July 2, 2012Response by Jesse Gorman on “Informatics: Where Is It?” by Linda Thede PhD, RN-BC (January 23, 2012).
with Reply by author
Thank you for your recent article “Informatics: Where Is It?” by Linda Thede PhD, RN-BC (January 23, 2012). There are many obvious advantages to EMR, such as continuity of care, reduction in duplicate testing, efficiency for diagnosing and treating illness, and overall cost effectiveness for healthcare organizations. However, my biggest concern lies in the implementation process referred to that will require all healthcare disciplines to develop an appreciation for the contributions from all members of the healthcare team. The elephant analogy was great, I have seen this all too often in my years of ER nursing. The different teams consulted all order tests, many repeated tests, without ever looking at what has already been ordered, or determined, on the patient. It is almost like no other team members exist, only their specialty. The system at my current hospital has a popup that alerts when you order a duplicate test within a certain time frame. This is definitely a step in the right direction to assist in a multidisciplinary approach.
My other concern is that charting is the biggest obstacle facing nursing and EMRs. Nurses are all for anything that can save time during their shift. I am cautiously optimistic that a system can be created that will actually be an effective time saver. The systems I have worked with vary in their user friendliness; some are down-right unfriendly and time wasters! Most nurses I speak with oppose many of the EMRs currently out there because nurses need to be able to remember a patient by their charting and many check box systems do not make this possible.
I also agree that the scanning of handwritten patient records needs to be eliminated; deciphering handwriting is too time-consuming and leaves open an opportunity for error. I am hopeful that the addition of basic informatics into nursing school curricula is another step in the right direction, especially with graduate degrees that specialize in Nursing Informatics. I believe it will take nurses to develop systems that can achieve the success we are striving for with EMRs.
Jesse Gorman, RN
University of Texas at El Paso
RN to BSN Nursing Student