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Kariotis TC, Prictor M, Chang S, Gray K. Impact of Electronic Health Records on Information Practices in Mental Health Contexts: Scoping Review. J Med Internet Res 2022; 24:e30405. [PMID: 35507393 PMCID: PMC9118021 DOI: 10.2196/30405] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 09/14/2021] [Accepted: 01/13/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The adoption of electronic health records (EHRs) and electronic medical records (EMRs) has been slow in the mental health context, partly because of concerns regarding the collection of sensitive information, the standardization of mental health data, and the risk of negatively affecting therapeutic relationships. However, EHRs and EMRs are increasingly viewed as critical to improving information practices such as the documentation, use, and sharing of information and, more broadly, the quality of care provided. OBJECTIVE This paper aims to undertake a scoping review to explore the impact of EHRs on information practices in mental health contexts and also explore how sensitive information, data standardization, and therapeutic relationships are managed when using EHRs in mental health contexts. METHODS We considered a scoping review to be the most appropriate method for this review because of the relatively recent uptake of EHRs in mental health contexts. A comprehensive search of electronic databases was conducted with no date restrictions for articles that described the use of EHRs, EMRs, or associated systems in the mental health context. One of the authors reviewed all full texts, with 2 other authors each screening half of the full-text articles. The fourth author mediated the disagreements. Data regarding study characteristics were charted. A narrative and thematic synthesis approach was taken to analyze the included studies' results and address the research questions. RESULTS The final review included 40 articles. The included studies were highly heterogeneous with a variety of study designs, objectives, and settings. Several themes and subthemes were identified that explored the impact of EHRs on information practices in the mental health context. EHRs improved the amount of information documented compared with paper. However, mental health-related information was regularly missing from EHRs, especially sensitive information. EHRs introduced more standardized and formalized documentation practices that raised issues because of the focus on narrative information in the mental health context. EHRs were found to disrupt information workflows in the mental health context, especially when they did not include appropriate templates or care plans. Usability issues also contributed to workflow concerns. Managing the documentation of sensitive information in EHRs was problematic; clinicians sometimes watered down sensitive information or chose to keep it in separate records. Concerningly, the included studies rarely involved service user perspectives. Furthermore, many studies provided limited information on the functionality or technical specifications of the EHR being used. CONCLUSIONS We identified several areas in which work is needed to ensure that EHRs benefit clinicians and service users in the mental health context. As EHRs are increasingly considered critical for modern health systems, health care decision-makers should consider how EHRs can better reflect the complexity and sensitivity of information practices and workflows in the mental health context.
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Affiliation(s)
- Timothy Charles Kariotis
- School of Computing and Information Systems, University of Melbourne, Parkville, Australia
- Melbourne School of Government, The University of Melbourne, Carlton, Australia
| | - Megan Prictor
- Melbourne Law School, University of Melbourne, Carlton, Australia
- Centre for Digital Transformation of Health, University of Melbourne, Parkville, Australia
| | - Shanton Chang
- School of Computing and Information Systems, University of Melbourne, Parkville, Australia
| | - Kathleen Gray
- Centre for Digital Transformation of Health, University of Melbourne, Parkville, Australia
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Zurynski Y, Ellis LA, Tong HL, Laranjo L, Clay-Williams R, Testa L, Meulenbroeks I, Turton C, Sara G. Implementation of Electronic Medical Records in Mental Health Settings: Scoping Review. JMIR Ment Health 2021; 8:e30564. [PMID: 34491208 PMCID: PMC8456340 DOI: 10.2196/30564] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/15/2021] [Accepted: 07/22/2021] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND The success of electronic medical records (EMRs) is dependent on implementation features, such as usability and fit with clinical processes. The use of EMRs in mental health settings brings additional and specific challenges owing to the personal, detailed, narrative, and exploratory nature of the assessment, diagnosis, and treatment in this field. Understanding the determinants of successful EMR implementation is imperative to guide the future design, implementation, and investment of EMRs in the mental health field. OBJECTIVE We intended to explore evidence on effective EMR implementation for mental health settings and provide recommendations to support the design, adoption, usability, and outcomes. METHODS The scoping review combined two search strategies that focused on clinician-facing EMRs, one for primary studies in mental health settings and one for reviews of peer-reviewed literature in any health setting. Three databases (Medline, EMBASE, and PsycINFO) were searched from January 2010 to June 2020 using keywords to describe EMRs, settings, and impacts. The Proctor framework for implementation outcomes was used to guide data extraction and synthesis. Constructs in this framework include adoption, acceptability, appropriateness, feasibility, fidelity, cost, penetration, and sustainability. Quality assessment was conducted using a modified Hawker appraisal tool and the Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. RESULTS This review included 23 studies, namely 12 primary studies in mental health settings and 11 reviews. Overall, the results suggested that adoption of EMRs was impacted by financial, technical, and organizational factors, as well as clinician perceptions of appropriateness and acceptability. EMRs were perceived as acceptable and appropriate by clinicians if the system did not interrupt workflow and improved documentation completeness and accuracy. Clinicians were more likely to value EMRs if they supported quality of care, were fit for purpose, did not interfere with the clinician-patient relationship, and were operated with readily available technical support. Evidence on the feasibility of the implemented EMRs was mixed; the primary studies and reviews found mixed impacts on documentation quality and time; one primary study found downward trends in adverse events, whereas a review found improvements in care quality. Five papers provided information on implementation outcomes such as cost and fidelity, and none reported on the penetration and sustainability of EMRs. CONCLUSIONS The body of evidence relating to EMR implementation in mental health settings is limited. Implementation of EMRs could benefit from methods used in general health settings such as co-designing the software and tailoring EMRs to clinical needs and workflows to improve usability and acceptance. Studies in mental health and general health settings rarely focused on long-term implementation outcomes such as penetration and sustainability. Future evaluations of EMRs in all settings should consider long-term impacts to address current knowledge gaps.
