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

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

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

Technology continues to be an indispensable part of the current innovative practice. In health care settings, the effectiveness of technology is demonstrated through its role in optimizing health outcomes and reducing inefficiencies (Malik et al., 2021). As a result, nurse informaticists and other health care professionals should continue exploring effective clinical systems and integrate them into patient care to improve health outcomes. Patient portals are among the widely used clinical systems for patients and health care practitioners. Nursing and health care research has explored its role in detail and provides different findings that underline their importance as a health care technology. The purpose of this paper is to annotate research on the use of patient portals in improving outcomes and efficiencies.

Hazara, A. M., Durrans, K., & Bhandari, S. (2020). The role of patient portals in enhancing self-care in patients with renal conditions. Clinical Kidney Journal, 13(1), 1-7. doi: 10.1093/ckj/sfz154

Self-care helps to improve health outcomes among patients with different chronic conditions. In this study, Hazara et al. (2020) reviewed the role of patient portals in enhancing self-care among patients with renal conditions. The review was based on the PatientView portal, a freely provided web-based platform for patients with renal conditions in the United Kingdom. Regarding patient outcomes, patient portals enable patients to access electronic health records, such as test results and clinical documents, at convenient locations as long as they have internet access. Such information helps patients with renal conditions and other complex illnesses to manage their health better and update their health care providers appropriately.

Efficient clinical systems reduce the distance between patients and care providers and facilitate communication. Hazara et al. (2020) observed the same in this study since the PatientView portal provided an efficient system that facilitated two-way communication between nurses and patients and provided an avenue for recording and disseminating essential patient data such as home blood pressure. The main lesson, as the authors underline, is that clinical systems should be designed to encourage patients to participate in managing their conditions. Such designs increase patient empowerment and self-management, which is the foundation of improved clinical outcomes. Critical design elements include functionality, easy access to information, and seamless two-way communication.

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Hefner, J. L., MacEwan, S. R., Biltz, A., & Sieck, C. J. (2019). Patient portal messaging for care coordination: a qualitative study of perspectives of experienced users with chronic conditions. BMC Family Practice, 20(1), 1-8. https://doi.org/10.1186/s12875-019-0948-1

Secure messaging is a critical component of the successful use of patient portals. In this study, Hefner et al. (2019) examined how experienced portal users engage with secure messaging to manage different chronic conditions. In the care context, secure messaging entails asynchronous communication between patients and health care providers. Hefner et al. (2019) found that such communication improves health outcomes by enabling patients to manage chronic conditions. In this case, patients can use patient portals as an extension of the office visit. Besides, patient portals support care coordination and patient collaboration with family and caretakers.

Efficient clinical systems reduce barriers to care significantly. They should also have minimal barriers that hamper user experience and adversely affect their integration into patient care. Similarly, patient portals reduce communication and collaboration barriers. The main lesson from the article is the importance of user experience in the effective use of patient portals. Hefner et al. (2019) stated that patient training in the proper use of secure messaging is critical to address uncertainty among users. Training also improves skills and experience, enabling patients to use patient portals effectively and without uncertainties. Health care organizations should also identify technological barriers that hamper secure messaging and implement appropriate interventions.

Reed, M. E., Huang, J., Brand, R. J., Neugebauer, R., Graetz, I., Hsu, J., … & Grant, R. (2019). Patients with complex chronic conditions: Health care use and clinical events associated with access to a patient portal. PLoS One, 14(6), e0217636. https://doi.org/10.1371/journal.pone.0217636

For chronically ill patients, access to health care services is critical to coping, illness management, and reducing infections. In this article, Reed et al. (2019) examined the impact of patient portals on outpatient visits, emergency visits, and preventable hospitalizations. The study included patients with only diabetes and others with multiple complex conditions. For both patient groups, access to patient portals was associated with higher rates of outpatient office visits since patients seek more health care services if they are actively engaged in care and understand their conditions. The other significant health outcome from the study was fewer emergency room visits among patients with complex chronic conditions due to the active use of patient portals.

Efficient clinical systems and procedures help health care facilities to reduce health costs significantly. Reed et al. (2019) found patient portals instrumental in reducing health costs by reducing preventable hospital stays among patients with multiple complex conditions. The main lesson from the article is that access to patient portals plays a critical role in increasing patient engagement in outpatient visits, which helps them promptly address unmet and emerging needs. The other lesson is that patient portals in health care settings should be encouraged and supported since it helps to reduce downstream health events that increase emergency and preventable care. As a result, health care practitioners looking forward to efficient, cost-effective, and effective care must prioritize patient portals as a tech-based clinical system.

Stewart, M. T., Hogan, T. P., Nicklas, J., Robinson, S. A., Purington, C. M., Miller, C. J., … & Shimada, S. L. (2020). The promise of patient portals for individuals living with chronic illness: Qualitative study identifying pathways of patient engagement. Journal of Medical Internet Research, 22(7), e17744. http://dx.doi.org/10.2196/17744

Chronic health conditions continue to be a huge burden for patients, families, and health care professionals. Effective management of such conditions is critical to improving health outcomes, and the role of patient portals cannot be underestimated. In this study, Stewart et al. (2020) explored how electronic patient portals facilitate patient engagement among individuals with diabetes. From a health perspective, patient engagement is characterized by the active involvement of patients in their care. Regarding the role of patient portals in improving outcomes, Stewart et al. (2020) found that patient portals provide a reliable platform for patients to better understand their health by asking health-related questions. This information improves engagement, diabetes control, and participation in care management since it helps patients to prepare for medication appointments by reviewing labs, notes, and symptoms.

Regarding efficiencies, patient care is more efficient when the distance between patients and health care professionals is reduced and care coordination challenges are minimal. Stewart et al. (2020) found that patient portals improve efficiencies by providing a quick and secure messaging platform and facilitating efficient care coordination between patients and health care providers. The main lesson from this article is that health care providers should embrace patient portals and encourage patients to use them appropriately. Patients also need to be supported by addressing their attitudes and fear toward patient portals.

Conclusion

Patients require appropriate support to enable them to understand their conditions, participate in care, and manage chronic conditions. Patient portals are valuable clinical systems for patients with chronic conditions. Beneficial outcomes associated with patient portals include increased patient-provider communication, illness self-management, and reduced hospitalizations. Such outcomes also change patients’ attitudes toward care and improve their relationships with families and caregivers. However, barriers such as negative attitudes toward patient portals and technology problems should be addressed. Patient training helps to improve user experience and should be prioritized in health care settings.

