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Supporters of electronic medical records say EMRs hold numerous benefits, such as enabling physicians and caregivers to make clinical decisions based on the data in the system. But issues arise and dangers occur when the data in that EMR is incorrect – something that happens all too frequently, thanks to the view/write/transcribe mentality of entering data.
"The old way of entering data into a record is looking at it in a monitor, writing in on a clipboard, and later transcribing it into the record. It's of great concern because it isn't timely and there are chances it can be inaccurate," says Sue Niemeier, chief nursing officer at Capsule, which develops connectivity technology.
"But when you introduce device integration into the picture, that goes away. You also increase the direct patient care interaction, and you automate the recording of patient data. Suddenly, the whole world changes for that caregiver, and you're relying on that caregiver to truly be at the point of care, which is the real reason they went into their profession."
Niemeier offers five ways in which device integration increases the value of data in an EMR.
1. It's more accurate. According to Niemeier, the accuracy of data increases tremendously with integration. "You now have data that was previously transcribed or taken from a device and keyed into a computer," she says. "So you no longer have the opportunity for error." More importantly, she continues, nurses or those keying in data no longer forget to do it. "There's not only accuracy, but there's an omission aspect as well," she says. "You don't forget to add a temperature or blood pressure or a key variable that would create a more comprehensive view of the record."
2. The data is timely. With device integration, data is now in near-real time. "You'll see a lot of data out there that shows once you're on a device, it can take hours to get it into the record," says Neimeier. "I've seen two hours and I've seen 12 hours, which tells me the nurse is waiting until the end of their shift to document." Waiting 12 hours, however, creates a disadvantage for patients, essentially leaving them for half a day with an incomplete record. "And other caregivers are relying on that record to make clinical decisions, and then there's this void," she says. Additionally, this impacts the way a patient is transferred from one setting to another. "You're holding out data. Device integration and the value of data allow it to be more timely and more accurate."
3. Your data is more frequent. With integration, data is presented in a more consistent and steady stream, instead of in a "batch" fashion, says Neimeier. "Nurses are trained to document when they have time, and they often don't have time because of the higher acuity of their patients," she says. "And then they have this little thing called a nursing shortage, too. But when you actually rely on data flowing naturally and automatically, all the clinician needs to do is open the record and do a check – check, check, check, that data is fine and it can be submitted." This is done instead of transcribing, writing and keying in notes, she adds, "so that frequency, again, is changed to more of a steady stream of data."
4. Data is much more succinct. When you rely on the data in nursing notes, it can be hard to discern what's important when it's in paragraph form, Neimeier says. "But when you change that to a grid and flow sheet concept, and they can track and trend it, that's where you get great value." Additionally, this allows for a "new picture" to form, displaying how the patient is truly doing. "Now you can actually see it – it's clear and concise," she says. "And it's not incomplete; it's succinct. It tells me where it is in that flow sheet, and that trend apparatus allows me to see my patient is progressing." Nurses can then communicate that information to the physician or the next caregiver.
5. Time is given back to caregivers. "Nurses and caregivers all want that time back that's been lost to them because they've been pulled in a million different directions," says Neimeier. "A lot of technologies or processes may be taking them away from the bedside, and that's unfortunate." With device integration, she says, nurses and caregivers are "pulled back" to the patient. "So that time is reinvested, and we give that back to them because they're out of that administrative function. They can really truly be thinking about 'how can I care for this patient better,' because they're at the bedside more."
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