Introduction
Technologies are gradually being introduced into all areas of activity, including healthcare. The use of clinical systems can enhance patient results and satisfaction. For example, electronic health records are essential for managing individual patients and tracking public health trends. However, in some cases, this system may face challenges that significantly reduce its effectiveness. Therefore, this paper aims to evaluate existing research on the use of EHRs in primary care to improve patient outcomes.
Annotated Bibliography
Classen, D.C., Longhurst, C.A., Davis, T., Milstein, J.A., Bates, D.W. (2023). Inpatient EHR user experience and hospital EHR safety performance. JAMA Network Open, 6(9), 1–10.
Classen et al. (2023) explore the challenges currently encountered in using electronic health records in healthcare and how they impact patient safety. According to researchers, EHRs are a common clinical system that can offer significant benefits for treatment and patient outcomes. However, in some cases, such as clinical decision-making, these technologies are sometimes ineffective (Classen et al., 2023). It leads to worse treatment results and can create patient safety issues.
The cross-sectional analysis demonstrated that EHR systems are often difficult for healthcare providers to use. The study involved 112 hospitals and 5689 respondents, making the results highly demonstrative and reliable. Classen et al. (2023) found that specific usability factors such as functionality, efficiency, and ease of learning were highly correlated with patient safety outcomes. However, in most cases, the ease of use of an EHR is related to healthcare providers’ relevant experience.
The study showed that due to the lack of knowledge and skills in working with EHR among medical professionals, as well as the complexity of the systems’ functionality, they are often challenging to implement effectively in clinical work (Classen et al., 2023). It creates issues when making clinical decisions, prescribing medications, and implementing therapeutic interventions. It has a significant negative impact on patient safety outcomes and reduces satisfaction with the services received.
At the same time, researchers provide possible solutions to existing problems to improve the effectiveness of EHR use for patient safety. One of the critical factors is cooperation among clinical system developers, providers, and the healthcare system (Classen et al., 2023). The research suggests that usability improvements must be accompanied by simultaneous measurement of security impacts to avoid compromising the system’s overall security. This approach will eliminate problems associated with the inconvenience of using systems for medical workers and, at the same time, improve patient outcomes.
Rotenstein, L.S., Holmgren, A.J., Healey, M.J., Horn, D.M., Ting, D.Y., Lipsitz, S., Salmasian, H., Gitomer, R., Bates, D.W. (2022). Association between electronic health record time and quality of care metrics in primary care. JAMA Network Open, 5(10), 1–11.
A study conducted by Rotenstein et al. (2022) highlights the relationship between the time healthcare providers spend completing electronic records and the quality of patient care. The focus is on ambulatory care quality indicators, chronic care processes, preventive care, and overall patient outcomes to assess the impact of EHR use on primary care quality. The authors note that US primary care physicians (PCPs) spend more time compiling electronic health records than their international counterparts (Rotenstein et al., 2022). This time could be used to communicate with patients, provide therapeutic services, or increase the number of services provided, thereby reducing clinic wait times.
Moreover, Rotenstein et al. (2022) note that primary care physicians often experience burnout due to the use of electronic health records, which increases routine work. It, in turn, has negative consequences for the quality of patient care and the provision of appropriate medical care. After conducting a qualitative study among 291 physicians, Rotenstein et al. (2022) found that providers’ time may negatively affect metrics, particularly hemoglobin A1c control, blood pressure control, and breast cancer screening. The main problem is that PCPs must populate the EHR immediately after a patient is seen, forcing them to shorten appointment times rather than increase wait times for other patients. In most cases, this reduction occurs because some diagnostic procedures take less time, which can lead to mistreatment and worsen patient outcomes.
At the same time, researchers recognize that the EHR is an essential system with significant potential to improve care. However, changing how the system is used could significantly improve patient satisfaction and safety scores. For example, extending EHR completion time could increase attention to detail, thoroughness in assessment and diagnosis, and increase patient communication time (Rotenstein et al., 2022). It, in turn, could have a positive impact on outcomes and improve the quality of medical care.
Rotenstein, L.S., Holmgren, A.J., Horn, D.M., Lipsitz, S., Phillips, R., Gitomer, R., Bates, D.W. (2023). System-level factors and time spent on electronic health records by primary care physicians. JAMA Network Open, 6(11), 1–12.
Rotenstein et al. (2023) conducted a cross-sectional study to examine factors influencing differences in time spent on EHRs among 307 primary care physicians (PCPs). This article provides a deeper understanding of the factors that affect EHR time and demonstrates how to address this issue. For example, a study found that using scribes can significantly reduce time spent in the EHR, allowing physicians to focus more on patient interaction (Rotenstein et al., 2023).
Thus, teamwork can be a decisive factor in effectively using electronic health records to improve patient outcomes. Research indicates that higher team contribution to service delivery is associated with reduced EHR time (Rotenstein et al., 2023). Moreover, the researchers note the importance of having a technician available to provide ongoing support for the operation of electronic systems.
Moreover, Rotenstein et al. (2023) highlight the relationship between EHR time spent and the quality of healthcare services. While this clinical system can significantly automate healthcare processes and improve treatment decision-making, it has some issues at this stage of implementation. The need to enter information into the EHR reduces the time providers spend interacting with patients, thereby worsening diagnostic and subsequent treatment outcomes. This article provides data to inform strategic decisions to enhance clinical workflows and staffing, thereby improving patient safety.
Sharma, P., & Patten, C. A. (2022). A need for digitally inclusive health care service in the United States: Recommendations for clinicians and health care systems. The Permanente Journal, 26(3), 149-153.
The article by Sharma and Patten (2022) focuses on the importance of digital health in the United States as demonstrated by the COVID-19 pandemic. The global epidemiological situation has driven rapid development and implementation of technologies in the healthcare sector to improve the delivery of medical care. At the same time, it highlighted the existing digital divide between different demographic groups. For example, vulnerable populations, such as those living in rural areas or those with lower socioeconomic status, often lack access to digital health (Sharma & Patten, 2022). Moreover, this problem may also extend to clinics in areas without broadband Internet access, making it impossible to use technology to provide services.
Researchers highlight the critical role of healthcare providers in bridging the digital divide between patients. One way to achieve this is to inform the public about digital health opportunities and to enter information about their access into the EHR (Sharma & Patten, 2022). This approach could provide demonstrative data on the availability of digital resources among patients and find ways to address existing disparities. For example, a healthcare system could provide patients with devices or Wi-Fi hotspots, improving the quality of healthcare services, reducing patient care time, and increasing patient safety.
Conclusion
All four studies highlight the importance of electronic health records as a potentially practical resource for improving the quality of care and patient outcomes. They help optimize healthcare processes for selecting optimal treatments, prescribing medications, and implementing therapeutic interventions. However, all authors emphasize that at this stage, EHRs are not realizing their full potential due to limited functionality, complex use, or the time spent on them. It creates a need to develop solutions to improve the efficiency of this system, ensuring patient safety and positive treatment outcomes.