References

Hazara, A. M., Durrans, K., & Bhandari, S. (2020). The role of patient portals in enhancing self-care in patients with renal conditions. Clinical Kidney Journal, 13(1), 1-7. doi: 10.1093/ckj/sfz154

Hefner, J. L., MacEwan, S. R., Biltz, A., & Sieck, C. J. (2019). Patient portal messaging for care coordination: a qualitative study of perspectives of experienced users with chronic conditions. BMC Family Practice, 20(1), 1-8. https://doi.org/10.1186/s12875-019-0948-1

Malik, M., Kazi, A. F., & Hussain, A. (2021). Adoption of health technologies for effective health information system: Need of the hour for Pakistan. PloS One, 16(10), e0258081. https://doi.org/10.1371/journal.pone.0258081

Reed, M. E., Huang, J., Brand, R. J., Neugebauer, R., Graetz, I., Hsu, J., … & Grant, R. (2019). Patients with complex chronic conditions: Health care use and clinical events associated with access to a patient portal. PLoS One, 14(6), e0217636. https://doi.org/10.1371/journal.pone.0217636

Stewart, M. T., Hogan, T. P., Nicklas, J., Robinson, S. A., Purington, C. M., Miller, C. J., … & Shimada, S. L. (2020). The promise of patient portals for individuals living with chronic illness: Qualitative study identifying pathways of patient engagement. Journal of Medical Internet Research, 22(7), e17744. http://dx.doi.org/10.2196/17744

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New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies.

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Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.

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In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.

To Prepare:

• Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
• Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
• Identify and select 5 peer-reviewed articles from your research.

The Assignment: (4-5 pages)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:

• Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
• Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples. NURS 6051 Literature Review The Use of Clinical Systems to Improve Outcomes and Efficiencies

Module 4: Technologies Supporting Applied Practice and Optimal Patient Outcomes (Weeks 6-8)

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Laureate Education (Producer). (2018). Informatics Tools and Technologies [Video file]. Baltimore, MD: Author.

According to Avdagovska et al. (2020), the rising costs of healthcare services and the increased prevalence of chronic conditions have necessitated transformative changes in the delivery of healthcare. One example of these transformations is the development of mobile access to electronic health records. Patient access to electronic health records through online platforms and mobile applications has been an expanding area in healthcare, even before the pandemic. It is a recent innovation that communicates medical information to patients and their caregivers in a quick, convenient, and reliable manner. These platforms also provide opportunities to schedule appointments, fill out forms/paperwork at the patient’s pace (as compared to the nervous or rushed feeling you get in the clinical setting), and easily communicate with their providers. Huerta et al. (2019) wrote that these online platforms also increase patient empowerment and engagement. Many of the platforms include resources for patient education and wellness, allowing them to take an active role in their health.

However, there are some downsides and risks to these platforms. First, there is the risk of information leaks and security violations. With any online platform that holds sensitive data, the risk of unlawful use of this data is inevitable. Some of the applications require a two-step verification process to protect identities and information, but this is not a certain measure. Additionally, the method of receiving medical information such as lab results and tests through mobile applications is not appropriate for all populations. Lab and imaging results are now auto-released to the patient much more quickly than before. This makes it very difficult for healthcare providers to discuss sensitive results before they reach the patient. Often, patients will receive their results before actually speaking with their provider. This can lead to misconceptions and false interpretations of diagnoses. With the increase in computerized medicine, the need for provider education and communication has also increased.

References

Avdagovska, M., Ballermann, M., Olson, K., Graham, T., Menon, D., & Stafinski, T. (2020). Patient portal implementation and uptake: Qualitative comparative case study. Journal of Medical Internet Research, 22(7). https://doi.org/10.2196/18973

Huerta, T., Fareed, N., Hefner, J. L., Sieck, C. J., Swoboda, C., Taylor, R., & McAlearney, A. S. (2019). Patient engagement as measured by inpatient portal use: Methodology for log file analysis. Journal of Medical Internet Research, 21(3), e10957. https://doi.org/10.2196/1095

Learning Objectives

Students will:
Evaluate healthcare technology trends for data and information in nursing practice and healthcare delivery
Analyze challenges and risks inherent in healthcare technology
Analyze healthcare technology benefits and risks for data safety, legislation, and patient care
Evaluate healthcare technology impact on patient outcomes, efficiencies, and data management
Analyze research on the application of clinical systems to improve outcomes and efficiencies
Due By
Assignment
Week 6, Days 1–2
Read/Watch/Listen to the Learning Resources.
Compose your initial Discussion post.
Week 6, Day 3
Post your initial Discussion post.
Begin to compose your Assignment.
Week 6, Days 4-5
Review peer Discussion posts.
Compose your peer Discussion responses.
Continue to compose your Assignment.
Week 6, Day 6
Post at least two peer Discussion responses on two different days (and not the same day as the initial post).
Week 6, Day 7
Wrap up Discussion.
Week 7, Days 1-7
Continue to compose your Assignment.
Week 8, Days 1-6
Continue to compose your Assignment.
Week 8, Day 7
Deadline to submit your Assignment.
Photo Credit: Westend61

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

Chapter 14, “The Electronic Health Record and Clinical Informatics” (pp. 267–287)
Chapter 15, “Informatics Tools to Promote Patient Safety and Quality Outcomes” (pp. 293–317)
Chapter 16, “Patient Engagement and Connected Health” (pp. 323–338)
Chapter 17, “Using Informatics to Promote Community/Population Health” (pp. 341–355)
Chapter 18, “Telenursing and Remote Access Telehealth” (pp. 359–388)
Dykes, P. C., Rozenblum, R., Dalal, A., Massaro, A., Chang, F., Clements, M., Collins, S. …Bates, D. W. (2017). Prospective evaluation of a multifaceted intervention to improve outcomes in intensive care: The Promoting Respect and Ongoing Safety Through Patient Engagement Communication and Technology Study. Critical Care Medicine, 45(8), e806–e813. doi:10.1097/CCM.0000000000002449
HealthIT.gov. (2018c). What is an electronic health record (EHR)? Retrieved from https://www.healthit.gov/faq/what-electronic-health-record-ehr
Healthcare Information Management and Systems Society. (2018). Electronic health records. Retrieved from https://www.himss.org/library/ehr/
Rao-Gupta, S., Kruger, D. Leak, L. D., Tieman, L. A., & Manworren, R. C. B. (2018). Leveraging interactive patient care technology to Improve pain management engagement. Pain Management Nursing, 19(3), 212–221. doi:10.1016/j.pmn.2017.11.002

Note: You will access this article from the Walden Library databases.
Skiba, D. (2017). Evaluation tools to appraise social media and mobile applications. Informatics, 4(3), 32–40. doi:10.3390/informatics4030032

Note: You will access this article from the Walden Library databases.
Required Media
Laureate Education (Producer). (2018). Public Health Informatics [Video file]. Baltimore, MD: Author.

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Laureate Education (Producer). (2018). Electronic Records and Managing IT Change [Video file]. Baltimore, MD: Author.

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By Day 7 of Week 8

Submit your completed Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK8Assgn+last name+first initial.(extension)” as the name.

