IndexAdvantages and Disadvantages of a SystemQuality Patient Care and DocumentationUse of Quality Improvement Data Leads to Measurable ImprovementsHIPAA and HITECH Security StandardsConclusionUsage of technology in healthcare is not a new concept but its growing need and use of technological advancements have had a great impact on healthcare as a whole. Health information systems (HIS) have become an important component in using technology to improve the quality of care, increase satisfaction and reduce costs. Although, as with all new advancements and programs, there are drawbacks. Since the goal of nursing informatics is to improve patient care, continuous monitoring of its advantages and disadvantages on the quality of patient-centered care should be carried out. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an Original Essay System Advantages and Disadvantages When choosing a new HIS system for a facility, there are four main areas to consider: usability, interoperability, scalability, and compatibility. The connection between technology and human acceptance and ability to use it, human-computer interaction (HCI), is usability (Acrobatiq, 2019). Simply put, usability is how easily staff can use it. Some benefits include the ability to complete charts in real time, increase staff productivity, provide immediate patient education and answers to care plan questions, and have all patient information at your fingertips. Some disadvantages of usability are the ability of staff to find alternative solutions, the lack of training and trust on the part of users, and the decrease in human-human interactions by nurses who do not look up from the computer during care and training, causing a decrease in patient satisfaction. Interoperability is the ability of different systems to work together and the ability of organizations to share information (Mastrian and McGonigle, 2017). In other words, the ability of programs to speak the same language. Imagine visiting the emergency room with increasing symptoms of gastrointestinal distress. Once you receive treatment, you are discharged and told to see a gastroenterologist the next day. During that visit your doctor can retrieve your treatment history, emergency room tests performed, and the number of times you have been to the emergency room for the same symptoms. As a patient you didn't have to try to remember what the emergency room doctor said, what medications you were given, or what tests they performed. It was all in your medical record and was reviewed at the start of the appointment, which led to a quicker diagnosis. This is a great advantage of interoperability. As a patient you already don't feel well, so being able to perform more timely patient-centered care increases patient satisfaction, decreases costs, and a quicker diagnosis improves symptoms and overall health. The main disadvantage of interoperability would be system failures. Failures can be caused by human errors, viruses, or power outages that prevent medical equipment and devices from transferring data (Mastrian and McGonigle, 2017). The ability of a system, such as the electronic health record (EHR), to grow with an organization and provide the resources to support growth and scalability. The advantage of scalability is the program's ability tostay updated and effective. With the emergence of new technologies such as diagnostics and medical devices, both patients and doctors follow these advances and want them added for their use. These programs will need room for expected growth. Adding cloud servers is useful and necessary to increase storage space throughout your organization. HIS are very expensive systems that require a large amount of time and resources to implement. If the program is not scalable it could be replaced within a few years, which leads to the main disadvantage being the cost. The more updates and customizations made within a system, the higher the investment cost will be. You need to find a balance between current needs and projected growth that leads to the final area, compatibility. Compatibility is the ability of devices and software to work with each other independently but in the same organization and platform (Acrobatiq, 2017). For doctors, having access to patient records to review, add notes, upload images and documents, and place orders from their phones and tablets is a great benefit. Additionally, allowing patients to access personal health information (PHI) as easily increases patient satisfaction and encourages them to take a broader role in managing their health. A system will fail in all areas of usability, interoperability and scalability if it is not compatible with multiple operating systems, networks and platforms such as MAC and Windows and their various versions in use such as Microsoft and Linux. This is the main disadvantage of a system. When these programs are not compatible, frustration increases and redundancy occurs which can lead to workarounds and human error. Users must be comfortable with the various programs, maintain training, logins and passwords, and be sure not to overlook or miss entering data from one program to another into the charts. Quality Patient Care and Documentation When all of the above components (usability, interoperability, scalability, and compatibility) are addressed HIS systems, such as the EHR, can have a tremendous impact on patient healthcare and dramatically improve outcomes of patients. So far, how doctors and patients can use HIS to improve care has been addressed, but little has been included about how essential the EHR is to the bedside nurse. To best illustrate this concept, let's follow a bedside nurse through the hospitalization of a neonatal patient. A neonatal intensive care unit (NICU) nurse is informed that a newborn will be admitted soon. A lot of data needs to be collected for this hospitalization to run smoothly and provide the best care and outcome for the patient and family. The newborn does not have a medical history to review, but the mother does so the nurse can access her PHI in the EHR. This data will include the mother's blood type, level of prenatal care, vaccine records, medications administered and prescribed at home, laboratory values, related diagnoses, and the newborn's gestation and labor tolerance based on decelerations on the fetal monitor. It is essential to know all this information when preparing for birth and anticipating the care that will be needed. The nurse learns that the mother was initially hospitalized to rule out HELLP syndrome and that she is 34 2/7 weeks gestation. Furthermore, she has an advanced maternal age and has followed all prenatal care, her only home medications were prenatal vitamins and calcium