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TN004: Technologies Supporting Applied Practice and Optimal Patient Outcomes
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- TN004: Annotated Bibliography on the Application of Clinical Systems
Clinical systems are vital in current healthcare since they make use of technology in promoting patient status and the healthcare system. Such systems are Electronic Health Records (EHR), Mobile Health (mHealth) applications, Telehealth /Telemedicine, Clinical Decision Support System, and Patient portal. All these systems have impacted the different facets of delivering healthcare and have included: increased efficiency in documentation, remote patient supervision, and clinical decisions, among others.
Today’s EHRs signify crucial aspects of contemporary medical practice as the management of patient information in the digital realm enhances organizational care and minimizes adverse events. Mobile health applications for patients, however, allow patients to personalize the management of their health through the smartphone with features such as self-assessment and monitoring of chronic diseases, and general healthy lifestyles.
Telehealth has helped increase access to care, especially among rural and those in areas that have poor health resource access, because patients can consult with providers from the comfort of their own homes.
CDSSs help clinicians make the right decision since it contains generalized recommendations and alerts based on clinical evidence, thereby improving diagnosis and management plans. Patient portals became popular because they help patients organize their own information rather than leaving patients’ choices up to health care providers.
This annotated bibliography aims to review recent literature on clinical systems and explore their new developments and uses. The five sources included are all from the last five years and were retrieved from online databases. The focus of the paper is to understand the role and benefits of these systems in augmenting the health care sector and patient care delivery, besides aspects of operational efficiency.
In each bibliography of an article, a summary of the article is provided, a comparison of advantages and disadvantages, and an understanding of the subjects and betters, and changes in outcomes, efficiencies, and lessons from a system clinically described.
Article 1
Schroeder et al. (2021) presented a substantial review of privacy and security issues in mobile health applications. Available in the Journal of Medical Systems, this article explores essential factors related to patient data safety in the field with tremendous potential in the area of mHealth.
In the study, the researcher presented several mHealth applications and evaluated them based on the privacy/ security standards of the applications. It draws attention towards the issues of data security breaches and emerging trends that point to the need for secure and strong security systems (Schroeder et al., 2021). The authors established that even though the utility of mHealth apps presented a lot of advantages, especially to the health of patients, these applications lacked in protecting the personal data of patients.
Analysis
This research is effective in that it comprehensively discusses different forms of mHealth applications and provides a detailed evaluation of the security nature of these applications. However, a disadvantage is that their dependency on information that is accessible to the public, and hence some measures may not be evident (Schroeder et al., 2021). The study also encourages the development of standard security policies that would be implemented on all the mHealth applications available.
Benefits and Limitations
Benefits: It gives the reader a proper understanding of how patient data is unprotected in mHealth applications, even as the article summarizes the privacy and security measures of mHealth (Schroeder et al., 2021). They, in turn, enhance the understanding of the potential dangers and the necessity of the implementation of stringent security measures that are central to developing and sustaining trust among patients in the use of mHealth apps.
Limitations: The reliance solely on data accessible to the public poses a disadvantage, given that the study is unable to delve deeper into the security measures implemented in the mHealth applications under consideration. Another gap is the absence of information collected at different time points, which can be used to assess the efficiency of the security measures in the long run.
Improvements to Outcomes, Efficiencies, and Lessons Learned
With regards to security, the article argues that mHealth applications are security-sensitive because they define the level of trust and engagement from patients. It is therefore important to have a secure framework for mHealth applications since they can improve the health of numerous patients through innovation on effective means of monitoring their needs and even communicating with their physicians (Schroeder et al., 2021). For instance, apps that incorporate strong cryptography and user authentication features guarantee that the patient data collected is not easy for unauthorized parties to access, therefore promoting the uptake of the technologies.
Outcomes: Mentioned safe mHealth applications provide better outcomes for patients associated with the preservation of data, along with increased use of innovations. For instance, in the case of mHealth Apps, such websites would help the patients carry along better and, in fact, use the applications, if they understood and believed that their own health records would not be exposed to the public domain.