Click the Week 8 Assignment Rubric to review the Grading Criteria for the Assignment.

Click the Week 8 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK8Assgn+last name+first initial.(extension)” and click Open.

If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.

Click on the Submit button to complete your submission.

Due to the nature of this assignment, your instructor may require more than 5 days to provide you with quality feedback.

The use of technology to leverage care interventions in different clinical settings and facilities cannot be overemphasized because of the critical role that it plays in enhancing patient safety and care outcomes. Clinical systems are essential tools in improving patients’ outcomes and efficiencies in healthcare delivery by reducing medication errors, promoting medication compliance and enabling providers to leverage technology for better decisions and informed interventions (Dykes et al., 2017). Personal health records or portals are some of the critical aspects that providers and healthcare systems use to support patients that have recently been diagnosed with diabetes. These portals offer access to health information from an organization’s electronic health record (EHR) and allow patients to conduct different medical-associated tasks like electronically communicating with their providers and even recording their symptoms (Tapuria et al., 2021). The purpose of this paper is to offer an annotated bibliography of the impact of personal health records or patient portals for individuals newly diagnosed with diabetes.

Coughlin, S. S., Williams, L. B., & Hatzigeorgiou, C. (2017). A systematic review of studies  of web portals for patients with diabetes mellitus. MHealth, 3(6). https://doi.org/10.21037/mhealth.2017.05.05

In this systematic review of studies on the portal for patients with diabetes mellitus, the researchers evaluate the impact of patient health records to improve outcomes from interventions to control glycemic levels. The authors identified 12 studies on the topic that include three cross-sectional and five randomized controlled trials. The researchers required web portals meant for diabetes patients and those tethered to electronic medical records. The findings show that web portals enhance the ability of patients to communicate with their clinicians and attain enhanced glycemic control. The authors emphasize the need for additional research to understand the level of control for patients. However, they are categorical that web portals improve glycemic control for these patients.

The study shows that web portals are essential and improve outcomes for diabetic patients since they enhance communication between them and their clinicians. Through effective communication, clinicians improve efficiencies in care provisions for diabetes patients. The study indicates that providers should leverage technologies and encourage their patients to embrace them to reduce adverse disease outcomes. A critical lesson learned from the use of web portals based on the study is that few patients embrace this technology to enhance diabetes self-management and self-care. Consequently, providers should be trained to leverage its use to improve self-care interventions for patients in remote locations.

Sun, R., Korytkowski, M. T., Sereika, S. M., Saul, M. I., Li, D., & Burke, L. E. (2018).  Patient Portal Use in Diabetes Management: Literature Review. JMIR Diabetes, 3 (4): e11199. https://doi.org/10.2196/11199.

In this article, the researchers affirm the critical role that health information technology tools have in promoting engagement, improvement of patient-provider communication, and enhancing clinical outcomes in the management of chronic disorders like diabetes mellitus. Based on a review of literature, the researchers focus on evidence about the efficacy of patient portal use by patients with diabetes mellitus type 1 and 2. The study examines the link between patient portal use and diabetes mellitus-related outcomes.

The authors identified opportunities for future improvement in the management of the condition. The findings also demonstrate the low levels of patient portal use among diabetes patients. The authors observed inconsistency in their findings of the use of these technologies among patients due to several barriers among patients and providers. While these portals enhance care and patient outcomes engagement of both providers and users will be critical to improving uptake.

The article shows that patient portal are critical to enhancing outcomes for individuals suffering from diabetes mellitus (DM). The portals improve communication and engagement between providers and patients. Effective engagement is a core aspect of patient participation and leads to better outcomes. These systems also improve efficiency as it eases interaction between nurses, clinicians and patients, and their families.

The vital lesson learned from the study is that providers should encourage patients to embrace technology as a way to reduce over-reliance on clinicians to make decisions. These portals allow patients to check different components of their disease status and employ the right interventions to address any challenges. The article also implores further research to address the inconsistencies in results about the efficacy of patient portals to enhance care among diabetes patients, especially those newly diagnosed.

Sieverink, F., Kelders, S., Braakman-Jansen, A., & van Gemert-Pijnen, J. (2019).  Evaluating the implementation of a personal health record for chronic primary and secondary care: a mixed-methods approach. BMC medical informatics and decision making, 19(1), 1-12. https://doi.org/10.1186/s12911-019-0969-7

In this study, the authors focus on evaluating the fidelity of personal health records (PHRs) in chronic care based on the level of implementation to ascertain the found effects or impacts. Using a mixed-method design, the researchers measure the responsiveness, the differences, and similarities between the intended and the real use of PHRs among a certain population sample. The study findings show that many providers were unaware of how to deploy the PHR in their present working routines. As such, they find it challenging to motivate and encourage their patients to use PHR. However, those participating in the user group indicated the value of a PHR in future interactions with their clinicians or care providers. The usability participants asserted that improvement in utilization among care providers will highly influence their decision to deploy the patient portals.

The findings show that the actual use of PHR by patients depended on the responsiveness of caregivers. Caregiver responsiveness relies on perceived support and fidelity by patients. However, the use of PHR intends to enhance efficiency and outcomes for patients with chronic conditions as outlined by the study. The critical lesson learned from this article is that providers have a substantial influence on technology uptake by patients in their settings, especially in the management of chronic conditions like diabetes mellitus.

Fidelity by patients to PHR is an added advantage in enhancing the use of this technology among patients and their families. The study indicates that responsiveness from providers is a critical aspect of encouraging diabetic patients to embrace patient portals to enhance efficiency and care provision. The implication is that nurses should focus on interactive sessions and engage their diabetes patients to leverage technologies like web portals to improve care outcomes.

Reed, M. E., Huang, J., Brand, R. J., Neugebauer, R., Graetz, I., Hsu, J., … & Grant, R.  (2019). Patients with complex chronic conditions: Health care use and clinical events associated with access to a patient portal. PLoS One, 14(6), e0217636. https://doi.org/10.1371/journal.pone.0217636

In this article, the researcher asserts that patients with diabetes can leverage patient portals to support self-management and coordination of health care services. The authors’ objective in the study was to examine the effects of access to the patient portal on the frequency of visits, emergency visits, and preventable admissions or hospitalizations. Using an observational study design, the researchers compare the visit rates with or without portal access among patients with chronic conditions, especially diabetes.

The study shows that access to patient portals is linked to increased rates of outpatient office visits in both diabetic patients and those with multiple complex conditions. Patient portals have a significant reduction on overall visits, right from emergency to office physician visits among diabetes and chronically ill patients. These findings show that portals web technology enhances care provision remotely for diabetes patients and improves expected outcomes. Access enhances engagement in outpatient visits allowing providers to address unmet clinical needs. The portals also reduce downstream health events that may necessitate emergency and hospital care, especially for diabetes patients and those with complex comorbidities.