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Affiliation(s)
- Yvonne Zurynski
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
- National Health and Medical Research Council Partnership Centre for Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Louise A Ellis
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
- National Health and Medical Research Council Partnership Centre for Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Huong Ly Tong
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Liliana Laranjo
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Robyn Clay-Williams
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Luke Testa
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Isabelle Meulenbroeks
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
- National Health and Medical Research Council Partnership Centre for Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Charmaine Turton
- Information for Mental Health, System Information and Analytics Branch, New South Wales Ministry of Health, St Leonards, Australia
| | - Grant Sara
- Information for Mental Health, System Information and Analytics Branch, New South Wales Ministry of Health, St Leonards, Australia
- Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
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Fennelly O, Cunningham C, Grogan L, Cronin H, O'Shea C, Roche M, Lawlor F, O'Hare N. Successfully implementing a national electronic health record: a rapid umbrella review. Int J Med Inform 2020; 144:104281. [PMID: 33017724 PMCID: PMC7510429 DOI: 10.1016/j.ijmedinf.2020.104281] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/27/2020] [Accepted: 09/19/2020] [Indexed: 11/03/2022]
Abstract
AIM To summarize the findings from literature reviews with a view to identifying and exploring the key factors which impact on the success of an EHR implementation across different healthcare contexts. INTRODUCTION Despite the widely recognised benefits of electronic health records (EHRs), their full potential has not always been achieved, often as a consequence of the implementation process. As more countries launch national EHR programmes, it is critical that the most up-to-date and relevant international learnings are shared with key stakeholders. METHODS A rapid umbrella review was undertaken in collaboration with a multidisciplinary panel of knowledge-users and experts from Ireland. A comprehensive literature review was completed (2019) across several search engines (PubMed, CINAHL, Scopus, Embase, Web of Science, IEEE Xplore, ACM Digital Library, ProQuest, Cochrane) and Gray literature. Identified studies (n = 5,040) were subject to eligibility criterion and identified barriers and facilitators were analysed, reviewed, discussed and interpreted by the expert panel. RESULTS Twenty-seven literature reviews were identified which captured the key organizational, human and technological factors for a successful EHR implementation according to various stakeholders across different settings. Although the size, type and culture of the healthcare setting impacted on the organizational factors, each was deemed important for EHR success; Governance, leadership and culture, End-user involvement, Training, Support, Resourcing, and Workflows. As well as organizational differences, individual end-users have varying Skills and characteristics, Perceived benefits and incentives, and Perceived changes to the health ecosystem which were also critical to success. Finally, the success of the EHR technology depended on Usability, Interoperability, Adaptability, Infrastructure, Regulation, standards and policies, and Testing. CONCLUSION Fifteen inter-linked organizational, human and technological factors emerged as important for successful EHR implementations across primary, secondary and long-term care settings. In determining how to employ these factors, the local context, individual end-users and advancing technology must also be considered.
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Affiliation(s)
- Orna Fennelly
- Insight Centre for Data Analytics, University College Dublin, Ireland; School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland.
| | - Caitriona Cunningham
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland.
| | - Loretto Grogan
- Office of the Nursing and Midwifery Services Director, Health Service Executive (HSE), Ireland.
| | | | - Conor O'Shea
- Irish College of General Practitioners, Ireland..
| | - Miriam Roche
- Maternal and Newborn Clinical Management System National Project Team, HSE, Ireland.
| | | | - Neil O'Hare
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland; Ireland East Hospital Group, HSE, Ireland.
