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Interoperability of EMRs: A Nursing Challenge?

Published February 3, 2014 6:46 PM by Matthew Dambrosio

Despite the widespread adoption of electronic medical records (EMRs), nurses still spend a large part of their shift on patient charting. This time could be better spent delivering patient care and working toward outcome and quality goals. The first thought that comes to mind regarding the time spent working with the EMR is But I thought computers are supposed to save time.

Responding to that assertion, both to providers and healthcare consumers, is a tough task. Many people watch TV programs that showcase the marvels of science with regards to forensics, as it applies to criminal justice and medical issues. Most medical professionals know that existing tools actually pale in comparison to their fictional counterparts. The computer systems used in healthcare mimic this dichotomy between reality and television entertainment. The EMR provides a wonderful toolset for providers, particularly for nurses charged with patient documentation. However, EMR systems have not yet reached the perfect level of usability. And the main reason for this is a lack of interoperability standards.

So what does interoperability mean? The basic definition of interoperability is the ability of a system to interact with all its parts, thereby producing useful and meaningful results.

Nurses know that for quite awhile now blood laboratories have had the ability to share patient test results through an electronic system, speeding their delivery and helping to improve quality of care. Doctors and nurses can now view these test results in the central patient record nearly in real-time, as soon as the tests are completed. But the ability of the EMR to do more than simply display data is where the concept of interoperability comes into play.

For example, an interoperable EMR might integrate lab results with nursing workflows. Critical lab results, like a blood sugar value less than 60, would not only be highlighted in red, but would sound an audible alert and require nursing staff nurse to acknowledge the result and document the action that was taken. This can help ensure a fast, direct patient intervention – as well as provide an audit trail for accountability of care, since the intervention can be tracked electronically.

Even more advanced interoperability might take all of this information and send the data through the mobile phone system – securely encrypted, of course – so the physician on call is immediately alerted of the situation and the actions taken.

Nurses can play a role in attaining that level of interoperability. How? They can engage the EMR administrator and assist in integrating evidence-based practice into the overall system that’s used throughout the entire facility. This daunting task for nurses is one that could potentially lead to great rewards, including reducing the need for nurses to manually input data, which in turn could allow more time for bedside care – and thereby ensure a high level quality, safety, and transparency for the patient’s dynamic health condition. Only the diligence of nursing on the front lines and promoting the interoperability of systems can meet the needs of our patients in years to come.

posted by Matthew Dambrosio

2 comments

Matthew,

You nailed it!

As a RN, it's very important for my workload to be captured and maximized by a EMR that does not lessen the value of the (my) Nursing Profession.  There is a compliment of science and art when I am delivering evidenced-based care regardless of my practice setting.  Nursing professionals are the majority stakeholders in almost all healthcare delivery systems.  It only makes sense to have us at the initial and ongoing EMR discussions where integration of technology equates to better patient outcomes and a more uniform format in data capture.

Thank you again!

Mr. Derwin Allen Bryant, Jr., RN, MS, BSN, BS

RN, Non-VA Care Coordination|Business Office

Department of Veterans Affairs Medical Center

Washington, DC

DERWIN BRYANT, CASE MANAGEMENT - RN, DEPT OF VETERANS AFFAIRS MEDICAL CENTER February 15, 2014 6:36 PM
WASHINGTON DC

Matthew, you bring up some really great points here. Given how new EMRs are to most healthcare systems, I think we will see a huge transition to exactly what you have discussed: using healthcare providers to help infuse evidence-based integration into the overall system. I guess we just have to play the waiting game now.

Eric, Biometrics - Sr. Enterprise Executive February 4, 2014 11:19 AM
Atlanta GA

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    Occupation: Nursing informatics experts and enthusiasts
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