Table of Contents

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

Name: Academic Research Bureau
Item: Academic Research Bureau
Rating: 5
Author: Shawn Chamberlain

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.

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.

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 4 peer-reviewed research articles from your research.
For information about annotated bibliographies, visit https://academicguides.waldenu.edu/writingcenter/assignments/annotatedbibliographies

The Assignment: (4-5 pages not including the title and reference page)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography. Be sure to address the following:

Identify the 4 peer-reviewed research articles you reviewed, citing each in APA format.
Include an introduction explaining the purpose of the paper.
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.
In your conclusion, synthesize the findings from the 4 peer-reviewed research articles.
Use APA format and include a title page.
Use the Safe Assign Drafts to check your match percentage before submitting your work.

By Day 7 of Week 8

Submit your completed Assignment.

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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

Students usually submit formatting several different ways. Your paper should follow this organizational model:

Start with a title page: Page numbers are always upper right-hand corner; centered on the page is Title of your paper (bolded); your name; Course number and course name; Walden University; Instructor name; date of submission. Do not add a header (this has not been required for nearly 2 years at Walden). Do not add an abstract. Do not add a Table of contents.
On the second page add a heading: Title of your paper (this first heading is bolded).
The first paragraph is the introduction to your topic. Include the main points to be found in your paper. Include a purpose statement: The purpose of this paper is…..
Body of the paper: Heading (left-justified): A couple word description of the topic(all of these headings are bolded with the first letter of each word capitalized). Ensure you include Summary of articles; Improvements to outcomes; Efficiencies; Lessons learned from application. This is not a brief exercise.
The final paragraph is the conclusion. Heading: Conclusion(left justified). The conclusion is a summary and reminds the reader of the main points. There is no new content added to a conclusion paragraph.
Lastly, Reference page. Heading: References is centered on the line and All articles and other scholarly sources noted in the paper will be presented here in full reference format. Please do review basic APA: double spaced, the second and third lines are indented 7 to 10 spaces; Titles of books, webpages with no journal, and journal titles and volume numbers are italicized. The author/s/organization is the AUTHOR, then the (year) of publication, then the title of the article or webpage, Add the journal title volume, issue, page number if you have it or the website name, and/or either the doi number or the retrieved from url. Follow APA guidelines.

Expert Answer and Explanation

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

Among the most recent but significant changes in healthcare and nursing is the introduction of technology-aided clinical systems. Starting from electronic health records to the use of artificial intelligence systems in delivering healthcare, these technology systems have helped to increase efficiency in healthcare organizations. Clinicians can also deliver healthcare with much ease, and it also becomes easy to reach the desired patient compliance levels. Healthcare technologies are also coupled with different challenges which upon addressing would help to achieve even better outcomes. This essay analyses different scholarly articles that explain the use of clinical systems in the improvement of efficiency in the care continuum and the windows of improvement of the available technologies.

Annotated Bibliography

Kruse, C. S., & Beane, A. (2018). Health Information Technology Continues To Show Positive Effect On Medical Outcomes: Systematic Review. Journal of medical Internet research, 20(2), e41. http://preprints.jmir.org/preprint/8793

The article explains about the positive effects that health information technology has on the medical outcomes. The authors explain about the origin of health information technology, where it was introduced in the 60s, and its implementation became evident in the 1990s. The article is qualitative and is conducted with a primary aim of analyzing the current literature about the implication of the HIT resources on the medical outcomes. The authors conducted a search in various databases with the main ones being MEDLINE and CINAHL, where the most recent peer-reviewed publications were assessed. According to the findings of the article, over 81% of the sources suggested that there is at least one medical outcome that is as a direct result of adoption of HIT in healthcare. The article is therefore a source that shows some of the positive effects that HIT is associated with in the healthcare outcomes.