Efficiencies: In this regard, mHealth applications eliminate the need for routine check-ups and facilitate interaction between health care providers and a patient. For example, mHealth apps can be leveraged by healthcare providers for monitoring the progress of patients from a distance and to intervene, when necessary, without the necessity for face-to-face visits.
Lessons Learned: Hence, there is a need to encourage the adoption of standard security features as well as intensified efforts towards developing secure encryption practices to enhance the protection of patients’ data. For example, the implication is that mHealth technology developers have an overriding responsibility to focus on security to retain patient confidence and proper dissemination of their technologies.
Article 2
According to Portz et al. (2019), patients’ resistance to patient portal use can be explained using the Technology Acceptance Model or TAM. In the BMC Medical Informatics and Decision Making article, discuss various determinants that affect patient usage of digital health applications.
Patient portals, as a piece of Health Information Technology (HIT), have been initially met with some reluctance, which was further examined in this literature review in terms of perceived ease of use and perceived usefulness (Portz et al., 2019). It is recommended to conclude that, despite the numerous benefits associated with patient portals, including accessing the client’s personal records and heightened interaction with healthcare organizations, compliance with the patient portals is limited by concerns regarding usability and confidentiality.
Analysis
From the structure of this study, it can be seen that it is well coordinated and offers ample discussion of prior literature. It especially emphasizes the inhabitants of Western nations; this, in a way, hampers the generalization of the study’s results in other cultures (Portz et al., 2019). Furthermore, the review underscores the call for further studies regarding the possible interventions for reducing resistance and increasing the overall acceptance by end-users.
Benefits and Limitations
Benefits: The article gives a comprehensive evaluation of the attributes that determine utilization of the patient portal, information that needs to be understood by stakeholders to design better patient tech acceptance programs (Portz et al., 2019).
Limitations: In this regard, the study is restricted to Western populations only, and for this reason, the results would not be applicable universally. Most of the study does not present actual quantitative evidence to support particular strategies that may reduce resistance and enhance adoption levels.
Improvements to Outcomes, Efficiencies, and Lessons Learned
Several ways have been given for the benefits of patient information-related portals in retaining patients, enhancing their health, and helping them cope more effectively with conditions (Portz et al., 2019). For example, friendly non-hospital patient portals that take issues of patient privacy into consideration enhance patient compliance with chronic diseases that require regular monitoring and timely follow-up.
Outcomes: Patient-Estaing health care teamwork and better patient-physician interaction (Portz et al., 2019). For example, patients using portals do have the ability to directly view their records on health, which allows them to make better decisions on their health.
Efficiencies: Increased and more efficient responsibilities of transmitting information and the general administration of various chronic illnesses. For example, electronic patient portals can lower costs for practitioners because such activities as appointment setting, prescription renewals, and basic inquiries can be done through online interfaces instead of having to be set up in person or via a phone call.
Lessons Learned: Investing in usability and privacy to increase patient portal engagement from the growing body of evidence. To promote adoption among users, for example, VHA healthcare organizations need to pay particular attention to developing clear and simple interfaces for the system and significantly improving privacy controls.
Article 3
Upadhyay & Hu (2022) used a systematic approach to assess the EHR improvement in health care quality. The article, which is available in the Journal of Healthcare Quality, discusses how EHRs impact care coordination mechanisms and many other aspects of patient care.
The review in question focused on the state of EHR implementation and the impact of the latter on healthcare quality according to the data from several works. A few of the NPRs suggest that EHRs increase documentation precision, decrease medication errors, and optimize care organization in normal cases. However, in the review of the use of the framework in practice, they note that issues like higher administrative costs and disruption of the flow of work are particularly noticeable during the initial stages of implementing the framework.
Analysis
The importance of this study lies in understanding the effects of EHRs based on reviewing different investigations and studies conducted on the topic. One limitation of the study is that there is a great difference across medical centers, and therefore, there is limited generalizability of results across different facilities. The study also considers the potential for continued education and training of healthcare facilities to achieve the full extent of innovation incorporated in EHRs.