Findings from this study are categorical that patient portals improve outcomes as they increase engagement between clinicians and patients in different care settings. The results also show that the motivation to use PHR is based on provider knowledge and engagement with patients and their families. The study demonstrates the need for providers to leverage educational interventions to enhance the deployment of patient portals for the management of diabetes and multiple chronic conditions.

Vital lessons learned from the use of the patient portal include the need for an interactive approach among the providers, patients, and the healthcare system. The study also shows the need to patients to enhance their engagement with technology to enhance overall outcomes and reduce visits to emergency rooms and physician offices. The article demonstrates the crucial role that web portals play in overall care delivery for diabetes patients.

Conclusion

The findings from the four peer-reviewed research articles demonstrate that patient portals are a critical component of enhancing overall care for individuals with diabetes, particularly those newly diagnosed. The portals allow patients to interact with providers remotely, record their symptoms, access tests, and laboratory results, and review their care plans. while several obstacles and factors influence the use of these portals, it is evident that they continue to constitute a core response to improve care delivery for patients with chronic conditions like diabetes.

Studies by Abd-alrazaq et al. (2019) and Ruh and Chugh (2021) show that despite certain barriers to their deployment and embracement, patient portals are enhancing overall care delivery and allowing users to interact more. Through these interventions, clinicians and patients and their families work collaboratively to enhance overall care outcomes. These products provide a host of content, connectivity, and collaboration-associated features and functions for their users. The overall value of these technologies goes beyond the constituents of the health care delivery chain. However, there is a need for further research to enhance usability, adoption, and value among providers and patients to attain effective benefits and leverage from patient portals.

References

Abd-Alrazaq, A. A., Bewick, B. M., Farragher, T., & Gardner, P. (2019). Factors that affect the

use of electronic personal health records among patients: a systematic review. International journal of medical informatics, 126, 164-175. https://doi.org/10.1016/j.ijmedinf.2019.03.014

Dykes, P. C., Rozenblum, R., Dalal, A., Massaro, A., Chang, F., Clements, M., Collins, S.

…Bates, D. W. (2017). Prospective evaluation of a multifaceted intervention to improve outcomes in intensive care: The Promoting Respect and Ongoing Safety Through Patient Engagement Communication and Technology Study. Critical Care Medicine, 45(8), e806–e813. https://doi.org/10.1097/CCM.0000000000002449

Coughlin, S. S., Williams, L. B., & Hatzigeorgiou, C. (2017). A systematic review of studies of web portals for patients with diabetes mellitus. MHealth, 3(6). https://doi.org/10.21037/mhealth.2017.05.05

Tapuria, A., Porat, T., Kalra, D., Dsouza, G., Xiaohui, S., & Curcin, V. (2021). Impact of patient access to their electronic health record: a systematic review. Informatics for Health and Social Care, 46(2), 192-204. https://doi.org/10.1080/17538157.2021.1879810

Reed, M. E., Huang, J., Brand, R. J., Neugebauer, R., Graetz, I., Hsu, J., … & Grant, R. (2019). Patients with complex chronic conditions: Health care use and clinical events associated with access to a patient portal. PLoS One, 14(6), e0217636. https://doi.org/10.1371/journal.pone.0217636

Ruhi, U., & Chugh, R. (2021). Utility, Value, and Benefits of Contemporary Personal Health Records: Integrative Review and Conceptual Synthesis. Journal of medical Internetresearch, 23(4), e26877. https://doi.org/10.2196/26877

Sieverink, F., Kelders, S., Braakman-Jansen, A., & van Gemert-Pijnen, J. (2019). Evaluating the implementation of a personal health record for chronic primary and secondary care: a mixed-methods approach. BMC medical informatics and decisionmaking, 19(1), 1-12. DOI: https://doi.org/10.1186/s12911-019-0969-7

Sun, R., Korytkowski, M. T., Sereika, S. M., Saul, M. I., Li, D., & Burke, L. E. (2018). Patient Portal Use in Diabetes Management: Literature Review. JMIR Diabetes, 3 (4): e11199. DOI: 10.2196/11199.

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NURS 6051 Discussion: Big Data Risks and Rewards

Risks and Rewards of Big Data

Healthcare researchers have high hopes for the potential of big data to advance treatment innovation, drug discovery, customized medicine, and optimal patient care with the goal of lowering healthcare costs and improving patient outcomes. For their big data programs, governments and businesses have spent billions of dollars on data collection (McGonigle & Mastrian, 2022). Internal sources, such as electronic health records, and external sources, such as pharmacies, laboratories, and government agencies, are both potential origins of healthcare-related big data.

Big Data Benefits

The potential advantages of merging, digitizing, and making good use of big data are shared between organizations. By analyzing massive amounts of data, big data might help us discover previously unseen correlations, hidden patterns, and insights. Electronic health records (EHRs) are one example of a big data source that aids in the collection of demographic and medical data such clinical data, lab tests, diagnoses, and medical problems that are used by healthcare professionals to offer high-quality care (Pastorino et al., 2019).

Big data aids healthcare institutions in increasing operational efficiency. Big data is used as part of a healthcare organization’s business intelligence strategy to look at things like patient admission rates and employee productivity. Hence, healthcare systems can save money with predictive analytics while also improving the quality of treatment they offer. To effectively use big data analytics outcomes, managers and employees need critical thinking and interpretation skills. Because misinterpreting reports might lead to major mistakes and questionable decisions. So, healthcare businesses must teach employees in fundamental statistics, data mining, and business intelligence to support the emerging information-rich work environment (Wang et al., 2018)

Challenges Associated with Big Data

Data security is a major issue with big data, especially with the rise in high-profile hacks, breaches, and ransomware attacks. Healthcare data is at risk from endless sources, including phishing assaults, viruses, and computers left in taxis. Patients’ privacy and the confidentiality of their health information are safeguarded by state and federal legislation, including the Health Insurance Portability and Accountability Act of 1996 (HIPAA) (Pastorino et al., 2019).

Strategies to Manage the Challenges of Big Data

Among the many technical protections mandated for businesses that manage PHI is encryption during transmission, authentication procedures, and management of access, integrity, and auditing. Use of up-to-date anti-virus software, a firewall, encryption of sensitive data, and multiple-factor authentication are all examples of practical measures that translate to these precautions. The greatest concern is that there will be a security breach.

There may have been as many as 25 million medical records compromised in the first half of 2019 (Davis, 2019). The proposed approach is to restrict patients’ access to the organization’s interdisciplinary team. The health records of an individual are confidential and should not be released to any outside parties. Personal information misuse can have serious repercussions. So selecting a big data computing firm that is both competent and efficient as protecting sensitive data is crucial for a successful resolution of this issue.

