Academic Electronic Health Record Research Articles

Academic Electronic Health Record in Mental Health Clinical: A Quality Review.

Developing competency in the use of EHRs is essential for entry-level professional nurses. Although nursing education has been encouraged to integrate this technology into nursing curriculum, many students still graduate feeling unprepared in this area. As a result, nursing graduates lack the skills necessary to effectively use EHRs, which may have negative consequences for safe patient care. Use of academic EMRs provides students the opportunity to integrate informatics education, develop critical thinking, and incorporate problem-solving skills in the clinical area. An academic EMR was introduced to students in the second semester of a baccalaureate degree nursing program. Students completed documentation on one patient from the mental health clinical rotation. A retrospective chart review was conducted, using a rubric to determine charting efficacy. Data analysis indicated that students struggled with documentation of the mental health assessment, care plan development, and nursing notes. Student documentation was strongest in vital signs and basic information. Students need practice documenting on the critical aspects of nursing care. Utilization of an academic EMR for clinical charting provides an opportunity for students to practice documentation and develop necessary skills for clinical practice.

Analysis of Inclusive Gender, Sexuality and Sexual Orientation Data Elements in Academic Electronic Health Records.

Findings from an analysis of three vended academic electronic health records used in health science education are presented in this article. The quality assurance project examined the lexical and semantic fit and content coverage of gender, sexuality, and sexual orientation data elements within the academic electronic health records. A semantic comparative content analysis using a cognitive walkthrough was conducted as a means of comparing the ideal set of gender, sexuality, and sexual orientation data elements with those found in the three vended academic electronic health records. The results indicated a need for alignment to the research literature, expert consensus, and technical standards similar to what is expected for electronic health records used in clinical practice because of a lack of ideal state data elements. The findings align with ongoing issues with bias and disparities seen in the care of the lesbian, gay, bisexual, and transgender population and a lack of diverse, inclusive media and teaching technologies in health science education. The quality project and findings can inform academic electronic health record vendors on how they can create more inclusive systems and bring awareness to healthcare educators about the potential for implicit and explicit bias in their teaching technologies.

Analysis of Inclusive Gender, Sexuality and Sexual Orientation Data Elements in Academic Electronic Health Records

Analysis of Inclusive Gender, Sexuality and Sexual Orientation Data Elements in Academic Electronic Health Records

Initial steps for integrating academic electronic health records into clinical curricula of physical and occupational therapy in the United States: a survey-based observational study.

Training programs must be designed to prepare physical and occupational therapy students to use electronic health records (EHRs) and interprofessional collaboration. This report aims to describe physical and occupational therapy students’ perceptions of integrating an academic EHR (AEHR) in their problem-based learning (PBL) curricula in the College of Health Professions, Sacred Heart University, Fairfield, Connecticut, the United States. A paper-based case approach to PBL was adapted by creating patient cases in an AEHR. Students were asked to complete chart reviews and review provider notes to enhance their learning. An online survey was conducted to determine their perceptions of using AEHR from May 2014 to August 2015. Eighty-five students completed the survey, and 88.1% felt that using an AEHR was needed, and 82.4% felt that the additional notes enhanced their understanding of the interdisciplinary team. However, 83.5% reported the AEHR system increased the time needed to extract meaningful information. Incorporating an AEHR into curricula is essential to ensure students are adequately prepared for future patient interactions.

Using the academic electronic health record to build clinical judgment skills in the classroom setting

Nursing faculty used an academic electronic health record to promote clinical judgment skills in a prelicensure Foundations of Nursing course. Students reviewed weekly patient charts for class preparation. During class, students and faculty discussed the findings, trends, nursing interventions, and rationales that pertained to the weekly course content. Students reported that the activities helped prepare them for clinical patient care. Faculty found that students came to class more prepared and able to engage in discussion. Faculty learned lessons by trial and error throughout the semester to make the workflow and creative process easier in the future.

Using "Diraya" System as a Complementary Tool in Nursing Process Education: A Controlled Clinical Study.

