Disadvantages Of Emr System
2012 EVALUATION /COMPARISON REPORT OF 2 EMR SOFTWARE SYSTEMS FOR POTENTIAL USE IN OUR HOSPITAL
Report Prepared By:
Gary Holt RN
Director of Nursing Informatics.
Pg. #1 TOPIC A: EMR SYSTEMS AND PATIENT QAULITY CARE OUTCOMES.
EMR stands for “Electronic Medical Record”. This section of the report is to explain to you the benefits to improving the quality of patient care we can provide to our patients by utilizing the EMR system. As we all know our number one goal is positive patient outcomes and safety of our patients. Part of this is always looking for the latest technologies and systems available in which to achieve this and to continue to improve positive patient outcomes. So you may ask how these positive outcomes would be …show more content…
achieved through utilization of an EMR software system.
The first topic I would like to make mention of which is crucial to all of us in direct patient care is, TIME MANAGEMENT. I have capitalized this in bold print to emphasize its importance. The EMR system in comparison to our current hand written system with the Physical medical record will cut down on documentation time immensely. How you may ask? The first main point I would like to make is with use of the EMR system all disciplines of the healthcare team will have the ability to access the patient’s medical record at the same time to review and enter any information for the care of the patient. You will no longer need to wait for a physical medical record in which you have to track down as well as wait to use if someone else is using it or if the patient is off the unit for a test.. And you will no longer have to wait to hand write a note, order, or assessment as you will be able to log in to the EMR system to enter and review this information. Once you have entered and saved this information it will be available almost immediately for not only you but for everyone else reviewing that patients information to see as well. And what this will do as a result is cut down on the time previously needed with a hand written chart being shared. This in turn will create much more time actually taking care of Pg. #2 Continued: the patients to better assess, provide more frequent communication with them as well amongst us as a multi-disciplinary team.
The second main point I would like to make is in regards to potential misinterpretations or medical mistakes as the result of illegible or messy handwriting.
As we all know the amount of documentation we have to provide for our patients is more and more every year. The reasons as we all know are mainly lawsuit and medical malpractice driven in conjunction with more and more state as well as federal rules and regulations. Having progress notes, assessments, and consults, diagnostic imaging studies and most importantly M.D. orders in a typed easy to read format will cut down on these potential errors drastically by being able to read and interpret them without question. Also, by being able to read the information that is now typed with ease; if there is a further need of clarification to be questioned, it will be recognized and addressed much quicker than previously.
TOPIC B: THE IMPORTANCE OF NURSING INVOLVEMENT IN THE PLANNING, CHOICE, AND IMPLEMENTATION OF THE EMR …show more content…
SYSTEM.
As we all know Nurses are on the front lines of patient care. Much of their job requires documentation and communication. This would include their Nursing assessments, progress notes, taking MD orders, documenting medications and treatment administration they have completed. In addition, to do this they are constantly reviewing patient data from imaging studies, laboratory studies, consults and evaluations just to name a few responsibilities. This is why it is crucial that Nurses have some of the greatest input and involvement for the choice of EMR systems and the way it is implemented in a Healthcare setting. They need to evaluate how the software system will work with the documentation and work
Pg. #3 Continued: requirements for their various units they are working on in order to ensure-both time management and effectiveness of communication including reviewing and documenting is as best as possible for improved and timely patient care and interventions.
This leads me to planning. Ideally the best way to roll out a new EMR system is to meet with the Unit Managers, CNO and most importantly the Staff/Floor Nurses to assess the requirements needed to facilitate a EMR system that will work effectively for the Nursing Staff and ensure again, positive patient outcomes as a result of it. This would include their input for the various areas of the medical record they need to access for their job responsibilities as well as any concerns they have with a EMR system and discussing this with the consultants with the EMR company and EMR team.
TOPIC C: BENEFITS TO MOBILE/HANDHELD DEVICES BY NURSES FOR BETTER PATIENT QAULITY CARE.
Nursing is one of the most demanding healthcare professions there is to work in.