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Shi S, He D, Li L, Kumar N, Khan MK, Choo KKR. Applications of blockchain in ensuring the security and privacy of electronic health record systems: A survey. Comput Secur 2020; 97:101966. [PMID: 32834254 PMCID: PMC7362828 DOI: 10.1016/j.cose.2020.101966] [Citation(s) in RCA: 119] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 07/08/2020] [Accepted: 07/14/2020] [Indexed: 11/28/2022]
Abstract
Due to the popularity of blockchain, there have been many proposed applications of blockchain in the healthcare sector, such as electronic health record (EHR) systems. Therefore, in this paper we perform a systematic literature review of blockchain approaches designed for EHR systems, focusing only on the security and privacy aspects. As part of the review, we introduce relevant background knowledge relating to both EHR systems and blockchain, prior to investigating the (potential) applications of blockchain in EHR systems. We also identify a number of research challenges and opportunities.
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Affiliation(s)
- Shuyun Shi
- School of Cyber Science and Engineering, Wuhan University, Wuhan, China.,Guangxi Key Laboratory of Trusted Software, Guilin University of Electronic Technology, Guilin, China
| | - Debiao He
- School of Cyber Science and Engineering, Wuhan University, Wuhan, China.,Guangxi Key Laboratory of Trusted Software, Guilin University of Electronic Technology, Guilin, China
| | - Li Li
- School of Cyber Science and Engineering, Wuhan University, Wuhan, China
| | - Neeraj Kumar
- Department of Computer Science and Engineering, Thapar Institute of Engineering and Technology, India.,Department of Computer Science and Information Engineering, Asia University, Taiwan
| | - Muhammad Khurram Khan
- Center of Excellence in Information Assurance, College of Computer & Information Sciences, King Saud University, Saudi Arabia
| | - Kim-Kwang Raymond Choo
- Department of Information Systems and Cyber Security, University of Texas at San Antonio, San Antonio, USA
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Exploring association between certified EHRs adoption and patient experience in U.S. psychiatric hospitals. PLoS One 2020; 15:e0234607. [PMID: 32555623 PMCID: PMC7299381 DOI: 10.1371/journal.pone.0234607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 05/31/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Certified Electronic Health Records (EHR) have been shown to improve the health service quality in some health settings, but there is scant evidence related to its adoption in psychiatric hospitals. This paper aimed to examine the relationship between certified EHR adoption and patient experience across psychiatric hospitals in the United States. METHODS A cross-sectional study design compared the difference in patient experience measures between psychiatric hospitals with and without certified EHR. Data were drawn from the American Hospital Association (AHA) Annual Survey Database and Hospital Compare datasets. Eleven publicly reported measures for patient experience from the Consumer Assessment of Healthcare Providers and Systems Hospital Survey (HCAHPS) were applied for analysis. Independent relationship of certified EHR adoption and patient experience was explored with multiple linear regression models adjusted for hospital organizational characteristics. RESULTS Positive associations were identified between certified EHR adoption and five patient perception measures-"recommend hospital" (β = 0.66, 95% CI = [0.16,1.16]; t = 2.68, p = 0.010), "overall hospital rating" (β = 0.39, 95% CI = [0.03,0.75]; t = 2.11, p = 0.035), "discharge information" (β = 0.45, 95% CI = [0.03,0.86]; t = 2.09, p = 0.037), "care transition" (β = 0.44, 95% CI = [0.14, 0.75]; t = 2.84, p = 0.005), and "responsiveness of hospital staff" (β = 0.47, 95% CI = [0.04, 0.90]; t = 2.13, p = 0.033). CONCLUSION Our results suggest the positive association between certified EHR adoption and patient experience. More studies are needed to explore impacts of certified EHR adoption and potential improvement in patient experience to quality of care.
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The Role of Nurse Managers in the Adoption of Health Information Technology: Findings From a Qualitative Study. J Nurs Adm 2019; 49:549-555. [PMID: 31651615 DOI: 10.1097/nna.0000000000000810] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aims to investigate the role of nurse managers in supporting point-of-care nurses' health information technology (IT) use and identify strategies employed by nurse managers to improve adoption, while also gathering point-of-care nurses' perceptions of these strategies. BACKGROUND Nurse managers are essential in facilitating point-of-care nurses' use of health IT; however, the underlying phenomenon for this facilitation remains unreported. METHODS A qualitative descriptive study was conducted with 10 nurse managers and 14 point-of-care nurses recruited from a mental health hospital environment in Ontario, Canada. Inductive and deductive content analyses were used to analyze the semistructured interviews. RESULTS Nurse managers adopt the role of advocate, educator, and connector, using the following strategies: communicating system updates, demonstrating use of health IT, linking staff to resources, facilitating education, and providing IT oversight. CONCLUSIONS Nurse managers use a variety of strategies to support nurses' use of health IT. Future research should focus on the effectiveness of these strategies.
