Feb 23, 2024 NURS 6051 Literature Review The Use of Clinical Systems to Improve Outcomes and Efficiencies
NURS 6051 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies
NURS 6051 Literature Review The Use of Clinical Systems to Improve Outcomes and Efficiencies
Technology continues to be an indispensable part of the current innovative practice. In health care settings, the effectiveness of technology is demonstrated through its role in optimizing health outcomes and reducing inefficiencies (Malik et al., 2021). As a result, nurse informaticists and other health care professionals should continue exploring effective clinical systems and integrate them into patient care to improve health outcomes. Patient portals are among the widely used clinical systems for patients and health care practitioners. Nursing and health care research has explored its role in detail and provides different findings that underline their importance as a health care technology. The purpose of this paper is to annotate research on the use of patient portals in improving outcomes and efficiencies.
Hazara, A. M., Durrans, K., & Bhandari, S. (2020). The role of patient portals in enhancing self-care in patients with renal conditions. Clinical Kidney Journal, 13(1), 1-7. doi: 10.1093/ckj/sfz154
Self-care helps to improve health outcomes among patients with different chronic conditions. In this study, Hazara et al. (2020) reviewed the role of patient portals in enhancing self-care among patients with renal conditions. The review was based on the PatientView portal, a freely provided web-based platform for patients with renal conditions in the United Kingdom. Regarding patient outcomes, patient portals enable patients to access electronic health records, such as test results and clinical documents, at convenient locations as long as they have internet access. Such information helps patients with renal conditions and other complex illnesses to manage their health better and update their health care providers appropriately.
Efficient clinical systems reduce the distance between patients and care providers and facilitate communication. Hazara et al. (2020) observed the same in this study since the PatientView portal provided an efficient system that facilitated two-way communication between nurses and patients and provided an avenue for recording and disseminating essential patient data such as home blood pressure. The main lesson, as the authors underline, is that clinical systems should be designed to encourage patients to participate in managing their conditions. Such designs increase patient empowerment and self-management, which is the foundation of improved clinical outcomes. Critical design elements include functionality, easy access to information, and seamless two-way communication.
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Hefner, J. L., MacEwan, S. R., Biltz, A., & Sieck, C. J. (2019). Patient portal messaging for care coordination: a qualitative study of perspectives of experienced users with chronic conditions. BMC Family Practice, 20(1), 1-8. https://doi.org/10.1186/s12875-019-0948-1
Secure messaging is a critical component of the successful use of patient portals. In this study, Hefner et al. (2019) examined how experienced portal users engage with secure messaging to manage different chronic conditions. In the care context, secure messaging entails asynchronous communication between patients and health care providers. Hefner et al. (2019) found that such communication improves health outcomes by enabling patients to manage chronic conditions. In this case, patients can use patient portals as an extension of the office visit. Besides, patient portals support care coordination and patient collaboration with family and caretakers.
Efficient clinical systems reduce barriers to care significantly. They should also have minimal barriers that hamper user experience and adversely affect their integration into patient care. Similarly, patient portals reduce communication and collaboration barriers. The main lesson from the article is the importance of user experience in the effective use of patient portals. Hefner et al. (2019) stated that patient training in the proper use of secure messaging is critical to address uncertainty among users. Training also improves skills and experience, enabling patients to use patient portals effectively and without uncertainties. Health care organizations should also identify technological barriers that hamper secure messaging and implement appropriate interventions.
Reed, M. E., Huang, J., Brand, R. J., Neugebauer, R., Graetz, I., Hsu, J., … & Grant, R. (2019). Patients with complex chronic conditions: Health care use and clinical events associated with access to a patient portal. PLoS One, 14(6), e0217636. https://doi.org/10.1371/journal.pone.0217636
For chronically ill patients, access to health care services is critical to coping, illness management, and reducing infections. In this article, Reed et al. (2019) examined the impact of patient portals on outpatient visits, emergency visits, and preventable hospitalizations. The study included patients with only diabetes and others with multiple complex conditions. For both patient groups, access to patient portals was associated with higher rates of outpatient office visits since patients seek more health care services if they are actively engaged in care and understand their conditions. The other significant health outcome from the study was fewer emergency room visits among patients with complex chronic conditions due to the active use of patient portals.
