Influences on Delivery of Health Care

Key points

1. Care team communication

   Through use of technologies such as EHRs, messaging systems, and patient portals, coordination of care has been enhanced.

2. Patient portal communication

   For example, patient portals allow patients to access their personal health information and provide two-way communication with their provider.

3. Telemedicine communication

   Telemedicine has provided the opportunity for patients to receive care via real-time, two-way communication with a provider or via asynchronous transmission of patient information.

4. Discharge summaries and safety

   Not only have discharge summaries enhanced communication for patients upon discharge, but they also serve to ensure continuity of care upon transfer to other levels of care, thereby protecting patient safety.

5. Technology and patient safety

   Information technologies are a valuable tool for improving health-care quality and safety.

6. Remote chronic condition monitoring

   Patients can use wearable devices to track vital signs, and health-care providers can access real-time data to make timely adjustments to treatment plans; these practices enhance accessibility to care, reduce the need for frequent in-person visits, and help manage chronic illnesses more effectively.

7. Computerized provider order entry

   For example, computerized provider order entry (CPOE) has allowed providers to enter medical orders directly into the patient’s electronic medical record. Not only has this practice reduced the human error in transcribing orders, but it has also been instrumental in catching possible medication order errors, such as prescribing a medication that the patient may be allergic to or a medication that is contraindicated.

8. Clinical decision support tools

   Clinical decision supports—such as notifications, alerts, reminders, clinical guidelines, condition-specific order sets, clinical summaries, documentation templates, and diagnostic supports—have supplied providers with the necessary information to make informed decisions to support patient care.

9. Medication administration safety

   Bar code administration has helped to ensure the right medication for the right patient. Smart pumps are programmed to reduce errors with intravenous (IV) administration.

10. Meaningful health-care data

    For data to be meaningful, however, it must be accurate, complete, reliable, relevant, and timely.

11. EHRs and nursing workload

    For example, the process of centralizing patient records into EHRs has eliminated time spent searching through paper charts, helped to clarify and streamline the documentation of care, and enabled the setting of electronic reminders for tasks that need to be completed.

12. Smart bed fall prevention

    Additional safety features to prevent falls include motion-activated night-lights and reminders for the health-care staff, such as alerts if the wheels are not locked or the bed alarm is not set.

13. Nurse responsibility with pumps

    Nevertheless, the nurse administering the medication is ultimately responsible for any errors that may occur, so they should always have a questioning and critical thinking mindset as they work.

14. Nurses leading technology transformation

    It is important that nurses take the lead in the transformation of services and involve themselves in all aspects of designing, developing, and implementing technologies.