carbonate, she is up to date with hervaccines and is blood type O+, so the RhoGAM injection is not necessary and the newborn is not at risk of ABO incompatibility. After reviewing the mother's vital signs and laboratory tests, the nurse notes an upward trend in blood pressure and liver enzymes that should correlate with the diagnosis of HELLP syndrome. The nurse then consults the mother's Medication Administration Record (MAR) to assess which medications she is currently taking. As expected, mother is on a magnesium drip to reduce blood pressure, Ringer's lactate as she is NPO and received betamethasone 3 hours prior. Based on this data, the nurse can anticipate the orders of the neonatologist, some signs, symptoms and needs of the newborn upon arrival in the unit. Due to the size of the newborn, an incubator and heater are set up, resuscitation equipment and ventilator are collected and set according to gestational age, blood tubes for blood tests are collected, materials for centerline placement, fluids, and a IV poles are also collected knowing that the child will be based on NPOon the set order. With maternal magnesium administration, late decelerations on the fetal monitor, and gestational age, the nurse anticipates that the newborn will have reduced muscle tone and respiratory effort, which is why the ventilator is used. Without the EHR the nurse would not have had enough time to prepare for arrival on the unit in a timely and accurate manner. The nurse would spend most of her time on the phone trying to gather as accurate data as possible from the delivery room nurse who is also caring for the mother. The information would have been late and not very detailed. When caring for the neonatal population, timeliness and efficiency of care are of the utmost importance. Newborns have very few reserves of blood glucose and brown fat available to maintain the vital functions of their little bodies. Wasted time greatly affects your results and quality of life. After the baby is delivered via cesarean section, the admission is called and the baby is activated in the EHR. This now allows the various systems to transfer data such as vitals on arrival and as ordered, medication scanning, ventilator settings, intravenous fluids administered via the pump, and blood sugar readings. It also allows the care team to activate order sets for the newborn. After the hustle and bustle of the initial admission and stabilization process, the nurse can now review orders within the EHR to verify they are all completed, track assessments, add notes, activate the nursing care plan, and review tests diagnostics. At shift change, the nurse can review all of the baby's and mother's history, orders and results with the oncoming nurse quickly and efficiently as all data is at their fingertips on one summary page , which is also used to help prioritize patient care. This example illustrates many of the benefits of HIS. The ability to review the complete medical history allowed the nurse to anticipate care needs and prepare to reduce stress on the newborn and the care team by improving the newborn's overall health. This also reduces waste by only collecting supplies you expect to use. Having systems that seamlessly transfer data such as lab values, vital signs, and equipment settings into the charting system saves time, reduces errors, and eliminatesredundancy, which reduces the overall cost of care. Real-time charting promotes assessment accuracy and family education. Additionally, the use of an HIS standardizes the terminology used which bridges the gap in communication between healthcare professionals (Hawkins, 2014). Using quality improvement data leads to measurable improvementsQuality improvement (QI) includes a combination of quality indicators produced by two main organizations: the Agency for Healthcare Research and Quality (AHRQ) and the National Indicators Database of Nursing Quality (NDNQI). The focus of these initiatives is on patient safety research after the “Crossing the Quality Chasm” report was published in 2001 by the Institute of Medicine which highlighted problems related to the safety and quality of patient care (Acrobatiq , 2019). The main focus of these two organizations is their main difference. The NDNQI's primary focus is more on the quality and outcomes of nursing care, while the AHRQ focuses more on hospital- and area-specific indicators regarding prevention, hospitalization, patient safety, and pediatrics. In the wake of the focus on healthcare reform, many projects have been initiated in the United States with the goal of improving the patient care experience, improving population health, and reducing healthcare costs (Weston & Roberts, 2013). Quality data must be relevant, timely, thorough, objective, transparent, reproducible and verifiable (Acrobatiq, 2019). HISs have become the standard tool used to collect and analyze data to monitor IQ, but nurses need to be aware that the information released is only as good as the information entered, so it is important to remember what quality data is when tracking graphs. Within the NICU there are numerous trends that are being monitored, some of these QIs include: central line associated bloodstream infection (CLASBI), urinary tract infections (UTI) related to catheter versus diaper care, neonatal abstinence syndrome (NAS) days of hospitalization, ventilator-associated pneumonia (VAP), rates of nosocomial infections, and rates of breastfeeding versus formula feeding, to name a few. Opioid abuse has become a major problem across America, and the rate of NAS hospitalizations has grown exponentially. Neonatologist, healthcare providers, and hospitals carefully monitor the length of stay (LOS) of these patients in relation to Medicaid limiting reimbursement to a specific LOS. The bedside nurse can monitor the infant's Finnegan scores, LOS, medication weaning schedule, and infant symptoms through the EHR. This help not only offers support and care to the newborn, such as volunteers to hold the newborn, swings, and sound restrictions, but also provides trends for the nurse to anticipate when the newborn will need these additional support measures. CLASBI can greatly influence the population within the hospital and its monitoring is an important goal in all units of the hospital. Not only can a CLASBI have detrimental effects on patients' health by now limiting much-needed venous access, but fighting a bloodstream infection takes a large toll on the body and increases morbidity rates and LOS. When a unit has an increasing number of CLASBIs, the quality management team quickly uses the EHR to perform chart reviews to determine the root cause so it can offer timely support to correct these measures. Not only is it.