Background: Healthcare has been revolutionized by the application of information and communication technologies. The implementation of electronic health record systems improves the quality and safety of patient healthcare. Nursing students who start learning the nursing process without contact with real patients experience difficulties in its correct application. Purpose: To compare the acquisition of skills and competencies in the nursing process by undergraduate nursing students between conventional learning with books and learning with an academic electronic health record system (Diraya). Methods: A controlled experimental study was conducted and included 379 students with a mean age of 20.54 ± 5.09 years, enrolled in the “Nursing Process and Basic Care” degree course at the School of Health Sciences in Granada. All participants gave their informed consent and were allocated by convenience sampling to a control group (n = 187; 21.20 ± 5.77 years) or an experimental group (n = 192, 19.91 ± 4.24 years). Findings: The experimental and control groups did not differ in sex distribution (p = 0.20), mean age (p = 0.01), or previous knowledge of the nursing process (p = 0.96). The groups did not significantly differ in multi-choice test results on the acquisition of theoretical knowledge (p = 0.13). However, the experimental group scored higher on clinical case planning (9.47 ± 0.80 vs. 8.95 ± 1.17; p < 0.001), took less time to complete it (46.9 ± 8.76 min vs. 82.66 ± 13.14 min; p < 0.001), and needed fewer autonomous learning hours to prepare for the final examination (2.26 ± 2.41 vs. 9.58 ± 3.83; p < 0.001). Satisfaction with the program and the rating of its quality were generally higher in the experimental group, while greater difficulty with most phases of the nursing process was reported by the control group. Conclusions: The academic electronic health record system “Diraya” is a useful tool to improve the learning and implementation of the nursing process by undergraduate nursing students.

Impact of CancelRx on discontinuation of controlled substance prescriptions: an interrupted time series analysis

BackgroundPrescription opioid misuse is a serious national crisis; in 2018 the top drugs involved in prescription overdose deaths included pain medications (opioids), benzodiazepines, and stimulants. Health information technology (health IT) provides a means to address this crisis through technologies that streamline the prescribing and discontinuation process. CancelRx is a health IT function that communicates when medications, such as controlled substances, are discontinued at the clinic and therefore should not be filled at the pharmacy. Prior to CancelRx, the communication of discontinued medications was a manual process, requiring the patient or a clinic staff member to personally contact the pharmacy to inform them of the change. The objective of this study was to assess how controlled substance medication discontinuations were communicated over time, before and after the implementation of CancelRx.MethodsSecondary data from a midwestern academic health system electronic health record and pharmacy platform were collected 12-months prior to CancelRx implementation and for 12-months post implementation. The study utilized an interrupted time series analysis (ITSA) to capture the percentage of controlled substance medications that were discontinued in the clinic’s electronic health record and discontinued in the pharmacy’s dispensing software. The ITSA plotted the percentage of successful discontinuation messages over time, particularly after the health system’s implementation of CancelRx, a novel technology.ResultsAfter CancelRx implementation there was an immediate (change = 77.7 percentage point) and significant (p < 0.001) increase in the number of controlled substance medications that were successfully discontinued at the pharmacy after being discontinued in the clinic. This change was sustained in the year following CancelRx (slope = 0.03 pp, 95% CI − 0.050 to 0.110) and did not revert to pre-CancelRx levels. The health IT functionality was able to effectively complete discontinuation tasks and potentially reduce workload for clinic staff.ConclusionsOverall, this study demonstrates the role that technology can play in promoting communication between clinics and pharmacies, especially when medications such as controlled substances are discontinued.

The Critical Need for Advanced Training in Electronic Records Use: Implications for Clinical Practice, Education, and the Advancement of Athletic Training.