Benefits and Limitations
Benefits: The present research includes a detailed description of the benefits of implementing EHRs with a focus on the quality enhancement in the records, prospects for the integration and cooperation within care teams, and patient protection enhancement.
Limitations: The different EHR systems in place and issues with the generalizability of the findings across different care environments. The initial implementation phase also involves activities that may be disruptive and may involve extensive modification by the healthcare providers.
Improvements to Outcomes, Efficiencies, and Lessons Learned
Patient care is also better as EHRs help to provide precise medical documentation and promote effective communication with/among different caregivers. For example, one source surveyed described that medication error decreased by 25% in an organization after adopting EHRs, thus implying that EHRs have an aspect of enhancing patient safety and quality of care.
Outcomes: This allowed the patient to receive the right medications and doses, getting rid of possible mistakes by the medical staff. Accurate records mean that the providers of the health care medications have complete and updated patient information, thereby minimizing wrong diagnoses.
Efficiencies: Greater improvement in documentation and increased coordination of care among the care team members. For example, replace the traditional paper documentation method by creating a system in which information related to a certain patient can be secured, updated, and accessed easily.
Lessons Learned: To obtain the full impact of EHR, speakers emphasized follow-up training and professional development. For instance, in order to effectively address the issues of EHR adoption and usage, healthcare organizations should employ training programs that aim at enabling the providers to adopt EHR systems and use them appropriately.
Article 4
Kishik et al. (2021) conducted a systematic review of the application of telehealth in chronic disease management. This article, Telehealth Interventions and chronic disease self-management, reconsidered in the journal Telemedicine and e-Health, describes the capacity for improvement offered by telehealth interventions.
The review included studies that assessed the effectiveness of telehealth platforms specifically for chronic diseases like diabetes and hypertension. According to the authors, the use of telehealth interventions was most often associated with better disease management, compliance with prescribed treatment regimens, and admission to the hospital fewer times (Kishik et al., 2021). The review also focused on the discussion on the specifics of telehealth to continue to support the ongoing care of patients during the COVID-19 pandemic.
Analysis
The study is systematic and useful to gain an effective understanding of the advantages of telehealth for chronic disease care. However, the authors define certain caveats regarding the quality of the evidence presented in this study, as well as other studies, highlighting that more effective substantiated research is needed to evaluate the long-term effects of telehealth initiatives (Kishik et al., 2021). Further, the review stresses that the quality of telehealth interventions can be further improved through efforts geared towards patient education and support.
Benefits and Limitations
Benefits: Summary of the extensive evaluation showcasing an understanding of the telehealth benefits needed for chronic disease management, including patient compliance, changes in the chronic disease outcome, and proven continuity of care in the COVID-19 period (Kishik et al., 2021).
Limitations: Recurrent tendencies among studies to use lower quality of evidence, and the necessity to conduct further research to confirm the efficacy of strategies. The review also identifies some of the weaknesses of Telehealth initiatives and their ability to adapt to the current health care structures.
Improvements to Outcomes, Efficiencies, and Lessons Learned
With the use of telehealth, there are enhanced follow-ups, timely adjustments, and thus yield better results for patients suffering from chronic diseases (Kishik et al., 2021). For example, patients diagnosed with diabetes who adopted the practice of telehealth experienced enhanced glycemic control as well as other health-related outcomes. In addition, telehealth increases efficiency as compared to face-to-face interaction, and clinicians can address more patients with in-person non-emergency visits.
Outcomes: The most significant benefits realized from the improved condition management include better disease management and compliance with treatment regimens. For example, using telemedicine solved the problem of routine check-ups of patients with chronic diseases and subsequent change of treatment plans to prevent deterioration of their conditions.
Efficiencies: Fewer patients marked that they were readmitted to the hospital than before, and fewer visits for service were necessary. For example, telehealth enhances the provision of healthcare through continued remote care delivery, enabling institutions to offload limited resources and focus on face-to-face consultations where necessary.
Lessons Learned: Understanding the role of patient engagement in order to enhance outcomes of tele-mental health interventions. For example, actively engaging patients in the process of telehealth system familiarization, as well as offering technical support, a wide range of positive effects on the telehealth process may be achieved.