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Strudwick G, Zhang T, Inglis F, Sockalingam S, Munnery M, Lo B, Singh Takhar S, Charow R, Wiljer D. Delivery of compassionate mental health care in a digital technology-driven age: protocol for a scoping review. BMJ Open 2019; 9:e027989. [PMID: 31340962 PMCID: PMC6661656 DOI: 10.1136/bmjopen-2018-027989] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION As digital technologies become an integral part of mental health care delivery, concerns have risen regarding how this technology may detract from health professionals' ability to provide compassionate care. To maintain and improve the quality of care for people with mental illness, there is a need to understand how to effectively incorporate technologies into the delivery of compassionate mental health care. The objectives of this scoping review are to: (1) identify the digital technologies currently being used among patients and health professionals in the delivery of mental health care; (2) determine how these digital technologies are being used in the context of the delivery of compassionate care and (3) uncover the barriers to, and facilitators of, digital technology-driven delivery of compassionate mental health care. METHODS AND ANALYSIS Searches were conducted of five databases, consisting of relevant articles published in English between 1990 and 2019. Identified articles will be independently screened for eligibility by two reviewers, first at a title and abstract stage, and then at a full-text level. Data will be extracted and compiled from eligible articles into a data extraction chart. Information collected will include a basic overview of the publication including the article title, authors, year of publication, country of origin, research design and research question addressed. On completion of data synthesis, the authors will conduct a consultation phase with relevant experts in the field. ETHICS AND DISSEMINATION Ethical approval is not required for this scoping review. With regards to the dissemination plan, principles identified from the relevant articles may be presented at conferences and an article will be published in an academic journal with study results. The authors also intend to engage interested mental health professionals, health professional educators and patients in a discussion about the study findings and implications for the future.
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Affiliation(s)
- Gillian Strudwick
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Information Management Group, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Timothy Zhang
- Information Management Group, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Fiona Inglis
- Education Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Sanjeev Sockalingam
- Education Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Mikayla Munnery
- Information Management Group, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Brian Lo
- Information Management Group, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Shuranjeet Singh Takhar
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Rebecca Charow
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Education, Technology and Innovation, University Health Network, Toronto, Ontario, Canada
| | - David Wiljer
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Education, Technology and Innovation, University Health Network, Toronto, Ontario, Canada
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Laine A, Välimäki M, Löyttyniemi E, Pekurinen V, Marttunen M, Anttila M. The Impact of a Web-Based Course Concerning Patient Education for Mental Health Care Professionals: Quasi-Experimental Study. J Med Internet Res 2019; 21:e11198. [PMID: 30821697 PMCID: PMC6418488 DOI: 10.2196/11198] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 11/15/2018] [Accepted: 11/25/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Continuing education has an important role in supporting the competence of health care professionals. Although Web-based education is a growing business in various health sectors, few studies have been conducted in psychiatric settings to show its suitability in demanding work environments. OBJECTIVE We aimed to describe the impact of a Web-based educational course to increase self-efficacy, self-esteem, and team climate of health care professionals. Possible advantages and disadvantages of the Web-based course are also described. METHODS The study used nonrandomized, pre-post intervention design in 1 psychiatric hospital (3 wards). Health care professionals (n=33) were recruited. Self-efficacy, self-esteem, and team climate were measured at 3 assessment points (baseline, 8 weeks, and 6 months). Possible advantages and disadvantages were gathered with open-ended questions at the end of the course. RESULTS Our results of this nonrandomized, pre-post intervention study showed that health care professionals (n=33) had higher self-efficacy after the course, and the difference was statistically significant (mean 30.16, SD 3.31 vs mean 31.77, SD 3.35; P=.02). On the other hand, no differences were found in the self-esteem or team climate of the health care professionals before and after the course. Health care professionals found the Web-based course useful in supporting their work and relationships with patients. The tight schedule of the Web-based course and challenges in recruiting patients to use the patient education program with health care professionals were found to be the disadvantages. CONCLUSIONS Web-based education might be a useful tool to improve the self-efficacy of health care professionals even in demanding work environments such as psychiatric hospitals. However, more studies with robust and sufficiently powered data are still needed.