Another method would be to insist that employees always log out of their accounts when they leave a computer terminal, change their passwords frequently, and never click on links in emails that they suspect might be malicious. At my organization, we get frequent tests of phishing emails to see if employees can recognize and report these. As an added precaution against hackers gaining access to sensitive information, healthcare providers should provide thorough training on the importance of data security standards and conduct regular reviews of employee access to sensitive data (Raghupathi & Raghupathi, 2014). Data breaches can result in costly lawsuits if these precautions are not taken.

References

Davis, J. (2019, August 2). The 10 biggest healthcare data breaches of 2019, so far. HealthITSecurity. Retrieved March 26, 2023, from https://healthitsecurity.com/news/the-10-biggest-healthcare-data-breaches-of-2019-so-far

McGonigle, D., & Mastrian, K. G. (2022). Nursing Informatics and the foundation of knowledge. Jones & Bartlett Learning.

Pastorino R; De Vito C; Migliara G ; Glocker K; Binenbaum I; Ricciardi W; Boccia S; (2019). Benefits and challenges of Big Data in Healthcare: An overview of the European initiatives. European journal of public health. Retrieved March 26, 2023, from https://pubmed.ncbi.nlm.nih.gov/31738444/

Raghupathi, W., & Raghupathi, V. (2014). Big Data Analytics in healthcare: Promise and potential. Health Information Science and Systems, 2(1). https://doi.org/10.1186/2047-2501-2-3

Wang, Y., Kung, L. A., & Byrd, T. A. (2018). Big Data Analytics: Understanding its capabilities and potential benefits for healthcare organizations. Technological Forecasting and Social Change, 126, 3–13. https://doi.org/10.1016/j.techfore.2015.12.019

The patient portal is a secure online that enables patients to access their health data whenever they require it. It has 24/7 accessibility, which reduces the need for patients to contact their primary care provider’s (PCP) office to inquire about their scheduled appointments or their prescribed medications (Sieck et al., 2018). The portal lets them view and download health information such as immunization records, diagnostic test results, allergies, prescriptions, previous PCP visits, instructions and appointment notes, discharge summaries, and billing information(Sieck et al., 2018). Patient portals increase patients’ access to health care and health information, thus improving patients’ outcomes and functional status and decreasing healthcare costs. Patients with chronic conditions benefit the most from using the portals as they are the highest consumers of healthcare.

The purpose of this paper is to summarize peer-reviewed articles that examine the impact of patient portals in improving patient outcomes and outline the lessons learned from the application of patient portals in each article.

Alturkistani, A., Qavi, A., Anyanwu, P. E., Greenfield, G., Greaves, F., & Costelloe, C. (2020). Patient portal functionalities and patient outcomes among patients with diabetes: Systematic review. Journal of medical Internet research, 22(9), e18976. https://doi.org/10.2196/18976

Alturkistani et al. (2020) conducted a systematic review to outline the evidence concerning the use of patient portal use and patient portal functionality use and their reported connection with health and outcomes in health care quality among adult diabetic patients. The review included twelve studies, which reported: The overall patient portal use and its connection with diabetes health and health quality outcomes; E-messaging/email use– related outcomes; Prescription refill–related outcomes. The reported health outcomes included the association of patient portal use with blood pressure, low-density lipoprotein cholesterol, and BMI.

The studies in the systematic review reported that patient portals and patient portal functionality attributed to improved health outcomes, such as glycemic control in DM patients. Besides, secure messaging, emailing, and repeat prescription ordering using the patient portal were connected with enhanced glycemic control, and patient outcomes seemed to improve with increased portal use. It was also established that the use of the patient portal might be connected with enhanced low-density lipoprotein cholesterol outcomes and blood pressure control. From this article, we learn that patient portals use and patient portal functionality can impact the utilization of health care services and can result in increased office visits and reduced emergency department visits. The article establishes that patient portal use is connected with improved quality of care for diabetic patients, thus improving their health outcomes.

Carini, E., Villani, L., Pezzullo, A. M., Gentili, A., Barbara, A., Ricciardi, W., & Boccia, S. (2021). The impact of digital patient portals on health outcomes, system efficiency, and patient attitudes: Updated systematic literature review. Journal of Medical Internet Research, 23(9), e26189. https://doi.org/10.2196/26189

Carini et al. (2021) conducted a systematic review to summarize the available evidence on the effect of patient portals on health outcomes and health care efficiency and to explore user characteristics, attitudes, and satisfaction. The researchers used primary studies discussing the impact of the adoption of the patient portal with regard to health outcomes, efficiencies in health care, and patient attitudes and satisfaction. The study found that patient portals were associated with improved preventive behaviors among patients and improved control of chronic conditions with enhanced control of diabetes parameters and asthma flares. In addition, patient portals were associated with positive results in control and maintenance of diseases and improved adherence to treatment.         Patient portals also reduced the number of missed appointments.

From the article, we learn that the patient portal is usually designed to minimize inappropriate health care utilization. However, barriers are limiting the utilization of portals, including user-related factors, such as time constraints, lack of interest in managing their disease, and inadequate digital knowledge. There are also clinician-related barriers, such as age and attitude toward the portal, as well as technology-related barriers, such as limited internet access, limited capacity to use technology, and security concerns. Therefore, health organizations should address privacy and security concerns and ensure patients and providers can utilize technological appliances when introducing patient portals in their settings.

Dendere, R., Slade, C., Burton-Jones, A., Sullivan, C., Staib, A., & Janda, M. (2019). Patient Portals Facilitating Engagement With Inpatient Electronic Medical Records: A Systematic Review. Journal of medical Internet research, 21(4), e12779. https://doi.org/10.2196/12779

Dendere et al. (2019) sought to review literature examining patient portals connected to an EMR in inpatient settings, including the portals’ role in patient engagement and their impact on health care delivery to establish factors and best practices for successful portal implementation. The study employed a systematic review of the literature. It found that patient portals improved patient engagement, patient safety, medication adherence, and patient-provider communication. Although patients and providers perceived that portals could improve patient care, they also thought it could cause anxiety. We learn from the article that patient portals are beneficial as they have improved medication adherence, promoted the discovery of medical errors, and enhanced patient-provider communication. Besides, we learn that improving patient engagement is an aim of patient portals, but the providers’ engagement is equally important as patients approach them with portal-related questions.

Han, H. R., Gleason, K. T., Sun, C. A., Miller, H. N., Kang, S. J., Chow, S., … & Bauer, T. (2019). Using patient portals to improve patient outcomes: systematic review. JMIR human factors, 6(4), e15038. https://doi.org/10.2196/15038

Han et al. (2019) conducted a systematic review to synthesize evidence concerning patient portals’ characteristics and psychobehavioral and clinical outcomes. The study found that most portals employed tailored alerts or educational resources tailored to a patient’s disease. The use of patient portals contributed to improvements in a myriad of psychobehavioral outcomes, including health knowledge, medication adherence, decision making, self-efficacy, and preventive service use. The impact of the patient portal on health outcomes included improved glycemic control, blood pressure, cholesterol, and weight loss. The study’s findings demonstrate the patient portal as a promising approach to improving particular psychological outcomes and health behaviors through simple strategies such as individually tailored messages, refill services, and communication between the patient and the PCP. We learn from the article that understanding the role of patient portals as a useful intervention approach is crucial to encouraging patients to be actively involved in their health care.

