NURS 5051/NURS 6051: Transforming Nursing and Healthcare Through Technology

NURS 5051/NURS 6051: Transforming Nursing and Healthcare Through Technology

Introduction

As a visiting nurse, I heavily rely on my tablet, cellphone, and more recently telehealth. Patient care starts over the phone. At the start of my shift, I do not receive a report from the prior shift nurse. Instead, I begin collecting data by reviewing the electronic record, hospital discharge attachments, and initiating the initial conversation over the phone. Before even meeting the patient, I start “acquiring, processing, and generating information or knowledge” (McGonigle & Mastrian, 2018) about my patient and the plan for our visit. This initial data gathering phase is crucial for delivering effective care. It’s at this point that my brain essentially transforms into a computer, processing and organizing patient information for our upcoming visit.

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During my visits, I rely on my tablet for 100% of my documentation within the electronic health record. This includes using my work cellphone and a HIPAA-secure app to upload wound photos and legal documents directly into the patients’ electronic records, ensuring comprehensive and accurate documentation of each patient encounter.

My home health agency uses a system called “Homecare Homebase” for documentation and charting, and we are affiliated with Atrius Health, receiving many referrals from Lahey and Partners-owned hospitals and medical offices. However, these entities all use different software systems. Our lack of shared networks and software interoperability limits the full potential of my practice. It’s crucial for networks, agencies, educational institutions, and healthcare providers to collaborate on software solutions, understanding that the effective use of informatics tools goes beyond having the tools themselves—it’s about strategic utilization (Laureate, 2018).

Scenario

Let’s consider a scenario involving a patient named John Doe who was admitted to Lahey Hospital for fluid overload and heart failure exacerbation on a Sunday. During his hospital stay, he received IV Lasix, which led to an electrolyte imbalance. Upon discharge on Tuesday, the patient’s medications were changed, including oral diuretics and potassium supplements. I, as a visiting nurse, take over the patient’s care following hospital discharge. However, the medication reconciliation process becomes complex due to the lack of synchronization between my electronic health record system and those of the hospital and the patient’s primary care doctor and cardiologist. This results in multiple calls to these offices to align the patient’s medication regimen.

Subsequently, on Thursday, the patient visits his cardiologist for a hospital follow-up, and further medication adjustments are made based on recent lab results and patient symptoms. A second visiting nurse conducts a follow-up visit with the patient on Friday, providing additional education and a skilled assessment. During this visit, the patient informs the nurse about the cardiologist’s medication changes, but the patient couldn’t pick up the new prescriptions. This situation necessitates a call to the cardiologist to obtain a verbal order for updating the patient’s electronic medication record within the VNA system. Unfortunately, the VNA lacks access to EPIC, which is used by the hospital, primary care doctor, and cardiologist for noting visit details, medication changes, allergies, and lab results. This fragmented system creates challenges in delivering efficient and coordinated care.

Conclusion

The scenario described highlights a common issue within healthcare: the lack of interoperability and coordination among healthcare systems and software. To improve patient outcomes, it is imperative for hospitals, doctor’s offices, VNAs, and specialty teams involved in patient care to have a shared system for coordination and communication that ensures the continuity of care (Nagle, Sermeus, & Junger, 2017). Unfortunately, the current landscape makes it unlikely that software companies will collaborate to create universal communication and productivity software for the entire healthcare industry. Transforming nursing and healthcare through technology requires overcoming these interoperability challenges and streamlining communication to benefit both healthcare providers and, most importantly, the patients they serve.

References:

Laureate Education (Producer). (2018). Health Informatics and Population Health: Trends in Population Health [Video file]. Baltimore, MD: Author.

McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge. Burlington, MA: Jones & Bartlett Learning.

Nagle, L. M., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist. Studies in Health Technology and Informatics, 232, 212–221.