The effective use of electronic records (ie, electronic health records or electronic medical records) is essential to professional initiatives and the overall advancement of the athletic training profession. However, evidence suggests that comprehensive patient care documentation and widespread use of electronic records are still limited in athletic training. The lack of formal training and education for clinicians and students is often cited as a primary barrier to electronic record use. Other health care disciplines have used academic electronic health record (AEHR) systems to address these barriers with promising results. To identify common challenges associated with the effective use of electronic records in clinical practice, discuss how an AEHR system can address these challenges and encourage more effective use of electronic records, and describe strategies for deploying AEHRs in the athletic training profession. The AEHR is an electronic records system specifically designed for educational use to support simulation learning among all types of learners (eg, practicing clinicians, students). Mimicking the form and function of an electronic health record, the AEHR offers various educational tasks, including patient care documentation projects, critical reviews of standardized patient cases, and assessments of patient care data for quality improvement efforts. Recent evidence suggests that the use of an AEHR can improve knowledge and enhance skills. Specifically, AEHR use has been associated with enhanced attitudes toward electronic health record technology, increased informatics competencies, and improved documentation skills. Also, the use of an AEHR has been associated with improved critical thinking and decision-making skills. This tool appears to be valuable for health professions education, and athletic training stands to benefit from its use to better train and upskill clinicians and students alike for clinical practice. Although the implementation of an AEHR will require much time and large-scale coordinated efforts, it will be a worthy investment to address current challenges and advance the athletic training profession.

Quality Improvement Project to Enhance Student Confidence Using an Electronic Health Record.

As the largest health care workforce, nursing is positioned to improve the health of populations using health information technology (HIT). Nurse graduates often lack confidence using HIT in practice, specifically, the electronic health record (EHR). Nurse scholars endorse the use of an academic electronic health record (AEHR) in nursing programs to provide students a safe learning platform to build levels of confidence using an EHR. A quality improvement project was completed to evaluate student learning outcomes, satisfaction, and sustainability of an AEHR. Using an interprofessional approach, nurse educators incorporated the Systems Life Cycle Model to adopt an AEHR in two prelicensure nursing programs. Students' levels of confidence using an EHR in clinical settings increased markedly. Satisfaction rates for using an AEHR were high. Integration of an AEHR in nursing education contributes to building a proficient nursing workforce confident in using HIT for health care quality. [J Nurs Educ. 2021;60(6):337-341.].

Academic Electronic Health Records in Undergraduate Nursing Education: Mixed Methods Pilot Study.

BackgroundTeaching students about electronic health records presents challenges for most nursing programs, primarily because of the limited training opportunities within clinical practice settings. A simulated electronic health record is an experiential, learner-centered strategy that enables students to acquire and apply the informatics knowledge needed for working with electronic records in a safe learning environment before the students have encounters with real patients.ObjectiveThe aim of this study is to provide a preliminary evaluation of the Lippincott DocuCare simulated electronic health record and determine the feasibility issues associated with its implementation.MethodsWe used one-group pretest-posttest, surveys, and focus group interviews with students and instructors to pilot the DocuCare simulated electronic health record within an undergraduate nursing program in Western Canada. Volunteering students worked through 4 case scenarios during a 1-month pilot. Self-reported informatics knowledge and attitudes toward the electronic health record, accuracy of computerized documentation, satisfaction, and students’ and educators’ experiences were examined. Demographic and general information regarding informatics learning was also collected.ResultsAlthough 23 students participated in this study, only 13 completed surveys were included in the analysis. Almost two-thirds of the students indicated their overall understanding of nursing informatics as being fair or inadequate. The two-tailed paired samples t test used to evaluate the impact of DocuCare on students’ self-reported informatics knowledge and attitudes toward the electronic health record revealed a statistically significant difference in the mean score of knowledge before and after using DocuCare (before: mean 2.95, SD 0.58; after: mean 3.83, SD 0.39; t12=5.80, two-tailed; P<.001). There was no statistically significant difference in the mean scores of attitudes toward the electronic health record before and after using DocuCare (before: mean 3.75, SD 0.40; after: mean 3.70, SD 0.34; t12=0.39, two-tailed; P=.70). Students’ documentation scores varied from somewhat accurate to completely accurate; however, performance improved for the majority of students as they progressed from case scenarios 1 to 4. Both the faculty and students were highly satisfied with DocuCare and highly recommended its integration. Focus groups with 7 students and 3 educators revealed multiple themes. The participants shared suggestions regarding the DocuCare product customization and strategies for potential integration in undergraduate nursing programs.ConclusionsThis study demonstrated the feasibility and suitability of the DocuCare program as a tool to enhance students’ learning about informatics and computerized documentation in electronic health records. Recommendations will be made to academic leadership in undergraduate programs on the basis of this study. Furthermore, a controlled evaluation study will be conducted in the future.

