Nursing Informatics: Solving Interoperability Problems in EHR Systems

This report delves into the challenges of interoperability within healthcare delivery environments, focusing on the dissatisfaction nurses experience with electronic health record (EHR) systems. It identifies issues such as non-nursing specific systems, failure to meet clinical needs, poor usability, and lack of standardization as root causes of nurse dissatisfaction. The analysis highlights that current EHR systems often prioritize regulatory and billing purposes over direct patient care and nursing needs, leading to cumbersome documentation processes and hindering clinical thinking. Recommendations include extended EHR training for nurses, reduced patient loads during the learning phase, and a comfortable adjustment period for system adoption. The report emphasizes the importance of aligning EHR systems with nursing workflows and patient-centered care to enhance nurse satisfaction and improve overall healthcare outcomes. Desklib provides access to this and many other solved assignments for students.

Running head: NURSING INFORMATICS
Nursing Informatics
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Introduction- Nursing informatics closely integrates nursing science with the analytical
sciences and the information management for the identification, managing and communicate the
wisdom, information and knowledge into the nursing practice. Thus, it is important to note that
the true interoperability includes more than the exchange of information. Interoperability deals
with the ability to two or more systems to share and exchange information and also use the same
information. It has been noticed that the nurse satisfaction is low when they use the electronic
health record systems. The dissatisfaction of the nurses is due to the several factors and issues
occurring at the system level. The factors include the non-nursing specific systems, failure to
meet the requirements of the clinical needs, missing components, limited functionality, lack of
the standards, poor interoperability, non-integrated systems, poor systems usability, lack of user
training pertaining to the use of electronic health records (Staggers et al., 2018).
The nurse’s satisfaction related to the usability of the electronic health records (EHR) is
low considering the fact at the system level EHR poses several difficulties and issues. It has been
observed that the EHR systems fail to meet the clinical and the nursing needs. Another concern
associated with the use of EHR and its inability to capture the exact story either in the structured
or in narrative format. Nurses always complain regarding the utility of the EHR and wants the
EHR system to undergo major changes for it to become suitable in clinical nursing. Nurses need
a better tool that can cater to the needs of the patient centred care that will be intuitive and easy
for the healthcare providers (Lanier et al., 2017). It has also been noticed that the EHR systems
have only a few benefits due to the fact that the EHR systems are viewed as the data repositories
and do not promote patient care. EHR systems does not enhance the patient care and the large
volumes of the data and documentation does not have a direct impact on the outcome.

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Furthermore, the data collected through the EHR systems are not valuable for the frontline users
because they do not have any documentation (Foster &Sethares, 2017).
Analysis of the workflow and the identification of the root cause- Studies have indicated
that the information systems pertaining to the EHR does not work well with gathering, storing
and the presentation of the nursing knowledge (Lanier et al., 2017). Some of the electronic
systems that have been developed for the regulatory and billing purposes do not have any
usefulness in the field of nursing. For example, the nursing documentation is related to the
regulatory and accreditation and it has nothing to do with the differences in the
populations/families and patients. Nursing information systems have been developed for the
management of the hospital expenses and they are not based on the nursing needs (Miller et al.,
2014). The current information systems present in the EHR are incapable of supporting and
reflect several aspects of the nursing. Nurses face several issues related to usability of the EHR
systems. Majority of the time it has been highlighted by the nurses that the EHR systems have
multiple screens that hinder the clinical thinking, requires too many key strokes for recording
simple information, time consuming and a slow process. The interface design is also blamed and
there are issues with working and identification of the interdisciplinary documentation. It has
been seen that the process of documentation is duplicative and cumbersome which is even hard
to keep a chronological track (Topaz et al., 2016).
Recommendations- Length of the EHR training and usage-Both the novice and the
nurse managers can be asked to consider an extended period of EHR training for better usage
capabilities. The training will be provided at their current workplace and 24 hours of training
must be made a mandatory for the interested nurses (Lanier et al., 2017). Patient loading must
be reduced when learning EHR- The new nurses that will use the EHR systems are not

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pressurized and at the same time the patient care load is decreased (Palabindala,
Pamarthy&Jonnalagadda, 2016).Comfortable time when the EHR systems will be used- The
nurses must be given a 3-month period where they can comfortably learn the EHR systems
(Rosiak, 2012). Factors that influence the EHR skill and knowledge level- The more the
experience of a nurse the more the nurses are capable of learning the EHR system (Miller et al.,
2014).
Conclusion- from the above discussion it can be concluded that the nurse satisfaction is
low when they use the electronic health record systems. Nurses always complain regarding the
utility of the EHR and wants the EHR system to undergo major changes for it to become suitable
in clinical nursing. EHR systems does not enhance the patient care and the large volumes of the
data and documentation does not have a direct impact on the outcome.

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Reference
Foster, M., &Sethares, K. (2017). Current Strategies to Implement Informatics into the Nursing
Curriculum: An Integrative Review. On-Line Journal of Nursing Informatics, 21(3).
Lanier, C., Dao, M. D., Hudelson, P., Cerutti, B., &Perron, N. J. (2017). Learning to use
electronic health records: can we stay patient-centered? A pre-post intervention study
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