The Pros and Cons of Electronic Health Records and Clinical Decision Support Technologies

Technology in Healthcare: Electronic Health Records and Clinical Decision Support

Today, health information technologies are serving a critical role in promoting optimal clinical outcomes and advancing healthcare in a rapidly changing world (van Velzen et al., 2023). Indeed, these technologies are instrumental in facilitating seamless transdisciplinary communication among healthcare providers, streamlining patient data management, and fostering data-driven decision-making. The purpose of this paper is to provide a brief description of the process used for selecting an information system solution and why is it important for nurses to be a part of the process. In addition, an evaluation concerning the types of health information technology that are currently used in my current organization and a discussion about the respective pros and cons of the software are followed by a summary of the research and key findings in the conclusion.

Review and Discussion

Process used for selecting an information system solution

Although the process used by my organization to select health information technologies was coordinated by the information resources management services, it is essential for nurses to be actively involved in selecting these systems for multiple reasons. For instance, nurses play a central role coordinating patient care across specialties and communicating both with patients and within the care team. Likewise, as frontline providers, nurses have valuable insights into current workflow needs and challenges that new systems might exacerbate or help alleviate. They understand intimately how clinical and administrative processes interact. Therefore, nurses should have a seat at the table early on when evaluating potential health IT investments and new technologies.

As the healthcare professionals that will actually be interacting with programs such as electronic patient records, e-prescription, and point of care systems daily, nurses can assess the actual intuitiveness and user-friendliness of these technologies (van Velzen et al., 2023). Their experience identifying existing inefficiencies or potential technology gaps makes them essential contributors weighing in on system design and implementation issues such as legacy system migrations, security compliance, and mobile capabilities, issues that have assumed new importance and relevance in recent years as patient autonomy and privacy are central issues of concern.

In addition, taking nursing knowledge, concerns and priorities into account during the selection process also promotes staff buy-in and trust in the adoption of the systems that are ultimately selected for use. Likewise, soliciting feedback from nurse system end users also serves to ensure that any solutions under review match and serve their real-world priorities by positively impacting healthcare delivery and relationships. In essence, ensuring that nurses have a voice in the healthcare IT decision making process leverages their valuable insights to select the optimal technologies that are best positioned to complement and improve nursing practice and patient care.

Evaluation of my organization’s health information technologies

At present, my organization uses integrated electronic health records (EHR) software and supplemental clinical decision support (CDS) technologies, among others. According to the definition provided by the Office of the National Coordinator for Health Information Technology, “An electronic health record (EHR) is a digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users” (Electronic health records, 2023, para. 2). In fact, of all the current healthcare technologies that are in place across the country, EHRs are among the most ubiquitous.

On the one hand, these technologies have generated meaningful improvements in patient care and clinical outcomes, but they are also characterized by a number of constraints to nursing workflows. Some of the main EHR benefits include streamlined medication administration charting and vital sign documentation that reduces paperwork and offers real-time data accessibility. On the other hand, though, and as noted above, rigid documentation templates and fragmented data views between specialty applications undermine some efficiency gains (Susanto et al., 2023). For example, according to Khan et al. (2022), “The amount of time spent on the EHR is often cited as a contributing factor to burnout and work-related stress in nurses. Increased electronic health record use also reduces the time nurses have for direct contact with patients and families” (p. 44).

Not surprisingly, the labor-intensity of early EHR systems compelled vendors to upgrade these systems to reduce the amount of time that was required for nurses to use them efficiently. In this regard, Khan et al. (2022) emphasize that, “Significant improvements in EHR interoperability have decreased much of the manual data entry required by health care providers since the establishment of electronic documentation systems in 1992” (p. 45). Nevertheless, many nurses, especially those working in specialty units, still spend an inordinate percentage of their time using EHR systems (Khan et al., 2022).

With respect to clinical decision support tools, these technologies provide a number of benefits for nurses, including medication interaction alerts and sepsis screening protocols that are based on vital signs which promote safer, protocolized care (Jimenez-Zambrano et al., 2023). Indeed, a study by Stephen et al. (2023) reports that a sepsis alert system was implemented using a hospital’s CDS tools was effective in generating 264 separate sepsis alerts among 173 non-ICU patients during the period from 2020 to 2021. Based on these findings, Stephen and his associates (2023) recommend the use of CDS tools by nursing staff for sepsis and other alerts based on dynamic patient data measures.

Notwithstanding these significant benefits, however, similar to the parable about the “boy who cried wolf,” nurses also face alert burnout due to lack of context-filtering. Likewise, based on empirical observations and personal use, it is reasonable to suggest that a majority of the communications generated by CDS and EHR tools remain primarily physician-centric as well. Therefore, it is important for healthcare organizations considering the adoption or refinement of these technologies to provide timely, ongoing, substantive training and demand-driven refinement to optimize their usability by nurses at the point of care (Harmon et al., 2023).