By Susan McBride, PhD, RN, professor at Texas Tech University Health Science Center School of Nursing. McBride and fellow nurse informaticists Mari Tietze and John Delaney will be blogging here on the intersection of nursing and informatics in the coming days.
Everyone knows by now that the Obama administration has made electronic health records (EHRs) a high priority and is providing financial incentives to health care providers (and yes, nurses are included in that group) to adopt them. But not everyone knows it’s not just about converting records from paper to digital—its much more than that.
On July 13, the Office of the National Coordinator (ONC) for Health Information Technology (HIT) released the final rules establishing definitions for the “meaningful use” of EHRs. The final rule is 864 pages and contains critical information for nurses to understand about how electronic records will change our lives.
(No one expects every nurse to read the entire document. That’s why we’re going to be blogging about some important aspects of the topic. In the meantime, click here for a good overview of meaningful use and electronic medical records, as well as links to more exhaustive information. And for a short, useful table breaking down the rule by health outcomes policy priorities such as “improving care coordination,” have a look at this PDF: Stage 1. Meaningful Use Objectives and Associated Measures Sorted by Core and Menu Set.)
Ongoing concerns. The idea behind these rules is to establish EHRs within a National Health Information Network that will allow us to exchange health care information regardless of where we are in the nation. There are many concerns about privacy and security related to this network, and these concerns are likely to be the most difficult component to address in establishing it. But there are definite clinical advantages.
Consider the benefits of the ability to retrieve information on patients entering the ER unresponsive and critically injured, or on a child whose parents aren’t there to provide a history. The EHR provides information at our fingertips on things such as health history, medication usage, and allergies. Another practical advantage is that we will no longer need to have patients fill out form after form with the same information on it. We may also reduce the need for expensive tests such as CT scans, MRIs, and laboratory tests that we frequently rerun because the results are not available when needed. And it will be easier to track outcomes, so it will be easier to establish which quality initiatives are successful.
Making nurses part of the design. The complexity is in how this will happen. These new “meaningful use” rules are at the epicenter of “the how.” What’s important for any nurse right now is that you find out what your organization is doing to develop EHRs and make sure nursing’s voice is represented in this process. We need to be part of the design in order to make it meaningful for use at the point of care. In an upcoming issue of AJN, and in upcoming posts on this blog, we’ll go into detail on what this specifically means for nurses.