Efficient clinical systems and procedures help health care facilities to reduce health costs significantly. Reed et al. (2019) found patient portals instrumental in reducing health costs by reducing preventable hospital stays among patients with multiple complex conditions. The main lesson from the article is that access to patient portals plays a critical role in increasing patient engagement in outpatient visits, which helps them promptly address unmet and emerging needs. The other lesson is that patient portals in health care settings should be encouraged and supported since it helps to reduce downstream health events that increase emergency and preventable care. As a result, health care practitioners looking forward to efficient, cost-effective, and effective care must prioritize patient portals as a tech-based clinical system.
Stewart, M. T., Hogan, T. P., Nicklas, J., Robinson, S. A., Purington, C. M., Miller, C. J., … & Shimada, S. L. (2020). The promise of patient portals for individuals living with chronic illness: Qualitative study identifying pathways of patient engagement. Journal of Medical Internet Research, 22(7), e17744. http://dx.doi.org/10.2196/17744
Chronic health conditions continue to be a huge burden for patients, families, and health care professionals. Effective management of such conditions is critical to improving health outcomes, and the role of patient portals cannot be underestimated. In this study, Stewart et al. (2020) explored how electronic patient portals facilitate patient engagement among individuals with diabetes. From a health perspective, patient engagement is characterized by the active involvement of patients in their care. Regarding the role of patient portals in improving outcomes, Stewart et al. (2020) found that patient portals provide a reliable platform for patients to better understand their health by asking health-related questions. This information improves engagement, diabetes control, and participation in care management since it helps patients to prepare for medication appointments by reviewing labs, notes, and symptoms.
Regarding efficiencies, patient care is more efficient when the distance between patients and health care professionals is reduced and care coordination challenges are minimal. Stewart et al. (2020) found that patient portals improve efficiencies by providing a quick and secure messaging platform and facilitating efficient care coordination between patients and health care providers. The main lesson from this article is that health care providers should embrace patient portals and encourage patients to use them appropriately. Patients also need to be supported by addressing their attitudes and fear toward patient portals.
Conclusion
Patients require appropriate support to enable them to understand their conditions, participate in care, and manage chronic conditions. Patient portals are valuable clinical systems for patients with chronic conditions. Beneficial outcomes associated with patient portals include increased patient-provider communication, illness self-management, and reduced hospitalizations. Such outcomes also change patients’ attitudes toward care and improve their relationships with families and caregivers. However, barriers such as negative attitudes toward patient portals and technology problems should be addressed. Patient training helps to improve user experience and should be prioritized in health care settings.
References
Hazara, A. M., Durrans, K., & Bhandari, S. (2020). The role of patient portals in enhancing self-care in patients with renal conditions. Clinical Kidney Journal, 13(1), 1-7. doi: 10.1093/ckj/sfz154
Hefner, J. L., MacEwan, S. R., Biltz, A., & Sieck, C. J. (2019). Patient portal messaging for care coordination: a qualitative study of perspectives of experienced users with chronic conditions. BMC Family Practice, 20(1), 1-8. https://doi.org/10.1186/s12875-019-0948-1
Malik, M., Kazi, A. F., & Hussain, A. (2021). Adoption of health technologies for effective health information system: Need of the hour for Pakistan. PloS One, 16(10), e0258081. https://doi.org/10.1371/journal.pone.0258081
Reed, M. E., Huang, J., Brand, R. J., Neugebauer, R., Graetz, I., Hsu, J., … & Grant, R. (2019). Patients with complex chronic conditions: Health care use and clinical events associated with access to a patient portal. PLoS One, 14(6), e0217636. https://doi.org/10.1371/journal.pone.0217636
Stewart, M. T., Hogan, T. P., Nicklas, J., Robinson, S. A., Purington, C. M., Miller, C. J., … & Shimada, S. L. (2020). The promise of patient portals for individuals living with chronic illness: Qualitative study identifying pathways of patient engagement. Journal of Medical Internet Research, 22(7), e17744. http://dx.doi.org/10.2196/17744
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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.
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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.
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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 5 peer-reviewed articles from your research.
