NUR 514 EMRs and EHRs Discussion

DQ2 Differentiate between EMRs and EHRs. Discuss the importance of interoperability in relationship to both types of records and to how the EMR and EHR improve quality and access to care.

What is Nursing Leadership in Healthcare Informatics?
The role of the nursing leader encompasses clinical and managerial responsibilities that may vary depending on clinical setting or placement in the . In looking at nursing leadership literature through the context of informatics, it is apparent that leaders are pivotal to technology integration in every arena of nursing practice (Honey & Westbrooke, 2016; Hussey, Adams & Shaffer, 2015; Kerfoot, 2015; Technology Informatics Guiding Education Reform, 2014). Healthcare’s continuous state of transformation now requires nurse leaders to develop informatics skills and competencies; it is no longer optional if one wants to lead effectively in the technological age (Collins et al., 2017; Honey & Westbrooke, 2016; Hussey & Kennedy, 2015; Hussey, Adams & Shaffer, 2015; Kerfoot, 2015; Lloyd & Ferguson, 2017; Phillips et al., 2017; Remus, 2016; Simpson, 2013; Staggers et al., 2018; Strudwick, 2016; Technology Informatics Guiding Education Reform, 2014; Troseth, 2014). Nursing leaders who develop informatics competencies can work more effectively in ensuring the “successful selection, development, and competent use of devices and clinical systems” (Kerfoot, 2015, p 342). Additionally, nurse leaders with informatics competencies and knowledge will be needed at higher levels to inform policy and decision making related to ICT implementation (Honey & Westbrooke, 2016; Hussey et al., 2015; Simpson, 2013; Strudwick, 2016; Technology Informatics Guiding Education Reform, 2014).

Given their clinical background, nurse leaders are also positioned to provide a when organizations move to develop integrated models of care that leverage technology, such as telehealth, to transform patient care delivery (Hussey et al., 2015; Hussey & Kennedy, 2016; Simpson, 2013; Technology Informatics Guiding Education Reform, 2014). The intertwining of technology and nursing practice creates an interdependency that, when leveraged properly by nursing leaders, can create project synergy and bolster their ability to advocate for ICT solutions that meet patient needs and yield sustainable quality patient outcomes (Honey & Westbrooke, 2016; Hussey & Kennedy, 2015; Hussey et al., 2015; Remus, 2016; Technology Informatics Guiding Education Reform, 2014; Troseth, 2014). To put it simply, leaders who develop and adopt informatics competencies can help bridge the gap between clinical nursing practice and IT (Hussey et al., 2015; Hussey & Kennedy, 2016; Lloyd & Ferguson, 2017; Simpson, 2013; Technology Informatics Guiding Education Reform, 2014).

in Healthcare Informatics Drives Interoperability
While the use of ICTs has become more widespread and new models of care emerge that capitalize on technological advancements, nurses continue to have usability issues related to ICTs in practice (Staggers et al., 2018). Common issues reported include EHR designs that do not support how nurses document or interact with patient information, computerized provider order entry (CPOE) systems that do not account for nursing activities, or lack of interfaces with biomedical devices and other patient data collection systems (Hussey & Kennedy, 2016; Staggers et al,. 2018; Technology Informatics Guiding Education Reform, 2014). For nurses this could translate into challenges with electronic documentation in the EHR, delays in care if physicians are required to enter nursing orders, or the need to access multiple systems for information to develop a comprehensive understanding of the patient picture (Hussey & Kennedy, 2016; Staggers et al., 2018; Technology Informatics Guiding Education Reform, 2014). Ultimately, lack of consideration for nursing workflows during planning and design can result in a fragmented system that functions contrary to the TIGER recommendation for professional interoperability- the sharing of expertise and knowledge across disciplines in a meaningful and transparent way (Technology Informatics Guiding Education Reform, 2014). According to Staggers et al. (2018) this “means nurses become the human interface and integrator among disparate systems” (p 192). As such, nurse leaders need to develop a deeper understanding of nursing informatics and merge it with their clinical knowledge to effectively inform, influence or lead technology related initiatives that impact nursing workflow at the point of care (Hussey et al., 2015; Hussey & Kennedy, 2016; Kerfoot, 2015; Lloyd & Ferguson, 2017; Simpson, 2013; Technology Informatics Guiding Education Reform, 2014).