The effect of early adoption of an academic electronic health record system in nursing education: A pilot outcome study

Objective: This study aimed to explore the faculty’s and students’ perceptions of an academic electronic health record system (AEHRs) for teaching/learning electronic nursing documentation and to assess the outcomes of the AEHRs on nursing students’ competency with electronic nursing documentation.Methods: With a mixed-method pilot study, a convenience sample of 41 undergraduate nursing students and a purposive sample of 7 faculty and 9 students were used. Two groups of student participants for the quantitative data were compared for their competency with electronic nursing documentation. For the qualitative data, an in-depth, exploratory approach to data collection was taken for the nursing faculty and the intervention group.Results: For the quantitative findings, the early adoption of an AEHRs could help students to collect a patients’ health information through the system even though it may not impact their critical thinking on a patient’s care. For the qualitative findings, three key themes were shared by the faculty and students: (1) benefits and challenges, (2) impact of the AEHRs, and (3) recommendations for future adoption.Conclusions: This study revealed that the successful adoption of an AEHRs includes many steps that can be used to create positive improvements. These findings were beneficial to prepare students and nursing educators for the future of health information technology. Meaningful adoption of an AEHRs will help in building the competence of undergraduate nursing students in electronic nursing documentation and improve patient care.

University of Massachusetts Medical School.

University of Massachusetts Medical School.

Academic Electronic Health Record Implementation: Tips for Success

Many nursing programs use simulation experiences to augment or replace clinical experiences. Use of an electronic health record (EHR) in the educational setting extends the realism. A task force reviewed EHR programs, selected an EHR, and created an implementation plan with successful rollout over 2 years.

Use of an Academic Electronic Health Record With an Interprofessional Simulation for Advanced Practice Nursing Students.

Simulation with interprofessional teams provides case management opportunities for advanced practice RN students they may not encounter in preceptorships. We designed standardized patient simulations to improve health care safety and outcomes; an academic electronic health record was used in some simulations. We report quality improvement findings from 74 APRN students who completed a survey with open-ended questions. We found that simulation in interprofessional teams positively impacted role immersion, confidence, problem-solving skills, and teamwork. Use of the academic electronic health record added realism. The findings are being incorporated as part of continuous quality improvement in the teaching-learning process.

Academic Electronic Health Record (AEHR) Implementation

AbstractRegistered Nurses (RNs) make up the largest group of healthcare workers that use electronic health records in the United States, yet many nursing schools do not have electronic health record training in their curricula. An academic electronic health record (AEHR) used within the nursing curriculum will prepare new nurses to use electronic documentation in a way that will provide safe, quality care. To determine to implementing an AEHR in nursing curricula, a review of the current literature was undertaken in widely recognized databases. Social cognitive theorywas the guiding framework of this study. The purpose of study is to investigate and compare student outcomes before and after implementation of EHR training in curriculum This study uses a quasi-experimental design with first and second semester students enrolled in a Baccalaureate of Science in Nursing (BSN) program at FHSU. The control group (second semester) did not receive EHR instruction in their first-semester. The intervention group (First semester) received instructional session using and navigating in an AEHR in first-semester. Surveys showed undergraduate first semester nursing students who received AEHR instruction had increased self-efficacy and increased competency at clinicals compared to peers (second semester) who did not receive instruction. The results of this study indicate that the use of an AEHR in nursing curricula may be a more effective teaching strategy to improve students’ self efficacy and competencyKeywords: Academic electronic health record, social cognitive theory, self-efficacy, and competency.

