week 2 reply
Professor and class,
I have been lucky enough to work with three different EHR systems between clinical and my current job in the ED. I have been able to compare and contrast the pros and the cons between the EHRs’ and their health information systems. Upon starting in my ED a year and a half ago I was originally oriented to the EHR called Cerner. I really enjoyed this EHR as I felt that the HIS worked well at providing safe and efficient patient care. The allergies and current patient medications came up as a “to-do” flag within each patient upon admission. This ensured that the nurse was able to check off what the patient may have already taken that day, or what they may be allergic to before giving a patient a medication. After entering the patients history it was then documented in a place that was easy for the doctors and pharmacy to locate in order to enter and verify medications. This allowed for three different healthcare professionals to verify that this patient would be getting a medication that was safe for them. I now work with the EHR “Epic.” Although I like EPIC a lot, I feel that there are some flaws with it’s HIS system. I did some research, and found a study on the effectiveness of healthcare information systems throughout the city of Neyshabur in 2019. “Despite great effort to develop and utilize HISs and improve their effectiveness in improving patient care, the present study indicated an index of 64.42 out of 100 and reflected that there was still a gap to complete effectiveness” (Mohammadpour et al., 2021). They found many gaps in the staffs’ understanding on how to gather and implement data in order to form safe and efficient interventions for each patient. I find that, with EPIC, it is easier to be quickly inputting data within the ED and forget to acknowledge the patients prior history and allergies as the system does not prompt you to do so (at least with the version of EPIC that we have). With that being said, it is easier for medication errors to happen. I also feel that EPIC does not communicate with the PYXIS (medication administration station) as well as it could. With Cerner it would not let you scan a medication in to give it to a patient if it was not physically ordered within the chart. In Epic it will let the nurse scan any medication into the chart, and will open the medication up under a “non-ordered” medication admin panel. If not paying attention, this could make for a huge medication error in the ED as we mainly pull potentially dangerous medications on override when in emergent situations. Lastly, with Epic patients now have 24/7 access to their health chart. They can view and screenshot their labs, meds, appointments etc. This is exciting for the patient as they are able to easily access appointment changes, and medication requests through all of their HCP. “Astute nurses need to be familiar with these advantages and disadvantages so that they can advise patients correctly” (Chamberlain College of Nursing, 2020). The nurse should be able to properly advise the patient on how to interpret their laboratory values. It is important for the patients to be educated on the need to speak with the HCP after getting new laboratory results before coming to their own conclusions. A struggle that I have seen through my ED is that we will be very busy and start what we call protocols in the waiting room. This is where the nurse draws the patients blood without them being sent to a room yet in order to speed up their care. This ensures we see the sickest patients as soon as possible. The patients will then get these results back while in the waiting room, and google them. This allows some patients extreme health anxiety while in the waiting room, and on the other hand will result in patients leaving without treatment as they feel whatever results they got back were “good enough to go home.” These three things have made the transition from Cerner to Epic negative for me, but I feel as though my nursing supervisor actively works on any complaints that we have regarding the transition we are having as a hospital. Epic has a lot of different versions and updates and through our feedback we are working out all of the “kinks”. This makes the transition into a new EHR less scary, and more positive, as I always think back to how much technology has the potential to upgrade as we identify areas in need of change. I feel that technology is very important in healthcare as it allows for quick and “easy” access to patient records, but there will always be room for improvements which means that nurses need to be that more cognizant of the potential of errors.
Resources
Mohammadpour, A., Ghaemi, M. M., Darrudi, R., & Sadagheyani, H. E. (2021). Use of Hospital Information System to Improve the Quality of Health Care from Clinical Staff Perspective.
Galen medical journal. DOI:
10.31661/gmj.v10i0.1830
Chamberlain College of Nursing (2020).
NR361 Information Systems in Healthcare: Downers Grove, IL: Online Publication.
