Application of Digital Health Record Systems in Hospitals and eHealth

This assignment, written by a nursing student, explores the application of digital health record systems (EHRs) in hospitals, focusing on a registered nurse's personal and professional reflection. The paper discusses the transition from paper-based to digital systems, highlighting the benefits such as improved efficiency and accessibility, while also addressing challenges like user-compatibility issues, potential for missed information, and the need for continuous learning in eHealth. The student utilizes the Gibbs Reflective Cycle to evaluate their experiences, analyze the advantages and disadvantages of EHRs, and propose strategies to enhance the integration of these systems into nursing practice, including incorporating practical training in the curriculum, promoting self-training, and providing support for novice nurses. The assignment references numerous studies to support the analysis and emphasizes the importance of nurses' perspectives in shaping the future of EHR systems, concluding that while EHRs offer significant advantages, addressing user-friendliness and providing robust IT support are crucial for their effective implementation.

Running head: DIGITAL HEALTH RECORDS
Application of digital record systems in hospitals and learning eHealth
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Introduction
The transition of traditional paper-based health record systems to the digitized electronic
health record system is increasingly being adopted in many hospital settings. Electronic
health record systems (EHR) provide a patient-centered chart in real-time in the digital form.
This chart consists of the patient’s medical history, diagnosis and pharmacological approach
of treatment, laboratory tests and radiology results (Evans, 2016). This paper focuses on the
application of digital records in hospitals and the necessity of adopting ongoing learning
regarding eHealth and reflects on the personal and professional reflection of a registered
nurse, its evaluation, analysis and strategies of the practice.
Personal and professional self-reflection
The adoption of digital health record system provides scope to enhance the quality and
delivery of clinical care in hospital settings. It requires continuity of learning the various
updates in applying eHealth practices. The electronic health record systems provide an
accessible channel to store all the information of a patient in one place and are increasingly
being adopted by various physicians and hospitals (Samuels et al., 2015). It has reduced our
efforts to maintain paper-based documents and storing these details in a folder. As it reduces
the effort of paperwork, it seems like a great idea in the beginning. However, with practice
and experience, I realized that these digital records are not very reliable as self-documented
health records as they are relatively new and all of its types have not been worked well.
While most of the relevant information is generally available in this kind of digital record,
some important details might get missed out which can affect the overall diagnosis of the
patient. However, we can experience similar issues in paper-based documents as well. Often,
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records are misfiled or sometimes lost by the nurses. I believe that a hybrid of the two both
digital and paper-based health record system is preferable for correct diagnosis.
As various hospitals and other professional settings are increasingly adopting the use of EHR,
I believe that it is of utmost urgency to learn and update our knowledge of eHealth and digital
record systems. It is because registered nurses like us have a significant role in providing
healthcare and managing the treatment plan and progress of the patients. I believe EHR to be
handy as it saves considerable time in documenting the patient-related notes which can be
utilized for other purposes such as patient monitoring. I find the EHR system particularly
beneficial as it enables communication with the pharmacy, makes clinical documentation
screens, calculators and educational documents regarding drugs and clinical data easily
accessible. Another fascinating feature of the EHR system is that it allows us to observe
trends in the clinical information over a specific duration of time and enables interoperability
among different medical devices which make the EHR system highly useful.
However, I find it difficult to understand some features and specific aspects of the
functionality of this digital health record system. Firstly, it is confusing to document patient
assessments and the care treatment provided as there are multiple places of storing similar
information. For instance, there is wounds skin integrity, and the questions asked include if
there are any abnormality and its location but again, the same documentation is asked during
wound dressing. Hence, it gets confusing as to the same question being asked twice. Clarity
on the same is required. Therefore, I believe that professional training and an ongoing
learning practice regarding the developments in eHealth is necessary for each nurse.
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Evaluation
Nurses constitute the most extensive section of the healthcare sector utilizing the electronic
health record system. This reason makes the perceptions and attitudes of the nurses towards
the application of the digital record systems of prime importance. Various studies have been
conducted to record the perceptions and confidence of nurses in using electronic health
systems. One of the studies depicted a comprehensive quantitative correlation between the
characteristics of nurses and their acceptance of digital medical records. It displayed an
overall positive response from the nursing population in the use of EHR systems (Kim et al.,
2015). A study conducted by Abu Raddaha (2018) suggested that although about half of the
nurse population in the study were confident regarding their use of the digital medical record
system, appropriate training and guidance is required to use the system, particularly among
the nurses with less professional experience. Nurses with significant experience did not face
much trouble in using these electronic records.