The Assignment: (4-5 pages)
In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:
Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
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. NURS 6051 Literature Review The Use of Clinical Systems to Improve Outcomes and Efficiencies
Module 4: Technologies Supporting Applied Practice and Optimal Patient Outcomes (Weeks 6-8)
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Laureate Education (Producer). (2018). Informatics Tools and Technologies [Video file]. Baltimore, MD: Author.
According to Avdagovska et al. (2020), the rising costs of healthcare services and the increased prevalence of chronic conditions have necessitated transformative changes in the delivery of healthcare. One example of these transformations is the development of mobile access to electronic health records. Patient access to electronic health records through online platforms and mobile applications has been an expanding area in healthcare, even before the pandemic. It is a recent innovation that communicates medical information to patients and their caregivers in a quick, convenient, and reliable manner. These platforms also provide opportunities to schedule appointments, fill out forms/paperwork at the patient’s pace (as compared to the nervous or rushed feeling you get in the clinical setting), and easily communicate with their providers. Huerta et al. (2019) wrote that these online platforms also increase patient empowerment and engagement. Many of the platforms include resources for patient education and wellness, allowing them to take an active role in their health.
However, there are some downsides and risks to these platforms. First, there is the risk of information leaks and security violations. With any online platform that holds sensitive data, the risk of unlawful use of this data is inevitable. Some of the applications require a two-step verification process to protect identities and information, but this is not a certain measure. Additionally, the method of receiving medical information such as lab results and tests through mobile applications is not appropriate for all populations. Lab and imaging results are now auto-released to the patient much more quickly than before. This makes it very difficult for healthcare providers to discuss sensitive results before they reach the patient. Often, patients will receive their results before actually speaking with their provider. This can lead to misconceptions and false interpretations of diagnoses. With the increase in computerized medicine, the need for provider education and communication has also increased.
References
Avdagovska, M., Ballermann, M., Olson, K., Graham, T., Menon, D., & Stafinski, T. (2020). Patient portal implementation and uptake: Qualitative comparative case study. Journal of Medical Internet Research, 22(7). https://doi.org/10.2196/18973
Huerta, T., Fareed, N., Hefner, J. L., Sieck, C. J., Swoboda, C., Taylor, R., & McAlearney, A. S. (2019). Patient engagement as measured by inpatient portal use: Methodology for log file analysis. Journal of Medical Internet Research, 21(3), e10957. https://doi.org/10.2196/1095
Learning Objectives
Students will:
Evaluate healthcare technology trends for data and information in nursing practice and healthcare delivery
Analyze challenges and risks inherent in healthcare technology
Analyze healthcare technology benefits and risks for data safety, legislation, and patient care
Evaluate healthcare technology impact on patient outcomes, efficiencies, and data management
Analyze research on the application of clinical systems to improve outcomes and efficiencies
Due By
Assignment
Week 6, Days 1–2
Read/Watch/Listen to the Learning Resources.
Compose your initial Discussion post.
Week 6, Day 3
Post your initial Discussion post.
Begin to compose your Assignment.
Week 6, Days 4-5
Review peer Discussion posts.
Compose your peer Discussion responses.
Continue to compose your Assignment.
Week 6, Day 6
Post at least two peer Discussion responses on two different days (and not the same day as the initial post).
Week 6, Day 7
Wrap up Discussion.
Week 7, Days 1-7
Continue to compose your Assignment.
Week 8, Days 1-6
Continue to compose your Assignment.
Week 8, Day 7
Deadline to submit your Assignment.
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Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
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
Note: You will access this article from the Walden Library databases.
Required Media
Laureate Education (Producer). (2018). Public Health Informatics [Video file]. Baltimore, MD: Author.
Accessible player –Downloads–
Download Video w/CC
Download Audio
Download Transcript
Laureate Education (Producer). (2018). Electronic Records and Managing IT Change [Video file]. Baltimore, MD: Author.
Accessible player –Downloads–
Download Video w/CC
Download Audio
Download Transcript
By Day 7 of Week 8
Submit your completed Assignment.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
Please save your Assignment using the naming convention “WK8Assgn+last name+first initial.(extension)” as the name.
Click the Week 8 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Week 8 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK8Assgn+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.
Due to the nature of this assignment, your instructor may require more than 5 days to provide you with quality feedback.
