Ready or Not: Here Come Electronic Health Records

Generally, EHR systems (also known as electronic medical records or EMRs) improve nursing documentation, reduce medication errors, and make for a better work environment. This study is different because it is an analysis of results at the front lines. University of Pennsylvania researchers surveyed 16,362 nurses working in 316 hospitals in California, Florida, New Jersey, and Pennsylvania. The nurses were asked about their workload and patient outcomes, as well as their hospital's patient safety culture. Of the 316 hospitals, only seven percent had a basic EHR system functioning on all patient care units.

The results: nurses working in an EHR environment are less likely to report poor patient safety compared to their peers working in non-EHR environments. In hospitals with fully implemented EHRs, nurses were significantly less likely to report unfavorable outcomes compared to nurses working in hospitals without fully implemented EHRs.

Nurses in the fully implemented hospitals also were less likely to note frequent medication errors, poor quality of care, and poor confidence in a patient being ready for discharge. These nurses also had a 14 percent decrease in the odds of reporting that "things fell between the cracks" when patients were transferred between units. They were also less likely to report that patient safety is a low priority for hospital management.

Aiming for 80 Percent Adoption

A May 2012 report from International Data Corporation provides an assessment of EHR products that target small physician practices and qualify for American Recovery and Reinvestment Act of 2009 (ARRA) incentives. The market intelligence company expects the US market to move from less than 25 percent adoption in 2009 to more than 80 percent adoption by 2016. This anticipated growth is primarily influenced by regulatory stipulations and government incentives under the ARRA. Additional trends include:

  • Quality of care improvements that result from using EMRs/EHRs in ambulatory practices

  • Their growing capabilities

  • Use of cloud computing

  • Use of mobile devices in ambulatory practices

  • Consolidation of provider vendors as market saturation increases

Going for the EHR Gold

For the first time, United States Olympic Committee (USOC) is using an EHR system for managing athlete care. GE’s Centricity Practice Solution is being used to manage the care of more than 700 Team USA athletes competing in the London Olympic Games (July 27 to August 12, 2012), as well as 3,000 additional records of other athletes who have been seen by USOC doctors in recent years.

As the USOC describes it, the technology will replace pallets of paper records historically shipped by the USOC to the Games and will provide physicians with faster access to athletes’ medical records—ultimately supporting more targeted care. Also, with the average Olympian seeing eight different doctors at any one time, having everything in one digital place makes EHRs a huge time saver.

William J. Moreau, DC, USOC managing director of sports medicine, said EHR technology will facilitate the monitoring and management of the health of Team USA athletes. On any given day, he said, Olympic athletes are spread all around the world, training, conditioning, competing, and, occasionally, getting injured or falling ill. When that happens, effective treatment and fast recovery can mean the difference between silver and gold. “Our elite athletes have dedicated themselves to performing at the highest levels in sport and I believe this technology will help us to support them with the highest levels of sports medicine.”

Corey Angst, PhD, MBA, assistant professor of management in the University of Notre Dame's Mendoza College of Business, is an expert on health information technology. He said, "I think it is fantastic that the U.S. Olympic Committee is finally going digital. I can't imagine the complexity of trying to maintain the mountains of paper records for those athletes."

It also offers new opportunities for study. Analytics can be used to track injuries, for example, comparing those who succeed with rehabilitation with those who do not recover. This may help identify best practices and develop clinical pathways to care that will help future athletes.

1. Kutney-Lee A, Kelly D. J Nurs Adm. 2011;41:466-72.
2. IDC MarketScape: US Ambulatory EMR/EHR for Small Practices May 2012 Vendor Assessment (Document # HI234732).

Keywords: Athletes, Patient Care, Sports, Medical Informatics, Data Collection, Patient Safety, Critical Pathways, Electronic Health Records, Medication Errors, Workload, American Recovery and Reinvestment Act, Sports Medicine, Nurses, United States

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