, evidence-based decisions at the point of care" (Elsevier). Computerized data systems create a sophisticated tool set to make sure that the most pertinent information is there when clinicians need it, making sure that clinicians engage in the necessary processes.

Recommendation

The system that the team should purchase is without question, the Epic system. This system was one of the pioneers of computerized health systems. It believed in digitizing all relevant information way before it was a trend in the industry. This company realized long before others that "the way this data is stored and used can literally be a matter of life and death -- which is why the transition to electronic health records is so sensitive. And why it's so important, Ms. Faulkner says. Computerized record systems can actively search for and analyze information in ways that paper files never can, thereby improving patients' health" (Freudenheim, 2012). The Epic system is far more intuitive than others, allowing for the training of staff members on this system to be easier and faster. It allow for a more stream-lined process of using and accessing information which will be more valuable to the team in the long run.