NURS 6051N Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

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NURS 6051N Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

Literature Review – The Use of Clinical Systems to Improve Outcomes and Efficiencies

Atasoy, H., Greenwood, B. N., & McCullough, J. S. (2019). The digitization of patient care:

a review of the effects of electronic health records on health care quality and

utilization. Annual review of public health, 40, 487-500.

Atasoy et al sought to, one, provide a base of understanding with regard to the impact of EHRs, and two, to present possible paths for research to improve clinical systems policy and propose research questions on digitization of health information and EHR design. The paper defined EHR as a digital medical chart that gathers, manages and shares digital information which can then be used to support decision making and clinical operations. Doing this on a computerized platform allows easy ability to update, store, retrieve and cross check data. Algorithms and functionalities such as clinical guidelines, medication administration applications, and treatment options can be embedded in the EHR system NURS 6051N Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies. These can then be used to check for drug-to-drug interactions and allergies, make alerts to care providers, prevent medical errors, and enable quick well-informed decision making, which contribute to patient safety, better time utilization and better quality of care.

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Atasoy et al did a thorough examination of the role that EHRs play in clinical settings and the impact they have on patients, care providers, medical decision making and clinical processes. The paper also has a rich literature review of the relationship between EHRs and healthcare quality. The discussion of EHRs, efficiency, and cost of care is also comprehensive. Atasoy et al also looked into the unintended outcomes of adopting EHRs. In as much as the paper succeeded in demonstrating positive outcomes of adopting EHRs, it is largely a qualitative study. As such there is a research gap for a quantitative study of similar nature and scope NURS 6051N Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies. However, the article is fit-for-use to inform further research and decision making by hospital administration and policy makers especially in parts of the world still lagging behind in digitizing health information.

Eltajoury, W. M., Maatuk, A. M., Denna, I., & Elberkawi, E. K. (2021, April). Physicians’

Attitudes towards Electronic Prescribing Software: Perceived Benefits and Barriers. In International Conference on Data Science, E-learning and Information Systems 2021 (pp. 47-53).

Eltajoury et al sought to understand the perception of physicians on the benefits and challenges associated with using e-prescribing software. The authors acknowledged that e-prescribing confers the benefits of enhanced personal and public care, reduced cost of medication, lower incidence of medication error, higher diagnostic accuracy, and more effective clinical and organizational processes. This was affirmed by literature review on the relationship between electronic prescribing and care outcomes. Eltajoury et al gathered data from a sample of 100 physicians and analyze it to establish doctors’ views of e-prescribing, whether it was the preferred prescribing method and why. It was found that physicians preferred using e-prescribing systems because of time-saving, reduced medical errors, the capacity to check for drug-to-drug interactions, all which aided in providing better service to patients. As a clinical system, e-prescribing supports effective decision making and implementation of care plans.

One strength of the study is it looked at an area that had been largely lacking in terms of research — physician perspective of e-prescribing. Eltajoury et al made good headway in addressing this issue and selected a suitably sized sample. The results of the study can be used in training sessions to improve acceptance of e-prescribing software where it is being implemented. Notably, physicians the world over face similar set of limitations when it comes to managing prescriptions and this study can serve a foundational role in research. One of the notable drawbacks of the study is its specificity in study population. NURS 6051N Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies It is true, there exists a gap in literature on physician’s perceptions to e-prescribing, but focusing on this limits the generalizability of the study to other populations in the clinical setting, notably patients.

Lee, J., & Choi, J. Y. (2021). Improved efficiency of coding systems with health information

technology. Scientific Reports, 11(1), 1-6.

Lee & Choi sought to investigate the impact of health information technology on the case mix index (CMI). The study was a longitudinal study conducted on a sample of 309 hospitals over a period of seven years. The main argument of the paper is that with the mandated use of EHRs in the United States, the opportunity exists for providers to change billing codes for patients and charge higher prices than warranted. The practice of data manipulation and improperly processing data to inflate prices is referred to as up-coding. Healthcare costs are reimbursed by insurers and up-coding leads to greater burden on insurance providers and society. Lee & Choi found that investing in health information technology (HIT) had a significant negative effect on the CMI. In essence, reduced reimbursements from insurance providers resulted from the adoption of EHR. Lee & Choi posited that this outcome is because of better coordination of care, lower incidence of medical errors and more accurate billing. Lower CMI translates to lower cost of care and lower burden on society.

Lee & Choi successfully arrived at the conclusion of improved efficiency of coding systems with adoption of health information technology. The study was comprehensive in its analysis of the relationship between adoption of health IT and efficiency of coding systems. The eventual cost implications are also well analyzed. However, the study focused on providers in California, United States. As such, the study may prove difficult to apply in other states and in other countries with different social, economic, legal and demographic parameters. More research is required for this NURS 6051N Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies.

Being a 7-year study with a large sample size, the results of the study have depth and are applicable to other healthcare organizations. The study can be used for reference by other researchers, and to inform decision-making by payers and policy makers. As noted above, there is need for further research to establish the nature of relationship between health information technology and coding systems in different communities, say, developing countries.

Zhu, C., & Zhang, J. (2019, December). Research on the Impact of Hospital Information

System Use on Doctors’ Job Performance. In 2019 3rd International Conference on

Education, Economics and Management Research (ICEEMR 2019) (pp. 500-503). Atlantis Press.

Zhu & Zhang sought to understand the impact of implementing a hospital information system (HIS) on the performance of doctors in China. From a theoretical perspective the paper added to the understanding of hospital information systems. On a practical level, the paper provided insight on how clinical systems influence the behavior of doctors and other frontline staff, which can aid the development of incentives to increase adoption and improve the performance of physicians. Zhu & Zhang looked at how perceived usefulness, customization, ease of use, and self-efficacy create a seamless health information system that leads to better work performance. The study collected data from a sample of 133 doctors and analyzed it to establish positive correlation between perceived value, customization, and self-efficacy to doctor’s performance. Perceived ease of use of a hospital information system was found to have no effect on system performance that leads to physician performance.

The study by Zhu & Zhang was well structured. Hypotheses are clearly stated, the sample size selected large and properly examined. The paper demonstrated the positive effect of heath information systems on work performance. In addition, the paper offered suggestions on the functional parameters a HIS needs to meet in order to have an impact. The authors successfully analyze different facets of a hospital information system that make it acceptable for use by, and contribute to the performance of, physicians. The paper contributes to the available research on health information systems, change management, and performance and thus can inform further study.

Conclusion

Health information systems are a critical part of contemporary healthcare provision. Healthcare information systems are computerized information systems that include electronic health records (EHRs), patient monitoring applications, e-prescribing, care application and billing systems. As shown above, healthcare information systems impact care provision by facilitating quick informed decision making, boosting work performance, incentivizing staff, reducing medication errors, medication administration, and lowering cost of care. These serve to improve quality and efficiency of care provision.

References