Their responsibilities are immense at times and they have to be able to juggle multiple tasks at once with multiple interruptions at times as they are completing their tasks. As a floor Nurse this is even more demanding. Taking care of multiple patients with all the responsibilities that go with it as a Nurse takes excellent Nursing judgment, critical thinking, communication and time management abilities. As much as a Nurse can strive to achieve all of these things to the best of their ability, having to go to the Nurses station to access a policy and procedure manual, access a patients’ physical chart, look up a medication in a drug manual or hand write a MD order can . add to time taken away at the patient’s bedside. PDA’s and W.O.W’s (workstations on wheels) can significantly change all of this. Having these with the Nurse at all times gives them the ability to access information needed to take care of their patients Pg. # 4 Continued: immediately. They can place a telephone order at the Pt’s bedside from a MD into the EMR system, they can look up a lab at the bedside, they could read a imaging study at the bedside, they could access the internet or links designated by the Hospital to research information on a patient or their condition. What this does is increase timely care, reduce time away from the pt and ultimately improve patient outcomes as a
result.
TOPIC D: SECURITY STANDARDS OF DATA/PATIENT CONFIDENTIALITY/STORAGE AND DATA BACKUP AND HIPPA AND HOW IT IMPACTS THE USE OF SYSTEMS. Security standards and patient confidentiality are vital to have in place as a healthcare organization in every type of healthcare setting. With the implementation of EMR systems this has never more been more important as the potential to gain access to this information by unauthorized people/persons has never been easier. To protect these information security standards for EMR’s healthcare organizations have to meet standards for access control this would also include technical requirements of the security and privacy rules of (HIPPA) the Health Insurance Portability and Accountability Act of 1996 as put in to place by the Federal Government. Under these standards for security the healthcare organization needs to protect patient information and with the use of the EMR system they need to permit access to only those persons that have been granted access and applications in the system. Health IT.gov and Health IT.gov and CMS.gov (Centers for Medicare/Medicaid Site) are two extremely important and excellent resources to look at when assessing the rules of HIPPA and a data security plan. The Health IT.gov website in particular points out four main subjects with subtopics as guidelines to use when examining and setting up systems for data
Pg. # 5 Continued: security and patient confidentiality. #1 is Preparation: The most important of the sub-topics related to this is providing leadership to over-see and guide the process. #2 Risk Analysis and Action Plan: This would include assessing/conducting security risk analysis with audits, walking through the units to see assess staff following the measures they were trained on to protect patient information. #3 Risk Management: After assessing all of the information identifying your high priority threat and vulnerabilities and the addressing fixing these areas in accordance with the Federal Standards. You can formulate a action plan that would including updating the Healthcare organizations policies and procedures, education of staff and associates of the healthcare setting including updating contracts and agreements, communication with patients. Also a big part of this is meeting with your Health IT and EMR representatives to assess what Servers and back up servers are need to ensure you have enough storage for all of the information for EMR As well as assessment and decision making processes on what would be the best backup servers and recovery software systems in case of corruption of files or power outages ect. #4 Meaningful Use: These are measures put into place by the Federal Government by “CMS” for EMR systems. Once a healthcare organization has completed and successfully met all the data security and patient confidentiality requirements you will need to “attest” that you have all the systems in place to meet the Federal Standards. When you “attest” to meaningful use it is a legal statement that you have met specific standards, including that you protect ePHI.
TOPIC E: HOW A NEW SYSTERMS CAN AFFECT HEALTHCARE COST.
With any new kind of a system that you are initially going to implement there is usually an initial monetary investment required. With implementation of a EMR system you have a large Pg # 6 Continued: initial investment. This would include the cost of actually purchasing the EMR software system from the company, the training by the company representatives as well as ongoing support and upgrades of the software systems, upgrades to networking systems, buying additional computers and mobile devices to access the EMR systems ect. However over time it is expected there will be a significant savings in administrative cost of a conventional paper type charting system. All the different types of forms needed to be previously hand written on will now be in the EMR system for the different healthcare disciplines/nurses to access and navigate to complete their specific areas needed as part of the patient care. Also, overall time actually spent documenting should be cut down and the Nurses in particular will have mobile computer stations to document as they are working in the halls and patients rooms. This will potentially cut down on amount of over time for Nurses previously needing to stay after completion of their assigned shift and finish their required notes and assessments.