Moreover, a quantitative study supported the design-related challenges faced in using
electronic record devices despite its advantage of reducing the time invested in documenting
paper-based records of the patient. It states the perceptions of various nurses and implies that
the EHRs available at present lack adequate design to aid the healthcare professionals in
utilizing these systems successfully (Strudwick et al., 2018). In conjunction, nurses viewed
EHR as a time-saving alternative to the traditional paper-based documentation. However, the
same study reveals that some sections of the nurses also found this system chaotic due to
excessive scrolling to find suitable data and unreliable due to incomplete details of the patient
which might be relevant for precise diagnosis. An attempt was made by the IT department to
resolve this issue by increasing the user-compatibility for its efficient use (Zadvinskis, Smith
& Yen, 2018). Another challenge noted in the application of the digital record systems was
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the frequent miscommunication observed in the transfer of information. With the
implementation of these electronic systems, many departments stopped the use of telephonic
handoffs which often missed important information. Moreover, it also led to variations in the
standards of documentation and individual prescribers did not store the patient assessment
information instantly. It resulted in significant trouble for the nurses and they demanded
standard policies and documentation practices to eliminate cross-professional
communication.
Analysis
From the various studies discussed above, it can be generalized that the electronic health
record system received a positive response with a few challenges. The information of the
patient on suitable assessment collected and stored by the registered nurses in the electronic
system is vital to develop the most appropriate plan of care. It can also be analysed that these
digital health records are easy-to-use and learn and conform to the nurses’ daily work
schedule. It eases the tedious task of documenting the records on papers and maintaining
these documents in files. It is believed to improve the daily performance of about 77.5% of
the nursing population. (Raddaha, 2017). It was also observed that increasing experience
improves clinical nursing performance in the use of the EHR system. Continuous learning of
the developments in the practices of eHealth is mandatory for nurses, particularly beginners.
Extensive training will also build the confidence of the nurses in effectively utilizing the
technology. Also, the suggestions and opinions on the experiences shared by the diverse
populations of nurses can be taken into consideration when the informatics team customizes
the EHR system. The overall positive response that can be analyzed by the use of electronic
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health records is improvements in efficiency, communication and safety, as stated by the
nurses (Nelson & Staggers, 2016).
Moreover, training on the continuous developments in practices of eHealth can be integrated
into the nursing education to enhance the patient-centered approach of care. It ensures
quality, safety and continuation in the process of care. Also, it is essential that nurses across
the hierarchy including nurse managers, nurse executives and clinical nurses, must be
considered in the decisions regarding health informatics decisions. They can provide more
precise modifications in the system for enhanced performances (Daly, 2015). Another
drawback which can be analysed is that adequate support and backup from the IT is not
readily available. In some instances of technical errors, even the IT personnel failed to
address and resolve the issue (Forrest et al., 2014). This issue led to delays in the treatment
processes of some patients. Overall, the negative responses can be summed up as the EHR
systems lacking sufficient user-compatibility and flexibility in keeping up with the pace of
work of the nurses.
Strategies for practice
As students transition into registered nurses, they face several issues, some of which include
theoretical knowledge to practical application, patient assessment expertise, documentation
skills and performance anxiety. As the use of electronic health record systems is growing and
being adopted in various healthcare settings, it is crucial to incorporate practical training on
the same in the nursing curriculum. This system enhances the ability of the nurse to use these
digitally-driven records in their professional careers. A theoretical knowledge only on the
subject will not give the hands-on training to apply the EHR system practically. Also, another
strategy that the students' nurses or registered nurses at the beginning level can inculcate is
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self-training on the use of the EHR system and eHealth practices. They need to stay updated
with the latest developments in technology to provide optimum care to their patients (Habibi-
Koolaee, Safdari & Bouraghi, 2015). A third strategy can be incorporated in improving the
practical experience of novice nurses in their eHealth and EHR practices. This strategy is to
be applied by the healthcare organization for the benefit of the newly appointed nurses. These
novices should be given less workload for them to adapt to the environment and provide
enough time to get compatible with the EHR system being used in the healthcare setting. This
is because each organization utilizes different types for digital record systems which might be
different from the ones that the novices have been trained on (Thomas, Seifert & Joyner,
2016). This time can be considered as an extended training period for the nurse. Thus, an
integration of these specific strategies to develop a positive response and experience of the
registered nurses recently transitioned from students in the application of electronic records in
their workplaces.
