Systematic Review on Electronic Health Record Related Disparities in Australian Healthcare Facility

A systematic review on Electronic Health Record related
disparities in Australian healthcare facility
ABSTRACT
BACKGROUND
Maintenance of electronic record system not only reduces the rate of medication
error but also helps the nursing professionals to take proper care of the patients and
provide them with the complete knowledge of their health status using the electronic
data so that they can use their details in any health system in the country or outside.
However, for the systematic review, this following PICO question could be used for
their identification and determination of the system and its benefit for patients and
healthcare facilities.
• Population: the registered nurses who are unable to understand the proper use of
EHR
• Intervention: intervention will be providing training and education
• Comparison: compared to the strict or other interventions
• Outcome: positive outcome that they all can use this technology properly.
The PICO question will be: Can educational and training intervention increase the
compliance level of registered nurses so that they can use the EHR system properly
compared to other interventions?
OBJECTIVES
• A systematic literature review was conducted in order to understand the
importance of maintaining medication recording for patient safety. The objectives
were listed as the following:
• To identify a proper strategy to reduce the medication error related to EHR within
the hospital setting
• To elucidate the challenges with respect to stringent electronic record related
compliance practices
• To identify the incidents in which electronic medication record should be
performed on a mandatory basis
METHODS
• In order to conduct the systematic review, a detailed search strategy was used and
search was carried out on research databases such as CINAHL, Google scholar and
PubMed. The search was conducted including the inclusion and exclusion criteria.
In which, the inclusion criteria involved complete and detailed search on papers
published in the English language and between 2012-2018, on the other hand, the
exclusion criteria helped to excluded the papers that were published in other
languages and before 2012. In order to critically appraise the research studies the
CASP tool was used.
RESULTS
• Most of the healthcare facility suffer from he EHR related medication error and majority of these are due
to the inability of the health professionals in the process (Middleton et al. 2014)
• Comparing the global health scenario, 50% of the health care organizations fail to comply with the EHR
related policies and guidelines (Roughead, Semple and Rosenfeld 2016)
• Lack of awareness among health care professionals about the importance of maintaining electronic
health record has been reported to be a primary cause for the electronic health record related
mediational error however awareness and training by supervisors have yielded positive outcome (Menon
et al. 2014)
• More than 50% of the professionals do not know the correct method of using healthcare EHR system
(Roughead, Semple and Rosenfeld 2016)
• Maintenance of proper EHR system can help in the decrease of medication error within the hospital
setting up to 50% (Meeks et al. 2014)
RESULTS
CONCLUSIONS
• Hence, it can be concluded that the medication error related to the EHR system
and its usage can be controlled to a considerable level with proper implementation
of effective training programs to educate about electronic health record system
• Health care organizations must ensure on a mandatory basis that professionals
comply with the data collection and register related guidelines.
• It has been reported as per the data of Australian Bureau of Statistics (2018) that
the rate of mediational error in the healthcare facilities of Australia is around
37.5% and the rate of EHR related disparities are around 41% of it (Gilmartin,
Hussainy and Marriott 2013). Therefore, maintenance and proper usage of the
health record system is important for the registered nurse involved in the care
process for the patients. Further, it has also be noted that majority of the
healthcare professionals are unable to use the EHR system properly due to their
lack of knowledge about the system. Hence, 5 out of 10 nursing professionals are
unable to comply with the recording system related aspects and leading to the
quality degradation of medication record for each of the patients (Roughead,
Semple and Rosenfeld 2016).
• The major reasons that have been identified in health care professionals as
obstacles to maintain maintaining the EHR system includes, lacking awareness
about the system, use of paper, hard copy of registers and others for the
identification and generation of managing the workstation (Menon et al. 2014)
• Further it has also been mentioned that professionals must understand the system
prior to make any record in the EHR system and hence, they provided with the
educational training to make this intervention successful (Roughead, Semple and
Rosenfeld 2016)
PRISMA 2009 Flow Diagram
PRISMA 2009 Flow Diagram
REFERENCES
AMIA. Journal of the American Medical Informatics Association, 20(e1), e2-e8.
Gilmartin, J.F.M., Hussainy, S.Y. and Marriott, J.L., 2013. Medicines in Australian nursing homes: a cross-sectional
observational study of the accuracy and suitability of re-packing medicines into pharmacy-supplied dose administration
aids. Research in Social and Administrative Pharmacy, 9(6), pp.876-883.
Menon, S., Singh, H., Meyer, A. N., Belmont, E., and Sittig, D. F. (2014). Electronic health record–related safety concerns: a
cross sectional survey. ‐ Journal of Healthcare Risk Management, 34(1), 14-26.
Meeks, D. W., Smith, M. W., Taylor, L., Sittig, D. F., Scott, J. M., and Singh, H. (2014). An analysis of electronic health
record-related patient safety concerns. Journal of the American Medical Informatics Association, 21(6), 1053-1059.
Middleton, B., Bloomrosen, M., Dente, M. A., Hashmat, B., Koppel, R., Overhage, J. M., ... and Zhang, J. (2013). Enhancing
patient safety and quality of care by improving the usability of electronic health record systems: recommendations from
Roughead, E. E., Semple, S. J., and Rosenfeld, E. (2016). The extent of medication errors and adverse drug reactions
throughout the patient journey in acute care in Australia. International journal of evidence-based healthcare, 14(3-4),
113-122.