Conclusion

The above articles examined the impact of using patient portals in improving health outcomes, including outcomes of diabetes patients. The articles establish that patient portals enhance patient engagement and provider-patient communication resulting in improved preventive behaviors, control of chronic diseases, and health outcomes. Patient portals also enhance care safety by reducing medical errors and increasing medication adherence resulting in better health outcomes. However, for the maximum adoption of patient portals, organizations should address digital knowledge, privacy, and security issues to increase engagement from patients and providers

References

Alturkistani, A., Qavi, A., Anyanwu, P. E., Greenfield, G., Greaves, F., & Costelloe, C. (2020). Patient portal functionalities and patient outcomes among patients with diabetes: Systematic review. Journal of medical Internet research, 22(9), e18976. https://doi.org/10.2196/18976

Carini, E., Villani, L., Pezzullo, A. M., Gentili, A., Barbara, A., Ricciardi, W., & Boccia, S. (2021). The impact of digital patient portals on health outcomes, system efficiency, and patient attitudes: Updated systematic literature review. Journal of Medical Internet Research, 23(9), e26189. https://doi.org/10.2196/26189

Dendere, R., Slade, C., Burton-Jones, A., Sullivan, C., Staib, A., & Janda, M. (2019). Patient Portals Facilitating Engagement With Inpatient Electronic Medical Records: A Systematic Review. Journal of medical Internet research, 21(4), e12779. https://doi.org/10.2196/12779

Han, H. R., Gleason, K. T., Sun, C. A., Miller, H. N., Kang, S. J., Chow, S., … & Bauer, T. (2019). Using patient portals to improve patient outcomes: systematic review. JMIR human factors, 6(4), e15038. https://doi.org/10.2196/15038

Sieck, C. J., Hefner, J. L., & McAlearney, A. S. (2018). Improving the patient experience through patient portals: Insights from experienced portal users. Patient Experience Journal, 5(3), 47-54. https://pxjournal.org/journal/vol5/iss3/8

Hello Fatmata, i appreciate the fact that you mention issues regarding insurance coverages, patient satisfaction and reduced exposure. Truly, it is without doubt that the advances in technology impact health care and health science careers in a huge way. Advanced technologies are being used to improve efficacy and care, and different technologies are being built to share information with other health care providers and organizations (HealthIT.gov, 2018). This allows for collaboration and continuum of care for patients in different settings.

In terms of threats, careers such as medical and nursing assistants face an imminent threat of extinction since robots can take up the roles of monitoring patients and alerting the nursing team or the care team- although it has been proven that technology can help detect health threats, situational awareness, response, and communications of illnesses (McGonigle & Mastrian, 2022). The deposition to robotic technology would be the lack of social interaction.

Preclinical studies show that social interactions such as a professional healthcare and patient relationship has the potential to release certain hormones and peptides such as oxytocin that help with healing. Research also shows that neurophysiological and neurochemical effects of trauma on the brain and body can be improved by social interactions (Sharma et al., 2020).

As we continue to advance in technology there’s an increased threat to ordinary human interaction, as we can witness now, parents on cell phones and their children on cell phones sitting across from each other at dinner with lack of interest in communicating with each other. Although modern technology is innovating and extraordinary, we must not let it blind us from life’s simple treasures such as social interactions.

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

Healthcare delivery has progressively evolved since the arrival of technology and the internet. Over time, healthcare providers have integrated numerous clinical systems into patient care to achieve higher effectiveness and efficiency. The continuous use of technology has benefitted healthcare delivery by reducing adverse events, better patient-provider communication, and improving patient privacy (Bates & Singh, 2018). Patients and populations can be better accessed, particularly rural and underserved populations. Among many clinical systems, telemedicine and telehealth systems have been central to delivering remote patient care.

Telemedicine typifies remote medical services, while telehealth is broader since it includes all health-related services, including education, reminders, and continuous monitoring (Giacalone et al., 2022; HealthIT.gov, 2019). For timely delivery of care and improved access, remote patient care continues to dominate current practice. The purpose of this paper is to review the current literature on the effectiveness of remote care systems (telemedicine and telehealth) in diabetes care.

Döğer, E., Bozbulut, R., Acar, A. Ş. S., Ercan, Ş., Uğurlu, A. K., Akbaş, E. D., … & Cinaz, P. (2019). Effect of telehealth system on glycemic control in children and adolescents with type 1 diabetes. Journal of Clinical Research in Pediatric Endocrinology, 11(1), 70-75. DOI: 10.4274/jcrpe.galenos.2018.2018.0017

Telehealth and related technologies continue to make remote patient care a reality. Döğer et al. (2019) evaluated the impacts of the telehealth system on diabetes control among children and adolescents with type 1 diabetes at Gazi University Faculty of Medicine. The patients confirmed the importance of telehealth in illness management and other outcomes crucial for comprehensive recovery and healthy living. Overall, telehealth was found to be an efficient system that improves access to care and reduces cost.

Regarding outcomes, patients suggested that they mostly used Whatsapp for instant messaging, education from nurses, and consulting the diabetes team about glucose regulation and insulin doses. HbA1 values reduced significantly in patients contacting their providers frequently. The main lesson from the study is that age determines telehealth use and preferred technologies. Young people showed Whatsapp preference, as confirmed in the study. The other important note for nurses and other healthcare professionals is the importance and frequency of counseling. Regular counseling led to improved blood glucose control.

Ju, H. H. (2020). Using telehealth for diabetes self-management in underserved populations. The Nurse Practitioner, 45(11), 26-33. DOI: 10.1097/01.NPR.0000718492.44183.87

Diabetes self-management is critical to improve outcomes among patients. Accordingly, patients should understand the strategies for effective disease management and be supported to achieve higher patient outcomes. Ju (2020) evaluated the importance of telehealth systems in meeting the needs of diabetic patients in underserved populations. Telehealth was found effective in medication management since it improved overall medication adherence. In diabetes care, medication adherence is a valuable self-care behavior for achieving glycemic control. The other theme central to improved outcomes in diabetes care was self-monitoring of blood glucose to achieve the recommended blood glucose goal. Above all, telehealth allowed patients to receive dietary education and exercise advice remotely. This support was crucial for improved outcomes, such as medication adherence, dietary regulation, and participation in various types of exercises.