TOPIC F: BENEFITS EMR SYSTEMS CAN OFFER TO PATIENT CARE AND NURSING CARE DELIVERY. The benefits to using any EMR system are potentially immense and far outweigh the cons. Having information readily available for Nurses as they are working out on the floors, and at the patients bed side is going to improve Nursing care delivery and will improve and increase positive patient outcomes. The reasons are simple; the ability for the Nurse to have ALL of the patient’s information on their mobile workstation computer will save the Nurse huge amounts of time having to run back and forth from the Nurses station to gather and research information and then run back to the patient room. Instead everything they will need will be set up on their mobile computers. The software will also have checks and balances to reduce medical errors such as allergic reactions to medications that are prescribed if the allergies were logged in
Pg # 7 Continued:
-already as a specific example. And the time savings for the Nurses equals more time being able to spend at the patient’s bedside treating them and assessing them more often than before with a paper chart system. As a result of increased patient care outcomes you will have much happier and satisfied patients and family members. Having this growing improvement in these areas will also potentially lead for the healthcare organization to make more money from increased patient admissions and visits and procedures. Below in section titled F #1. , I have compared the 2 different EMR systems our organization is looking at for possible purchase and implementation A: “Paragon” and B “Meditech 6.0”
TOPIC F/# 1: EMR SYSTEM SOFTWARE RECCOMENDATIONS FOR PURCHASE.
As the Director of Nursing Informatics I have reviewed and used the two software systems we are looking at potentially purchasing. I have named one system A: “Paragon” EMR System and the other system B: Meditech 6.0 EMR System.
System A “Paragon”- Pros.:
#1 Cost:-EMR system A is $50,000 dollars less expensive than system B.
#2-The EMR company is local and have their Representative can come out almost immediately if there is a issues that needs addressing.
#3-The EMR system is very data secure to use as it requires you to enter your username and password not just to enter the EMR itself but for every area within the EMR chart like UR for case managers, progress notes, imaging studies ect.
System A “Paragon” Cons:
Pg. #8 Continued:
#1 Ease of Use: The EMR systems is very cumbersome, too task extensive to navigate the EMR chart as a result of the security measures they built in. For Example: You have so many different symbol Icons it is difficult to remember what Icons stands for what section of the chart. Once the user does click on these various icons they have to again enter their username and password. This is adding to additional time needed to review, document and navigate the patients chart not much of an improvement over a physical chart. Therefore not rally a cost savings or predicted improvement of nursing care or time management savings for Nurses.
System B “Meditech 6.0” Pros:
#1: Ease of use/Reputation: System B is extremely easy to use and navigate. As a result, the Meditech system is much quicker to navigate through all of the areas of the chart. It is also less confusing. Instead of numerous Icon symbols there are clearly labeled and titled areas of the chart, so instead of having to try to remember all of these Icons you just read the title of that part of the EMR .For example, notes, reports, labs, medications ect. Also once you click on it you do not have to renter your username and password again and again like the other software system. Also the documents and systems are much more user friendly to put information in and
Pg # 9 continued:
-less confusing to read and review. Also per research of this EMR system it is found to be one of the most widely used systems in the Nation with a excellent reputation per all the review. Even though system B-Meditech costs $50,000 more dollars than system A Paragon I believe it will save us even more money and provide better quality patient outcomes than system A in the long term as well as even the short term. The time saving is immense over system A- Paragon and even more immense over our hand written conventional medical record. Also system B has a better and more comprehensive customer services and ongoing product support package than system A.
F#1 Cont Reccs.
As a result of above information I recommend system B: “Meditech 6.0” to be the EMR system that we move forwards with purchasing for our healthcare organization.
F#1a Justification:
In Conclusion and justification, in choosing Meditech 6.0 EMR System over Paragon EMR System I have looked at ease of use to navigate the EMR system which included simplicity to navigate and complete necessary documentation for the Nurses as well as review EMR information far surpasses the Paragon system. The Paragon system is much too difficult to navigate is more complicated and requires the Nurse to enter their username and password again and again each time they enter a new area of the EMR as well as having numerous icons that seem far too unnecessary and confusing to remember. Also Meditech is one of the most widely used EMR systems in our area. This will also benefit the outside Attending MD’s who round at
Pg. #10 continued:
-other Hospitals who use the same system and they will need less training as a result. The same is for the Nurses it appears Meditech will require much less training to implement with the Nurses as well as they will be able to navigate through the EMR for each patient so much faster than Paragon that they will have much more time with actual patient care over the Paragon system and even much greater time than with a Physical Charting system.