Using Simulation to Increase Student Confidence with EHR Documentation

In today’s complex and evolving healthcare system, it is crucial for nurses to proficiently comprehend electronic health records (EHR) in the provision of quality, safe, patient care. Accordingly, the Institute of Medicine report in 2003 emphasized informatics as one of the core competencies for nursing education to improve upon. Upon completion of the their first academic clinical experience, the authors found a gap in the student’s ability to perform at the bedside and balance the documentation requirements of the electronic health record. In order to better equip Fort Hays State University Nursing students with the technological skill sets necessary to navigate modern health care informatics, we designed an academic electronic health record (AEHR) training module to incorporate into their regularly scheduled simulation.

Successful Integration of an Academic Electronic Health Record Into the Curriculum of an Associate Degree Nursing Program.

The use of electronic data management systems is rapidly expanding. Nurses need to be competent in the use of electronic health records (EHRs) and understand their contribution to safe, effective, high quality patient care. Faculty must incorporate learning experiences in the application of EHRs into undergraduate nursing programs in order to adequately prepare students for employment. This article reports the challenges involved in the successful addition of an academic EHR into an existing curriculum.

Academic Electronic Health Record Implementation Proposal

In today’s complex and evolving healthcare system it is crucial for nurses to proficiently comprehend electronic health records (EHR) in the provision of quality, safe patient care. Electronic health records have become a federal mandate for patient funding securement in many settings. Studies suggest that implementation of an academic electronic health record (AHER) augments student learning for assuming the nurse role in key areas such as: data analysis, assessing patient care needs, administering medications safely, documenting effectively and professionally, and learning how to maintain a therapeutic nurse-client relationship with effective communication in the presence of technology (Jansen, 2014; Herbert &amp;amp; Connors, 2016). Additionally, evidence shows that the implementation of AEHR in a simulation enhances the realism and depth of learning for students as it better mirrors the clinical setting while facilitating faculty assessment of student skills (Meyer, Sternberger&amp;amp; Toscos, 2011). Even though research demonstrates ample benefits to the implementation of an AEHR in nursing education, the Nursing Department at Fort Hays State University (FHSU) utilizes paper patient charts in practice scenarios and in simulation experiences. This researcher recommends the implementation of an AEHR at FHSU to promote aptitude of the EHR, giving more time to direct patient care at time of clinicals.

The need for academic electronic health record systems in nurse education

The nursing profession has been slow to incorporate information technology into formal nurse education and practice. The aim of this study was to identify the use of academic electronic health record systems in nurse education and to determine student and faculty perceptions of academic electronic health record systems in nurse education. A quantitative research design with supportive qualitative research was used to gather information on nursing students' perceptions and nursing faculty's perceptions of academic electronic health record systems in nurse education. Eighty-three participants (21 nursing faculty and 62 students), from 5 nursing schools, participated in the study. A purposive sample of 9 nursing faculty was recruited from one university in the Midwestern United States to provide qualitative data for the study. The researcher-designed surveys (completed by faculty and students) were used for quantitative data collection. Qualitative data was taken from interviews, which were transcribed verbatim for analysis. Students and faculty agreed that academic electronic health record systems could be useful for teaching students to think critically about nursing documentation. Quantitative and qualitative findings revealed that academic electronic health record systems regarding nursing documentation could help prepare students for the future of health information technology. Meaningful adoption of academic electronic health record systems will help in building the undergraduate nursing students' competence in nursing documentation with electronic health record systems.

Curricular Path to Value: Integrating an Academic Electronic Health Record.

Regulatory mandates consistently focus on quality, safety, and improving patient care as better evidence surfaces. One of those mandates is the adoption of electronic health records (EHRs) across all patient care settings. New graduate nurses must know how to access patient data and document and synthesize patient information accurately to plan safe, quality care and mitigate potential errors. In an undergraduate nursing program, the objectives were to provide faculty with simple teaching strategies that promoted ease of integrating an academic EHR (AEHR) across a curriculum, as well as to steadily increase students' use of an AEHR. Faculty stressed an appreciation for having a supportive environment with an innovative way to educate nursing students. Students' feedback and course evaluations were positive, with students noting that they enjoyed learning in a different way. Faculty should continue to share their innovative teaching strategies for AEHR integration. Further research should include measurable outcomes of integrating an AEHR throughout a curriculum. [J Nurs Educ. 2016;55(12):716-719.].