Hodgson, T., Magrabi, F., & Coiera, E. (2018). Evaluating the Efficiency and Safety of Speech Recognition within a Commercial Electronic Health Record System: A Replication Study. Applied clinical informatics, 9(2), 326. Doi: 10.1055/s-0038-1649509

This article entails the analysis of a critical aspect in an electronic health record system, which is a speech recognition system. The authors conduct a study with the aim of validating different risks and inefficiencies that are encountered when using speech recognition technologies in electronic health record system. The study analyses thirty five ED clinicians using the experimental design, examining the various technical issues that could lead to poor performance of the speech recognition systems. The results of the study show that speech recognition is a technology that leads to increased errors as well as reduced time deficiencies. The study suggests that much as the new technology of speech recognition software may have a smart model of implementation, it poses various challenges to performance, which call for integration of even better technologies in the collection of information using electronic health records.

Gidwani, R., Nguyen, C., Kofoed, A., Carragee, C., Rydel, T., Nelligan, I., & Lin, S. (2017). Impact of Scribes on Physician Satisfaction, Patient Satisfaction, and Charting Efficiency: A Randomized Controlled Trial. The Annals of Family Medicine, 15(5), 427-433. https://doi.org/10.1370/afm.2122

The article explains the impacts of having scribes in healthcare, in terms of the charting efficiency, patient satisfaction, and physician satisfaction. Scribes are medical professionals who assist in the transcription of information during patient visits into the electronic health records in the presence of the supervision of physicians. One of the main reasons why clinical systems have become hard to implement is the workload they create for direct care physicians, and hence most healthcare facilities have implemented the position of scribes. The authors of the article conducted the study with the aim of understanding the effect that medical scribes have using a randomized control trial. In the control set up, the study involved tasks where physicians conducted their regular activities such as charting without the assistance of the scribes. The findings show that scribes are among the top individuals who help in boosting physician satisfaction as they help to maintain their healthy contact without interference from the other technology demands of the healthcare process. They also help in improving the accuracy of charts, reduce physician burnout, and hence indirectly promote improvement in implementation of new technologies in facilities.

Griffin, A., Skinner, A., Thornhill, J., & Weinberger, M. (2016). Patient Portals: Who Uses Them? What Features Do They Use? And Do They Reduce Hospital Readmissions? Applied clinical informatics, 7(2), 489. Doi: 10.4338/ACI-2016-01-RA-0003

The article explains some of the information surrounding the use of patient portals, which is among the top technologies that have been implemented recently to improve healthcare outcomes. The aim of the article is to identify the common characteristics of patients who are associated with the use of patient portals, to determine the frequency of usage of patient portals, and to examine the relationship between the usage of patient portals with hospital readmission. The authors start by explaining some of the proven benefits of using patient portals, which include but are not limited to improved patient engagement, better patient-provider relations, and increased patient satisfaction. The methodology applied in the study is the monitoring of the UNC Chart, where patients of pneumonia, myocardial infarction, and congestive heart failure are examined. The results indicate that chronic disease patients who have higher chances of readmission are the primary users of patient portals. It also recommends healthcare systems to increase the campaigns for the use of patient portals in healthcare as they are associated with improved results.

Conclusion

The four peer-reviewed sources show that clinical systems play a central role in the implementation of clinical outcomes, despite the presence of different challenges that prevent their swift implementation. The use of health information technology has increased over the course of the past few decades, and has been successfully applied in the implementation of physician and patient satisfaction. Patient portals, for example, have made it easier for patients to access first hand healthcare, where they can monitor the progress of their illness and healthcare givers can also track their medications. Among some of the common challenges that are associated with the application of the new clinical systems is increased fatigue among primary healthcare providers. A solution to the same is the use of scribes, who take up much of the non-clinical roles such as documentation and patient charting. Some technologies, however, are not as successful, and need improvement for them to be beneficial in the implementation of better patient outcomes. One example of such technologies is the speech recognition software, which does not have significant effects in improving healthcare delivery. Healthcare managers should vet the different technologies before implementing them in facilities on a wide scale.

References