Thank You Gary Holt RN
Director of Nursing Informatics.
Report Prepared By:
Gary Holt RN
Director of Nursing Informatics.
Pg. #1 TOPIC A: EMR SYSTEMS AND PATIENT QAULITY CARE OUTCOMES.
EMR stands for “Electronic Medical Record”. This section of the report is to explain to you the benefits to improving the quality of patient care we can provide to our patients by utilizing the EMR system. As we all know our number one goal is positive patient outcomes and safety of our patients. Part of this is always looking for the latest technologies and systems available in which to achieve this and to continue to improve positive patient outcomes. So you may ask how these positive outcomes would be …show more content…
achieved through utilization of an EMR software system.
The first topic I would like to make mention of which is crucial to all of us in direct patient care is, TIME MANAGEMENT. I have capitalized this in bold print to emphasize its importance. The EMR system in comparison to our current hand written system with the Physical medical record will cut down on documentation time immensely. How you may ask? The first main point I would like to make is with use of the EMR system all disciplines of the healthcare team will have the ability to access the patient’s medical record at the same time to review and enter any information for the care of the patient. You will no longer need to wait for a physical medical record in which you have to track down as well as wait to use if someone else is using it or if the patient is off the unit for a test.. And you will no longer have to wait to hand write a note, order, or assessment as you will be able to log in to the EMR system to enter and review this information. Once you have entered and saved this information it will be available almost immediately for not only you but for everyone else reviewing that patients information to see as well. And what this will do as a result is cut down on the time previously needed with a hand written chart being shared. This in turn will create much more time actually taking care of Pg. #2 Continued: the patients to better assess, provide more frequent communication with them as well amongst us as a multi-disciplinary team.
The second main point I would like to make is in regards to potential misinterpretations or medical mistakes as the result of illegible or messy handwriting.
As we all know the amount of documentation we have to provide for our patients is more and more every year. The reasons as we all know are mainly lawsuit and medical malpractice driven in conjunction with more and more state as well as federal rules and regulations. Having progress notes, assessments, and consults, diagnostic imaging studies and most importantly M.D. orders in a typed easy to read format will cut down on these potential errors drastically by being able to read and interpret them without question. Also, by being able to read the information that is now typed with ease; if there is a further need of clarification to be questioned, it will be recognized and addressed much quicker than previously.
TOPIC B: THE IMPORTANCE OF NURSING INVOLVEMENT IN THE PLANNING, CHOICE, AND IMPLEMENTATION OF THE EMR …show more content…
SYSTEM.
As we all know Nurses are on the front lines of patient care. Much of their job requires documentation and communication. This would include their Nursing assessments, progress notes, taking MD orders, documenting medications and treatment administration they have completed. In addition, to do this they are constantly reviewing patient data from imaging studies, laboratory studies, consults and evaluations just to name a few responsibilities. This is why it is crucial that Nurses have some of the greatest input and involvement for the choice of EMR systems and the way it is implemented in a Healthcare setting. They need to evaluate how the software system will work with the documentation and work
Pg. #3 Continued: requirements for their various units they are working on in order to ensure-both time management and effectiveness of communication including reviewing and documenting is as best as possible for improved and timely patient care and interventions.
This leads me to planning. Ideally the best way to roll out a new EMR system is to meet with the Unit Managers, CNO and most importantly the Staff/Floor Nurses to assess the requirements needed to facilitate a EMR system that will work effectively for the Nursing Staff and ensure again, positive patient outcomes as a result of it. This would include their input for the various areas of the medical record they need to access for their job responsibilities as well as any concerns they have with a EMR system and discussing this with the consultants with the EMR company and EMR team.
TOPIC C: BENEFITS TO MOBILE/HANDHELD DEVICES BY NURSES FOR BETTER PATIENT QAULITY CARE.
Nursing is one of the most demanding healthcare professions there is to work in.