The use of technology to leverage care interventions in different clinical settings and facilities cannot be overemphasized because of the critical role that it plays in enhancing patient safety and care outcomes. Clinical systems are essential tools in improving patients’ outcomes and efficiencies in healthcare delivery by reducing medication errors, promoting medication compliance and enabling providers to leverage technology for better decisions and informed interventions (Dykes et al., 2017). Personal health records or portals are some of the critical aspects that providers and healthcare systems use to support patients that have recently been diagnosed with diabetes. These portals offer access to health information from an organization’s electronic health record (EHR) and allow patients to conduct different medical-associated tasks like electronically communicating with their providers and even recording their symptoms (Tapuria et al., 2021). The purpose of this paper is to offer an annotated bibliography of the impact of personal health records or patient portals for individuals newly diagnosed with diabetes.
Coughlin, S. S., Williams, L. B., & Hatzigeorgiou, C. (2017). A systematic review of studies of web portals for patients with diabetes mellitus. MHealth, 3(6). https://doi.org/10.21037/mhealth.2017.05.05
In this systematic review of studies on the portal for patients with diabetes mellitus, the researchers evaluate the impact of patient health records to improve outcomes from interventions to control glycemic levels. The authors identified 12 studies on the topic that include three cross-sectional and five randomized controlled trials. The researchers required web portals meant for diabetes patients and those tethered to electronic medical records. The findings show that web portals enhance the ability of patients to communicate with their clinicians and attain enhanced glycemic control. The authors emphasize the need for additional research to understand the level of control for patients. However, they are categorical that web portals improve glycemic control for these patients.
The study shows that web portals are essential and improve outcomes for diabetic patients since they enhance communication between them and their clinicians. Through effective communication, clinicians improve efficiencies in care provisions for diabetes patients. The study indicates that providers should leverage technologies and encourage their patients to embrace them to reduce adverse disease outcomes. A critical lesson learned from the use of web portals based on the study is that few patients embrace this technology to enhance diabetes self-management and self-care. Consequently, providers should be trained to leverage its use to improve self-care interventions for patients in remote locations.
Sun, R., Korytkowski, M. T., Sereika, S. M., Saul, M. I., Li, D., & Burke, L. E. (2018). Patient Portal Use in Diabetes Management: Literature Review. JMIR Diabetes, 3 (4): e11199. https://doi.org/10.2196/11199.
In this article, the researchers affirm the critical role that health information technology tools have in promoting engagement, improvement of patient-provider communication, and enhancing clinical outcomes in the management of chronic disorders like diabetes mellitus. Based on a review of literature, the researchers focus on evidence about the efficacy of patient portal use by patients with diabetes mellitus type 1 and 2. The study examines the link between patient portal use and diabetes mellitus-related outcomes.
The authors identified opportunities for future improvement in the management of the condition. The findings also demonstrate the low levels of patient portal use among diabetes patients. The authors observed inconsistency in their findings of the use of these technologies among patients due to several barriers among patients and providers. While these portals enhance care and patient outcomes engagement of both providers and users will be critical to improving uptake.
The article shows that patient portal are critical to enhancing outcomes for individuals suffering from diabetes mellitus (DM). The portals improve communication and engagement between providers and patients. Effective engagement is a core aspect of patient participation and leads to better outcomes. These systems also improve efficiency as it eases interaction between nurses, clinicians and patients, and their families.
The vital lesson learned from the study is that providers should encourage patients to embrace technology as a way to reduce over-reliance on clinicians to make decisions. These portals allow patients to check different components of their disease status and employ the right interventions to address any challenges. The article also implores further research to address the inconsistencies in results about the efficacy of patient portals to enhance care among diabetes patients, especially those newly diagnosed.
Sieverink, F., Kelders, S., Braakman-Jansen, A., & van Gemert-Pijnen, J. (2019). Evaluating the implementation of a personal health record for chronic primary and secondary care: a mixed-methods approach. BMC medical informatics and decision making, 19(1), 1-12. https://doi.org/10.1186/s12911-019-0969-7
In this study, the authors focus on evaluating the fidelity of personal health records (PHRs) in chronic care based on the level of implementation to ascertain the found effects or impacts. Using a mixed-method design, the researchers measure the responsiveness, the differences, and similarities between the intended and the real use of PHRs among a certain population sample. The study findings show t
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