As healthcare practitioners continue supporting patients to use telehealth, awareness of the barriers to implementation is crucial. The awareness allows healthcare providers to customize care according to patient needs and ensure that healthcare services are accessed conveniently. Ju (2020) found that patients’ beliefs could be a key barrier to telehealth since some patients modified medications as their beliefs guided them. Accordingly, healthcare providers should continually monitor patients in all dimensions to ensure they adhere to all recommendations. Health education is crucial to counter cultural and religious barriers that might hamper telehealth effectiveness.

Lee, P. A., Greenfield, G., & Pappas, Y. (2018). Patients’ perception of using telehealth for type 2 diabetes management: a phenomenological study. BMC Health Services Research, 18(1), 1-9. https://doi.org/10.1186/s12913-018-3353-x

Type 2 diabetes has severe implications on one’s health if not effectively managed. Typically, the effectiveness of telehealth and related technologies depends on how patients benefit from them and their perceptions. In this study, Lee et al. (2018) explored patients’ perceptions regarding telehealth for type 2 diabetes management. One of the central findings underlining the importance of telehealth among these patients is the technology application in self-management. Patients embraced telehealth since it is an inevitable technology in today’s world and can help them to manage their health better. The other notable impact of telehealth related to effectiveness and efficiency was reliability and comfort. Patients noted that telehealth helped them to monitor their health and provide advice 24/7, even when healthcare services are limited, such as during weekends.

One of the greatest lessons from this study is that telehealth usability depends on patients’ perceptions. In this case, patients use it more for diabetes management if they consider it beneficial to their health. As Lee et al. (2018) observed, patients perceived telehealth as “Big Brother” watching them at a distance. Patients also noted the importance of telehealth in providing a sense of security and comfort. Importantly, telehealth was a means to convenient access to healthcare services. It helps patients to have easy and convenient access to doctors. Therefore, implementing such systems could be beneficial for improved access to care and patients’ continued use of technologies for cost-effective, timely, and efficient care.

Lee, J. Y., Chan, C. K. Y., Chua, S. S., Paraidathathu, T., Lee, K. K. C., San San Tan, C., … & Lee, S. W. H. (2019). Using telemedicine to support care for people with type 2 diabetes mellitus: a qualitative analysis of patients’ perspectives. BMJ Open, 9(10), e026575. http://dx.doi.org/10.1136/bmjopen-2018-026575

The importance of technology in independent and convenient care cannot be underestimated. In chronic disease management, independent care is crucial to reduce patient visits to providers and ensure patients are as comfortable as possible. In this study, Lee et al. (2019) conducted a randomized controlled study examining the use of telemedicine for diabetes management. Forty-eight patients within the Klang Valley participated in providing their experiences with the technology. Participants noted that telemedicine was convenient for diabetes management since it allowed them to overcome time constraints and logistical barriers that prevented them from attending clinics for physical appointments. Tele-monitoring devices further encouraged patients to monitor their glucose levels regularly to determine whether they needed detailed check-ups. The other observation instrumental in diabetes management is communication with providers. The system allowed patients to share health data privately, which helped them to be more accountable for their diabetes management.

Despite the various benefits experienced through telemedicine in remote patient care, concerns, and challenges are widespread. Indeed, this is among the lessons from this study as healthcare practitioners continue promoting remote patient care in disease management. Participants stressed the need for user-friendly technology due to difficulties related to internet connectivity and availability in rural areas. Technology and internet access are low in low-income communities, hampering remote care in such areas (Graves et al., 2021). Other issues noted in the study include internet connection stability and cost, limiting patients’ ability to use tele-monitoring devices effectively. To help patients overcome the technical challenges, healthcare professionals should provide ready technical support to ensure successful telemedicine implementation.

Conclusion

The use of clinical systems has intensified in healthcare delivery as technology use intensifies. Nursing research continues to evaluate the practicality of these systems in achieving higher efficiency and other outcomes. In the four reviewed studies, remote care systems improve access to care and reduce costs. Patients with diabetes can use these systems for messaging providers, seeking advice, and seeking medication assistance. The studies have further underlined the importance of telehealth and telemedicine in improving self-care behaviors, medication adherence, and assisting patients in self-monitoring. Lessons include technology choice according to patients’ age, issues with security, and the importance of user-friendly systems. Continuous counseling of patients is also crucial for improved outcomes.

References

Bates, D. W., & Singh, H. (2018). Two decades since to err is human: an assessment of progress and emerging priorities in patient safety. Health Affairs, 37(11), 1736-1743. https://doi.org/10.1377/hlthaff.2018.0738

Döğer, E., Bozbulut, R., Acar, A. Ş. S., Ercan, Ş., Uğurlu, A. K., Akbaş, E. D., … & Cinaz, P. (2019). Effect of telehealth system on glycemic control in children and adolescents with type 1 diabetes. Journal of Clinical Research in Pediatric Endocrinology, 11(1), 70-75. DOI: 10.4274/jcrpe.galenos.2018.2018.0017

Giacalone, A., Marin, L., Febbi, M., Franchi, T., & Tovani-Palone, M. R. (2022). eHealth, telehealth, and telemedicine in the management of the COVID-19 pandemic and beyond: Lessons learned and future perspectives. World Journal of Clinical Cases, 10(8), 2363–2368. https://doi.org/10.12998/wjcc.v10.i8.2363

Graves, J. M., Abshire, D. A., Amiri, S., & Mackelprang, J. L. (2021). Disparities in technology and broadband internet access across rurality: Implications for health and education. Family & Community Health, 44(4), 257–265. https://doi.org/10.1097/FCH.0000000000000306

HealthIT.gov. (2019). Frequently asked questions. https://www.healthit.gov/faq/what-telehealth-how-telehealth-different-telemedicine

Ju, H. H. (2020). Using telehealth for diabetes self-management in underserved populations. The Nurse Practitioner, 45(11), 26-33. DOI: 10.1097/01.NPR.0000718492.44183.87

Lee, J. Y., Chan, C. K. Y., Chua, S. S., Paraidathathu, T., Lee, K. K. C., San San Tan, C., … & Lee, S. W. H. (2019). Using telemedicine to support care for people with type 2 diabetes mellitus: a qualitative analysis of patients’ perspectives. BMJ Open, 9(10), e026575. http://dx.doi.org/10.1136/bmjopen-2018-026575

Lee, P. A., Greenfield, G., & Pappas, Y. (2018). Patients’ perception of using telehealth for type 2 diabetes management: a phenomenological study. BMC Health Services Research, 18(1), 1-9. https://doi.org/10.1186/s12913-018-3353-x

Technology Trends in Healthcare 

Electronic health records have been one of the biggest advancements in technology in healthcare. An EHR is the digital version of a patient’s paper chart and make patient information instantly available while remaining secure to authorized users (What Is an Electronic Health Record (EHR)? | HealthIT.gov, n.d.). I have seen the benefits of EHRs from a provider and patient perspective in the healthcare setting. From a provider perspective, having access to an EHR at all times creates a seamless patient care environment.