Their responsibilities are immense at times and they have to be able to juggle multiple tasks at once with multiple interruptions at times as they are completing their tasks. As a floor Nurse this is even more demanding. Taking care of multiple patients with all the responsibilities that go with it as a Nurse takes excellent Nursing judgment, critical thinking, communication and time management abilities. As much as a Nurse can strive to achieve all of these things to the best of their ability, having to go to the Nurses station to access a policy and procedure manual, access a patients’ physical chart, look up a medication in a drug manual or hand write a MD order can . add to time taken away at the patient’s bedside. PDA’s and W.O.W’s (workstations on wheels) can significantly change all of this. Having these with the Nurse at all times gives them the ability to access information needed to take care of their patients Pg. # 4 Continued: immediately. They can place a telephone order at the Pt’s bedside from a MD into the EMR system, they can look up a lab at the bedside, they could read a imaging study at the bedside, they could access the internet or links designated by the Hospital to research information on a patient or their condition. What this does is increase timely care, reduce time away from the pt and ultimately improve patient outcomes as a
result.
TOPIC D: SECURITY STANDARDS OF DATA/PATIENT CONFIDENTIALITY/STORAGE AND DATA BACKUP AND HIPPA AND HOW IT IMPACTS THE USE OF SYSTEMS. Security standards and patient confidentiality are vital to have in place as a healthcare organization in every type of healthcare setting. With the implementation of EMR systems this has never more been more important as the potential to gain access to this information by unauthorized people/persons has never been easier. To protect these information security standards for EMR’s healthcare organizations have to meet standards for access control this would also include technical requirements of the security and privacy rules of (HIPPA) the Health Insurance Portability and Accountability Act of 1996 as put in to place by the Federal Government. Under these standards for security the healthcare organization needs to protect patient information and with the use of the EMR system they need to permit access to only those persons that have been granted access and applications in the system. Health IT.gov and Health IT.gov and CMS.gov (Centers for Medicare/Medicaid Site) are two extremely important and excellent resources to look at when assessing the rules of HIPPA and a data security plan. The Health IT.gov website in particular points out four main subjects with subtopics as guidelines to use when examining and setting up systems for data
Pg. # 5 Continued: security and patient confidentiality. #1 is Preparation: The most important of the sub-topics related to this is providing leadership to over-see and guide the process. #2 Risk Analysis and Action Plan: This would include assessing/conducting security risk analysis with audits, walking through the units to see assess staff following the measures they were trained on to protect patient information. #3 Risk Management: After assessing all of the information identifying your high priority threat and vulnerabilities and the addressing fixing these areas in accordance with the Federal Standards. You can formulate a action plan that would including updating the Healthcare organizations policies and procedures, education of staff and associates of the healthcare setting including updating contracts and agreements, communication with patients. Also a big part of this is meeting with your Health IT and EMR representatives to assess what Servers and back up servers are need to ensure you have enough storage for all of the information for EMR As well as assessment and decision making processes on what would be the best backup servers and recovery software systems in case of corruption of files or power outages ect. #4 Meaningful Use: These are measures put into place by the Federal Government by “CMS” for EMR systems. Once a healthcare organization has completed and successfully met all the data security and patient confidentiality requirements you will need to “attest” that you have all the systems in place to meet the Federal Standards. When you “attest” to meaningful use it is a legal statement that you have met specific standards, including that you protect ePHI.
TOPIC E: HOW A NEW SYSTERMS CAN AFFECT HEALTHCARE COST.
With any new kind of a system that you are initially going to implement there is usually an initial monetary investment required. With implementation of a EMR system you have a large Pg # 6 Continued: initial investment. This would include the cost of actually purchasing the EMR software system from the company, the training by the company representatives as well as ongoing support and upgrades of the software systems, upgrades to networking systems, buying additional computers and mobile devices to access the EMR systems ect. However over time it is expected there will be a significant savings in administrative cost of a conventional paper type charting system. All the different types of forms needed to be previously hand written on will now be in the EMR system for the different healthcare disciplines/nurses to access and navigate to complete their specific areas needed as part of the patient care. Also, overall time actually spent documenting should be cut down and the Nurses in particular will have mobile computer stations to document as they are working in the halls and patients rooms. This will potentially cut down on amount of over time for Nurses previously needing to stay after completion of their assigned shift and finish their required notes and assessments.