Article 5
The review of the literature focused on the Integrated CDSS in various clinical backgrounds. The conclusion drawn from the study is that the usage of CDSS can optimize the patient’s clinical status since it offers appropriate recommendations, thus providing less probability of mistakes concerning diagnosis and treatment strategies as well as increasing the intake of medications by patients, the exceptional work presented also shows potential drawbacks, including compatibility with currently used EHR systems and the importance of creating intuitive interfaces (Sutton et al., 2020).
Analysis
One strength of this study is that it focuses on CDSS usage of relevance to daily care and its effects on them. A limitation is that different CDSS systems and studies have different structures and different designs of implementation, making it difficult to directly compare studies across them. The authors also point out that this information has to be constantly updated and optimized in the context of CDSS to coincide with the changes in the state of medical knowledge (Sutton et al., 2020).
Benefits and Limitations
Benefits: CDSS intervention effectiveness of patient outcomes is supported with supporting evidence in the use of CDSS to augment clinical decision making, decrease diagnostic errors, and improve compliance with prescribed regimes.
Limitations: Variability in the features of the CDSS systems and the generalization of study designs make comparison difficult. It also offers real difficulties when the integration with existing EHR systems has to be provided.
Improvements to Outcomes, Efficiencies, and Lessons Learned
CDSS increases health quality by offering healthcare givers with relevant and accurate information to utilize while attending to the patient (Sutton et al., 2020). For instance, one study reviewed while evaluating the effects of CDSS implementation in an emergency department showed a 20 percent reduction in diagnostic errors. It also addresses efficiency by aligning with clinical processes and lessening the cognitive processing load for clinicians involved.
Outcomes: Less frequent diagnostic mistakes and better judgment in case management. For example, in CDSS, the detailed recommendations are given to the healthcare providers, which increases the probability of the right diagnosis and improves outcomes of the patient treatment.
Efficiencies: Efficient clinical information processes to minimize the information load on employees of healthcare institutions. For example, CDSS in aspects related to routine jobs and decision-making can free up time that the providers, in turn, can use in other important elements of diagnostics and treatment.
LessonsLearned: CDSS requires updating so that they can always be in harmony with the changing medical knowledge, which is one constant factor in the modern world. For instance, Healthcare organizations thus need to ensure they commence implementing CDSS alongside other systems and also offer continuous training to the users.
Conclusion
TN004: Annotated Bibliography on the Application of Clinical Systems reviews EHR, mHealth, telehealth, CDSS & patient portals to improve patient outcomes and care efficiency. The use of the annotated bibliography is justified as it is evident that a wide range of clinical systems has a positive impact on patient outcomes and the organization’s performance.
These systems, including EHR, telehealth, and CDSS, offer several advantages, including improved coordination of care, fewer medical errors, and improved chronic illness management. However, some problems like data protection, users’ acceptance, and compatibility issues with other systems remain. Future studies should aim at meeting these challenges, together with refining even more clinical systems to improve the functionality and outcomes in various healthcare environments.
References
Kishik, S., Vinther, K. S., & Müller, S. D. (2021). Journal of Medical Internet Research. https://doi.org/10.2196/26991
Portz, J. D., Bayliss, E. A., Bull, S., Boxer, R. S., Bekelman, D. B., Gleason, K., & Czaja, S. (2019). Using the technology acceptance model to explore user experience, intent to use, and use behavior of a patient portal among older adults with multiple chronic conditions: descriptive qualitative study. Journal of Medical Internet Research, 21(4), e11604. https://doi.org/10.2196/11604
Schroeder, T., Haug, M., & Gewald, H. (2021). Where does all the data go? JMIR Formative Research, 6(6). https://doi.org/10.2196/28025
Sutton, R., Pincock, D., Baumgart, D., Sadowski, D., Fedorak, R., & Kroeker, K. (2020). NPJ Digital Medicine, 3(1), 1–10. https://doi.org/10.1038/s41746-020-0221-y
Upadhyay, S., & Hu, H. (2022). Health Services Insights, 15(1), 1–7. https://doi.org/10.1177/11786329211070722