There have been multiple times where I am in a patient room and able to review their chart while answering patient’s questions that they may have. This creates a unique opportunity to constantly have the patient resources that I need and makes me feel more confident in the care that I am providing. From a patient perspective, I have also seen the benefits of EHRs in the medical setting. Many times patients forget what medications they are taking or forget what procedures or care they may have gotten recently. With patient access to EHRs, patients are able to quickly look up what medications they are taking as well as recent care or lab work they have gotten done which provides us with more accurate information on how to care for these patients.

On top of this, one major benefit with EHRs is that it reduces errors in the hospital setting. In the US, medical errors caused an estimated 250,000 deaths each year (Medical Error Statistics, n.d.). The use of digital patient records allows providers to track and standardize patient interactions providing the potential of reduced error (7 Benefits of EHR for Hospitals | the Univ. Of Scranton, 2022). Digital paper trails are created allowing there to be minimal confusion in orders and the ability to easily track down the ordering provider to ask clarifying questions. This also creates the ability for orders to be checked by multiple participating providers in the patients care and patient information to be constantly reviewed, reducing errors and improving patient care experiences.

There are also risks associated with electronic health records. One major risk is patient information security and protecting against data theft. Healthcare has historically lacked behind when it comes to cybersecurity and EHRs are no different (Boyles, 2019). One attack has compromised 78.8 million patient records in the past and every year health organizations fall prey to hackers (Boyles, 2019). Hospital employees tend to be the biggest risk factor when it comes to exposure of patient data which is why cybersecurity training is essential for all employees (Boyles, 2019). On top of this, any out of date software can also create vulnerabilities that can be exploited (Boyles, 2019). When trying to secure patient data and keep it safe, EHRs may not be the best option as attacks and breaches are seen often.

Telehealth is one aspect of technology in healthcare that has advanced and will continue to advance in the future. Telehealth allows providers to visit with patients over a video chat which means that the patient and provider do not need to be in the same place at the time of the visit (Alu, 2022). There are many benefits and aspects to Telehealth that I believe will grow and change healthcare in the future. Telehealth will increase access with patients who live in rural areas or patients with decreased mobility (Alu, 2022). This is beneficial as practitioners can foster a healthy relationship and encourage healthy lifestyles for patients that may not have easy access to a physicians office (Alu, 2022). This will also allow healthcare providers to follow up with their patients in a more efficient and timely manner and continue to check on their patients through video chat or messaging (Alu, 2022). Telehealth became popular with the start of the pandemic, but I believe it will continue to trend upward in popularity as healthcare continues to evolve.

I believe that Telehealth will continue to improve patient care and patient outcomes because of the availability of its service to patients. It it normally very quick to schedule and set up a Telehealth visit with a provider which allows patients to receive timely care. It also allows providers to easily follow up with their patients which can ensure that patients are compliant with care. A risk with Telehealth is that a provider is not able to examine the patient. They are not able to monitor vital signs or listen to a patients heart or lungs which is why Telehealth can never replace in person physician appointments. Telehealth will serve as a great tool in addition to physician appointments for patients to ensure that their care is up to date and no changes need to be made between visits.

Healthcare has come so far in the last 20 years with the use of technology. New ways are being invented and modified every day. Nurses use technology and data to effectively communicate with other professionals to provide patients with the best possible outcomes. Just as healthcare changes, the technology we use changes as well. Telehealth is one of those. It was initially introduced in the 1960s for physicians to monitor astronauts in the space program. Now we are able to have visits with patients in real-time in their homes via video chats. Before the pandemic, Medicare beneficiaries were not able to reap the benefits of telehealth. Usage increased 15x pre-pandemic levels (U.S. Government Accountability Services, 2022).

A few benefits include lower costs, reduced hospital admissions, and promptness of care. Telehealth reduces travel time for patients whether it be in gas, public transportation, or paying someone to carry them to appointments (Ox Digital Health, 2021). Telehealth allows physicians to monitor their patients more closely and identify those at high risk. Patients tend to stay home when they are not feeling well. Telehealth visits can allow them to see the physician to get treatment before symptoms become too severe.

Nurses and physicians can treat and observe patients in a matter of minutes rather than hours in a waiting room (Health Recovery Solutions, 2022). Some risks include compliance related to the inability to understand how to use the technology, language barriers, being hearing impaired, and a lack of mistrust that they are not getting adequate care over the phone. Surveys conducted in 2021 stated only 36% felt comfortable with connecting the telehealth visit, 15% had difficulty hearing, and 35% had a lack of interest in not seeing the physician in the clinic (Mao et al., 2022). Although the increase in telehealth is on the rise, it is still not for everyone.

I have worked in home health for over 13 years. Until COVID we were never able to bill for telehealth visits. Now they are less expensive and more convenient. When our agency is short-staffed, we are still able to provide care to more patients than seeing them strictly in their homes face to face. Certain patients qualify for telehealth every other week or every third week reducing the costs Medicare pays out per episode and limiting the workload on full-staff nurses (Welkin Health, 2021).

Atrial fibrillation is very common in a majority of our patients. A recent device that has been created is the ability for patients to complete a 6-lead EKG at home when they have atrial fibrillation. This device is essential in helping us detect cardiac problems in our home care patients. We can get them to clinics or ER for cardioversion sooner before blood clots develop and cause further problems for the patients. The cost is not where it could be for all of our patients to afford, however, neither were blood glucose machines when they came out. Hopefully, in the near future, the prices will go down and more of our patients can afford it or our agency can start providing it to patients with certain diagnoses.

References

Health Recovery Solutions. (2022, September 8). 5 ways to reduce healthcare costs with Telehealth & RPM. Remote Patient Monitoring & Telehealth. https://www.healthrecoverysolutions.com/blog/5-ways-to-reduce-healthcare-costs-with-telehealth-and-rpm

Mao, A., Tam, L., Xu, A., Osborn, K., Sheffrin, M., Gould, C., Schillinger, E., Martin, M., & Mesias, M. (2022). Barriers to Telemedicine Video Visits for Older Adults in Independent Living Facilities: Mixed Methods Cross-sectional Needs Assessment. JMIR aging, 5(2), e34326. https://doi.org/10.2196/34326

OX Digital Health. (2021, April 16). 5 ways Telehealth is reducing the cost of healthcare. https://www.oxdh.health/resources/5-ways-telehealth-is-reducing-the-cost-of-healthcare

U.S. Government Accountability Office. (2022, September 29). Telehealth in the pandemic—How has it changed health care delivery in Medicaid and Medicare? U. https://www.gao.gov/blog/telehealth-pandemic-how-has-it-changed-health-care-delivery-medicaid-and-medicare

Welkin Health. (2021, September 25). Home health Telehealth: How to implement a program. https://welkinhealth.com/home-health-telehealth/