TOPIC F: BENEFITS EMR SYSTEMS CAN OFFER TO PATIENT CARE AND NURSING CARE DELIVERY. The benefits to using any EMR system are potentially immense and far outweigh the cons. Having information readily available for Nurses as they are working out on the floors, and at the patients bed side is going to improve Nursing care delivery and will improve and increase positive patient outcomes. The reasons are simple; the ability for the Nurse to have ALL of the patient’s information on their mobile workstation computer will save the Nurse huge amounts of time having to run back and forth from the Nurses station to gather and research information and then run back to the patient room. Instead everything they will need will be set up on their mobile computers. The software will also have checks and balances to reduce medical errors such as allergic reactions to medications that are prescribed if the allergies were logged in
Pg # 7 Continued:
-already as a specific example. And the time savings for the Nurses equals more time being able to spend at the patient’s bedside treating them and assessing them more often than before with a paper chart system. As a result of increased patient care outcomes you will have much happier and satisfied patients and family members. Having this growing improvement in these areas will also potentially lead for the healthcare organization to make more money from increased patient admissions and visits and procedures. Below in section titled F #1. , I have compared the 2 different EMR systems our organization is looking at for possible purchase and implementation A: “Paragon” and B “Meditech 6.0”
TOPIC F/# 1: EMR SYSTEM SOFTWARE RECCOMENDATIONS FOR PURCHASE.
As the Director of Nursing Informatics I have reviewed and used the two software systems we are looking at potentially purchasing. I have named one system A: “Paragon” EMR System and the other system B: Meditech 6.0 EMR System.
System A “Paragon”- Pros.:
#1 Cost:-EMR system A is $50,000 dollars less expensive than system B.
#2-The EMR company is local and have their Representative can come out almost immediately if there is a issues that needs addressing.
#3-The EMR system is very data secure to use as it requires you to enter your username and password not just to enter the EMR itself but for every area within the EMR chart like UR for case managers, progress notes, imaging studies ect.
System A “Paragon” Cons:
Pg. #8 Continued:
#1 Ease of Use: The EMR systems is very cumbersome, too task extensive to navigate the EMR chart as a result of the security measures they built in. For Example: You have so many different symbol Icons it is difficult to remember what Icons stands for what section of the chart. Once the user does click on these various icons they have to again enter their username and password. This is adding to additional time needed to review, document and navigate the patients chart not much of an improvement over a physical chart. Therefore not rally a cost savings or predicted improvement of nursing care or time management savings for Nurses.
System B “Meditech 6.0” Pros:
#1: Ease of use/Reputation: System B is extremely easy to use and navigate. As a result, the Meditech system is much quicker to navigate through all of the areas of the chart. It is also less confusing. Instead of numerous Icon symbols there are clearly labeled and titled areas of the chart, so instead of having to try to remember all of these Icons you just read the title of that part of the EMR .For example, notes, reports, labs, medications ect. Also once you click on it you do not have to renter your username and password again and again like the other software system. Also the documents and systems are much more user friendly to put information in and
Pg # 9 continued:
-less confusing to read and review. Also per research of this EMR system it is found to be one of the most widely used systems in the Nation with a excellent reputation per all the review. Even though system B-Meditech costs $50,000 more dollars than system A Paragon I believe it will save us even more money and provide better quality patient outcomes than system A in the long term as well as even the short term. The time saving is immense over system A- Paragon and even more immense over our hand written conventional medical record. Also system B has a better and more comprehensive customer services and ongoing product support package than system A.
F#1 Cont Reccs.
As a result of above information I recommend system B: “Meditech 6.0” to be the EMR system that we move forwards with purchasing for our healthcare organization.
F#1a Justification:
In Conclusion and justification, in choosing Meditech 6.0 EMR System over Paragon EMR System I have looked at ease of use to navigate the EMR system which included simplicity to navigate and complete necessary documentation for the Nurses as well as review EMR information far surpasses the Paragon system. The Paragon system is much too difficult to navigate is more complicated and requires the Nurse to enter their username and password again and again each time they enter a new area of the EMR as well as having numerous icons that seem far too unnecessary and confusing to remember. Also Meditech is one of the most widely used EMR systems in our area. This will also benefit the outside Attending MD’s who round at
Pg. #10 continued:
-other Hospitals who use the same system and they will need less training as a result. The same is for the Nurses it appears Meditech will require much less training to implement with the Nurses as well as they will be able to navigate through the EMR for each patient so much faster than Paragon that they will have much more time with actual patient care over the Paragon system and even much greater time than with a Physical Charting system.
Thank You Gary Holt RN
Director of Nursing Informatics.