Conclusion
In conclusion, an analysis of the positive responses and the challenges presented provides an
overall scenario of the use of electronic health record systems and eHealth practices within
the nursing profession. Gibb’s reflective cycle helps in self-analysis and assessment upon the
events occurring in the work environment and the requisites in the developments of the
current expertise and extending the scope for learning to avoid medical errors in the delivery
of care (Edwards, 2017). Based on the various studies discussed above, it can be summarized
that EHRs have made the daily tasks of the nurses more efficient and saves the time incurred
in documentation which is of great benefit to the nurses. However, it presents some
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challenges as well, including reliability concerns, missing out of information and user-
compatibility issues which has kept the use of EHR systems a debatable issue.
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References
Abu Raddaha, A. H. (2018). Nurses’ perceptions about and confidence in using an electronic
medical record system. Proceedings of Singapore Healthcare, 27(2), 110-117.
https://doi.org/10.1177/2010105817732585
Aldosari, B., Al-Mansour, S., Aldosari, H., & Alanazi, A. (2018). Assessment of factors
influencing nurses acceptance of electronic medical record in a Saudi Arabia
hospital. Informatics in Medicine Unlocked, 10, 82-88.
https://doi.org/10.1016/j.imu.2017.12.007
Daly, P. (2015). Clinical nurses lead the charge with EHR. Nursing2019, 45(10), 25-26.
10.1097/01.NURSE.0000471426.47075.d2
Edwards, S. (2017). Reflecting differently. New dimensions: reflection-before-action and
reflection-beyond-action. International Practice Development Journal, 7(1).
http://dx.doi.org/10.19043/ipdj.71.002
Evans, R. S. (2016). Electronic health records: then, now, and in the future. Yearbook of
medical informatics, 25(S 01), S48-S61. 10.15265/IYS-2016-s006
Forrest, G. N., Van Schooneveld, T. C., Kullar, R., Schulz, L. T., Duong, P., & Postelnick,
M. (2014). Use of electronic health records and clinical decision support systems for
antimicrobial stewardship. Clinical Infectious Diseases, 59(suppl_3), S122-S133.
https://doi.org/10.1093/cid/ciu565
Habibi-Koolaee, M., Safdari, R., & Bouraghi, H. (2015). Nurses readiness and electronic
health records. Acta Informatica Medica, 23(2), 105. 10.5455/aim.2015.23.105-107
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Kim, S., Lee, K. H., Hwang, H., & Yoo, S. (2015). Analysis of the factors influencing
healthcare professionals’ adoption of mobile electronic medical record (EMR) using
the unified theory of acceptance and use of technology (UTAUT) in a tertiary
hospital. BMC medical informatics and decision making, 16(1), 12.
https://doi.org/10.1186/s12911-016-0249-8
Nelson, R., & Staggers, N. (2016). Health Informatics-E-Book: An Interprofessional
Approach. Elsevier Health Sciences.
Raddaha, H. A. (2017). Nurses’ characteristics and perceptions toward using the electronic
health record system as predictors of clinical nursing performance
improvement. Clinical Nursing Studies, 5. 10.5430/cns.v5n4p32
Samuels, J. G., McGrath, R. J., Fetzer, S. J., Mittal, P., & Bourgoine, D. (2015). Using the
electronic health record in nursing research: Challenges and opportunities. Western
journal of nursing research, 37(10), 1284-1294.
https://doi.org/10.1177/0193945915576778
Strudwick, G., McGillis Hall, L., Nagle, L., & Trbovich, P. (2018). Acute care nurses’
perceptions of electronic health record use: a mixed method study. Nursing
Open, 5(4), 491-500. https://doi.org/10.1002/nop2.157
Thomas, T. W., Seifert, P. C., & Joyner, J. C. (2016). Registered nurses leading innovative
changes. OJIN: The Online Journal of Issues in Nursing, 21(3).
10.3912/OJIN.Vol21No03Man03
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Zadvinskis, I. M., Smith, J. G., & Yen, P. Y. (2018). Nurses’ experience with health
information technology: Longitudinal qualitative study. JMIR medical
informatics, 6(2), e38. 10.2196/medinform.8734
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