Nursing Informatics Project Proposal Comprehensive Essay Example

Nursing Informatics Project Proposal Comprehensive Essay Example

Patient outcome is a significant indicator of nursing process efficiency. The growing diversity of populations and the dynamics of illnesses necessitate improving nursing processes to ease care delivery. There are various health care technologies developed to improve the nursing process with significant success. An example of such technology is the wide variety of electronic health records (EHR) technologies. EHR is provider-maintained and includes administrative and clinical data for patients receiving care. EHR supports automated access to information, streamlining workflow, and care-related activities through various interfaces such as decision support, quality management, and outcome reporting.(Nursing Informatics Project Proposal Comprehensive Essay Example)

There is an increasing national discourse on the impact of EHRs on nurse practitioners. Research on the association of EHRs to practitioners’ wellness indicates a significant threat to nursing process efficiency (McGreevey et al., 2020; Howe et al., 2018). The problems are linked to usability, burdensome alerts, arduous documentation, data entry needs, and clinically unrelated functions and processes (Topaz et al., 2016; Drowning et al., 2018)(Nursing Informatics Project Proposal Comprehensive Essay Example). As a result, EHR alerts have been considered an outright nuisance and unhelpful by most practitioners, leading to alert fatigue and dismissal of EHR alerts, also known as overriding. While overrides may be clinically appropriate in some cases, others may represent poor clinical decision-making and lead to poor clinical outcomes. McGreevey et al. (2020) report that EHR overrides are as high as 96% in clinical settings. The project proposes a nursing informatics tool, Scribble, to optimize EHR use and the consequent patient-care efficiency in a clinical setting.(Nursing Informatics Project Proposal Comprehensive Essay Example)

The Project Proposal

The proposed project involves the implementation of Scribble. Scribble was developed by Inventurus Knowledge Solutions (IKS Health), a premier partner for ambulatory care organizations in the United States. Scribble is a virtual EHR Scribe technology linked to EHR and aimed to lessen clinician burnout and cognitive workload (Siwicki, 2018). The authenticity of Scribble is based on IKS Health’s ability to allow physicians to delegate and centralize clinical tasks. IKS Health brings integrated health solutions aligned with trends in the healthcare industry to help organizations increase operational efficiency for better clinical, financial, and organizational outcomes.(Nursing Informatics Project Proposal Comprehensive Essay Example)

Scribble offers a hybrid technical-human system that allows physicians to obtain an encrypted audio record of a patient encounter. IKS Health physician partner, also known as a Virtual Physician Partner (VPP), assesses the practitioners-patient recording, synthesizes comprehensively, and provides a concise clinical note in the EHR. The hospital practitioner reviews, edits, and approves the clinical note. The IKS Health coding team reviews the clinical documentation and provides coding guidance and billing(Nursing Informatics Project Proposal Comprehensive Essay Example). The VPP provides accurate and comprehensive clinical documentation for every patient visit, freeing primary physicians from computer terminals for more bedside patient interaction and clinical decision-making, which inspires working and satisfaction. In contrast, to live to transcribe solutions, Scribble relieves the healthcare providers from additional expenses on personnel, the hassle of scheduling and managing additional staff, and wages.(Nursing Informatics Project Proposal Comprehensive Essay Example)

Stakeholders Impacted by the Project

Adopting and implementing Scribble to optimize EHR will require the intervention of various stakeholders. The primary stakeholders in the process improvement efficiency are clinicians, including advanced care practitioners, physicians, and pharmacists, whose roles are to outline the provider goals for adequate documentation of clinical data and alerts. The other stakeholders are informaticists, including informatics physicians, pharmacists, and nurses, whose roles are to provide expert knowledge on clinical data management, arbitrate between technical staff, administrators, and clinicians, and offer a broad knowledge of technical and clinical knowledge. The other stakeholders are information technologists and optimization staff, including data scientists and analysts whose roles are to inform decision-makers about the capability of the adopted system from a technical viewpoint and mitigate arising technical issues. The last group of stakeholders to be affected by the project are the administrators, whose roles are to define personnel, make a budgetary allocation, and allocate time resources.(Nursing Informatics Project Proposal Comprehensive Essay Example)

Outcomes/Patient-Care Efficiencies

The primary outcomes of Scribble implementation are personnel wellness and patient safety. The ultimate efficiency of Scribble adoption depends on various healthcare factors and processes enhanced by the technology. According to Mosier, Roberts, and Englebright (2019)(Nursing Informatics Project Proposal Comprehensive Essay Example), patient safety is a healthcare subset characterized by preventing, avoiding, and ameliorating injuries or adverse health outcomes across the healthcare continuum. The technology will improve the efficacy of clinical processes, including admission, diagnosis, prescribing, discharge, and referral, based on the clarity of clinical data documentation. These factors justify the choice of technology as an efficient way of data collection.(Nursing Informatics Project Proposal Comprehensive Essay Example)