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Affiliation(s)
- Anna Laine
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Maritta Välimäki
- Department of Nursing Science, University of Turku, Turku, Finland.,School of Nursing, Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | | | - Virve Pekurinen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Mauri Marttunen
- University of Helsinki, Helsinki, Finland.,Helsinki University Hospital, Helsinki, Finland
| | - Minna Anttila
- Department of Nursing Science, University of Turku, Turku, Finland
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Electronic Health Records and Meaningful Use in Local Health Departments: Updates From the 2015 NACCHO Informatics Assessment Survey. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2016; 22 Suppl 6, Public Health Informatics:S27-S33. [PMID: 27684614 PMCID: PMC5050007 DOI: 10.1097/phh.0000000000000460] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study provides an updated view using the most recent data to identify the primary storage of clinical data, status of data for meaningful use, and characteristics associated with the implementation of electronic health records in local health departments. Electronic health records (EHRs) are evolving the scope of operations, practices, and outcomes of population health in the United States. Local health departments (LHDs) need adequate health informatics capacities to handle the quantity and quality of population health data.
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10
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Strudwick G, Hardiker NR. Understanding the use of standardized nursing terminology and classification systems in published research: A case study using the International Classification for Nursing Practice(®). Int J Med Inform 2016; 94:215-21. [PMID: 27573329 DOI: 10.1016/j.ijmedinf.2016.06.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 05/04/2016] [Accepted: 06/21/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND In the era of evidenced based healthcare, nursing is required to demonstrate that care provided by nurses is associated with optimal patient outcomes, and a high degree of quality and safety. The use of standardized nursing terminologies and classification systems are a way that nursing documentation can be leveraged to generate evidence related to nursing practice. Several widely-reported nursing specific terminologies and classifications systems currently exist including the Clinical Care Classification System, International Classification for Nursing Practice(®), Nursing Intervention Classification, Nursing Outcome Classification, Omaha System, Perioperative Nursing Data Set and NANDA International. However, the influence of these systems on demonstrating the value of nursing and the professions' impact on quality, safety and patient outcomes in published research is relatively unknown. PURPOSE This paper seeks to understand the use of standardized nursing terminology and classification systems in published research, using the International Classification for Nursing Practice(®) as a case study. METHODS A systematic review of international published empirical studies on, or using, the International Classification for Nursing Practice(®) were completed using Medline and the Cumulative Index for Nursing and Allied Health Literature. RESULTS Since 2006, 38 studies have been published on the International Classification for Nursing Practice(®). The main objectives of the published studies have been to validate the appropriateness of the classification system for particular care areas or populations, further develop the classification system, or utilize it to support the generation of new nursing knowledge. To date, most studies have focused on the classification system itself, and a lesser number of studies have used the system to generate information about the outcomes of nursing practice. CONCLUSIONS Based on the published literature that features the International Classification for Nursing Practice, standardized nursing terminology and classification systems appear to be well developed for various populations, settings and to harmonize with other health-related terminology systems. However, the use of the systems to generate new nursing knowledge, and to validate nursing practice is still in its infancy. There is an opportunity now to utilize the well-developed systems in their current state to further what is know about nursing practice, and how best to demonstrate improvements in patient outcomes through nursing care.
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Affiliation(s)
- Gillian Strudwick
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.
| | - Nicholas R Hardiker
- School of Nursing, Midwifery, Social Work & Social Science, University of Salford, Salford, United Kingdom.
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Abstract
Federal directives, nursing and nursing education associations, as well as accrediting bodies emphasize the importance of integrating health information technology and EHRs into nursing practice. Additionally, informatics is a required competency of baccalaureate nursing graduates. Nursing education's efforts to enhance students' learning in the area of electronic documentation is at its peak. The goal of enabling nurses to make healthcare safer, more effective, efficient, patient-centered, timely and equitable can only be achieved if a variety of technologies are clearly integrated into nursing education. Therefore, some schools have developed educational innovations to incorporate academic EHRs. As the mental health setting is unique, extraordinary attention has to be provided during the education of electronic documentation. Nursing education efforts must focus on interventions that provide resources that enhance the participant's knowledge and skills related to electronic documentation in a variety of clinical settings. Additionally, implementing academic EHRs in clinical settings offers nursing educators an opportunity to note the benefits. The state of nursing education depends on the accessibility to utilize academic EHRs in the nursing curriculum within the clinical setting to effectively prepare students for real-word practice.
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Affiliation(s)
- Stephanie Wynn
- a Samford University , Ida V. Moffett School of Nursing , Birmingham , Alabama , USA
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