Comprehensive clinical documentation has been proven to improve nursing process efficiencies. Scribble will help capture patient care information during admission, diagnosis, treatment, resource usage, and discharge. As a result, the data captured by the EHR will be comprehensive, limiting unproductive EHR alerts and consequent cognitive burden and overrides by physicians(Nursing Informatics Project Proposal Comprehensive Essay Example). Clinical documentation provides complete, accurate, and extensive clinical data, thereby preventing ambiguity and improving communication between healthcare workers (Alotaibi & Federico, 2017). Ambiguity in clinical data and poor communication are associated with medical errors, adverse patient health outcomes, lengthy hospital stays, and increased healthcare costs. Furthermore, comprehensive technology will indicate high-quality healthcare services, support for coding health records, and effective presentation of key data elements for accurate reporting and analysis of hospital data. Lastly, the technology will optimize potential funding and enhance greater focus on accountability and quality of patient outcomes and mortality rates.(Nursing Informatics Project Proposal Comprehensive Essay Example)

Technologies Required

Scribble will be integrated into the existing EHR technology. Besides, Scribble uses artificial intelligence tools, including speech recognition (SR) and natural language processing (NLP) technologies, to automate documentation. Using NLP allows Scribble to reliably extract data from texts for prompt billing purposes and clinical note summaries for clinician reviews (Zhou et al., 2021)(Nursing Informatics Project Proposal Comprehensive Essay Example). Moreover, the SR technology would facilitate extraction and dictation of speech into the EHR software for sharing with relevant and authorized personnel, including physicians, nurses, and pharmacists, for effective care coordination and efficiency. Beyond data capture, the NLP and SR technology will be crucial in clinical decision support based on comprehensive clinical notes. Therefore, it is safe to conclude that the technologies involved in the intervention will be essential in improving patient-care efficiencies.(Nursing Informatics Project Proposal Comprehensive Essay Example)

Project Team and Nurse Informaticist

The project team will include the Scribble vendor, EHR developer, project manager, technology analyst, test engineer, clinicians, and administrators. The product vendor, IKS Health, will provide the services associated with the technology, such as VPP, and advice on required technical interphase. The EHR developer will be responsible for customizing the EHR system for specific needs. The quality assurance test engineer will test the system from various viewpoints to evaluate its performance. Clinicians will be responsible for the day-to-day operation of the system, while the administrators will be responsible for making decisions regarding issues related to the acquisition and performance of the adopted system.(Nursing Informatics Project Proposal Comprehensive Essay Example)

Nurse informaticists will be involved in clinical data management (McGonigle & Mastrian, 2017). Ideally, nurse informaticists have the broad technical and clinical knowledge to initiate system changes and support system maintenance. The nurse informatics’ role will include the direct engagement and coordination of project activities, including design, development, implementation, and testing. The informaticist will gather and conceptualize ideas based on the facility’s needs in a technical form for developers and vendors to consider in the application design. The interlinking role of the nurse informaticist will contribute to the successful buy-in, implementation, adoption, and evaluation of the project.(Nursing Informatics Project Proposal Comprehensive Essay Example)

References

Alotaibi, Y. K., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi medical journal, 38(12), 1173(Nursing Informatics Project Proposal Comprehensive Essay Example). https://doi.org/10.15537%2Fsmj.2017.12.20631

Downing, N. L., Bates, D. W., & Longhurst, C. A. (2018). Physician burnout in the electronic health record era: are we ignoring the real cause? Annals of Internal Medicine, 169(1), 50-51. https://doi.org/10.7326/M18-0139

McGreevey III, J. D., Mallozzi, C. P., Perkins, R. M., Shelov, E., & Schreiber, R. (2020). Reducing alert burden in electronic health records: state of the art recommendations from four health systems. Applied clinical informatics, 11(01), 001-012. https://doi.org/10.1055/s-0039-3402715

Mosier, S., Roberts, W. & Englebright, J. (2019). A Systems-Level Method for Developing Nursing Informatics Solutions. JONA: The Journal of Nursing Administration, 49 (11), 543-548.(Nursing Informatics Project Proposal Comprehensive Essay Example) https://doi.org/10.1097/nna.0000000000000815

Siwicki, B. (December 2018). How a scribe tool linked to Epic EHR is helping ease physician burnout. https://www.healthcareitnews.com/news/how-scribe-tool-linked-epic-ehr-helping-ease-physician-burnout

Topaz, M., Seger, D. L., Slight, S. P., Goss, F., Lai, K., Wickner, P. G., … & Zhou, L. (2016). Rising drug allergy alert overrides in electronic health records: an observational retrospective study of a decade of experience. Journal of the American Medical Informatics Association, 23(3), 601-608(Nursing Informatics Project Proposal Comprehensive Essay Example). https://doi.org/10.1093/jamia/ocv143

Zhou, B., Yang, G., Shi, Z., & Ma, S. (2021). Natural language processing for smart healthcare. arXiv preprint arXiv:2110.15803. Retrieved 21 September 2022, from https://arxiv.org/pdf/2110.15803.pdf