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Clinical Systems Leadership

What You Should Know About Patients and EHRs

Electronic health records and other health care software have become a major part of nursing education. From learning how to code specific procedures to inserting notes into a patient’s chart, technology has become a critical aspect to patient care and the financial health of a medical practice. However, EHRs aren’t just for nurses and doctors anymore.

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Beth Israel Deaconess Medical Center in Boston (BIDMC) recently announced a pilot program that will allow patients to input as much information into their EHRs as they want. Called OurNotes, it’s part of the OpenNotes movement, which promotes transparency among doctors and their patients when it comes to EHRs.

Promoting patient involvement
Since OpenNotes started in 2010, studies show that it has improved communication, involvement and efficiency, according to OpenNotes. This new health IT program from BIDMC takes patient involvement even further.

Funded by a $450,000 grant from the Commonwealth Fund, OurNotes will let patients see what doctors or nurse practitioners write, and then add to it. It’s expected to build off of the patient satisfaction associated with OpenNotes.

“We believe that OurNotes, which will enable patients to contribute to their own medical records, has the potential to further enhance communication and engage patients in managing illness more effectively and efficiently, leading to improved patient safety and quality of care and potentially, to lower healthcare costs,” Jan Walker, a researcher at BIDMC and co-director of the OpenNotes project, R.N., said in a statement.

Supporters of OurNotes expect the program to improve patient engagement and ultimately reduce health care costs. In the early stages, Walker explained that the program organizers will be talking to patients and health care professionals about which aspects they’d like to see in OurNotes.

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The role of nurses in changing EHRs
While this new pilot program will only be at BIDMC and four other facilities associated with OpenNotes, nurses and nursing students should be ready for increased patient participation in EHRs in the near future.

Patient participation is required as part of stage 2 of the Centers for Medicare and Medicaid Services’ meaningful use incentive program in certain core objectives, including the ability for patients to view their online records or communicate through secure messaging. Although these incentives are tailored for physicians, nurses can have a significant impact on the practice receiving the incentive payment.

As EHR systems are moving toward greater patient involvement and improved conversation, nurses may actually begin playing an even bigger role in their use, Debra Wood, R.N., explained in an article for Nurse Zone. While involving staff nurses can be critical to the practical implementation of any new software for a medical practice, Wood pointed to the increasingly important role of nurse informaticists.

Nurse informaticists typically earn a Master of Science in Nursing specializing in health IT then work in health care technology. They can help a practice do everything from training the staff on how to use a new system to customizing EHRs for optimized practice use. One of their benefits is seeing EHRs from every angle, as a nurse, a software expert and the patient, Barbara Guy, R.N., M.S.N., director of the electronic medical record department at South Nassau Communities Hospital in Oceanside, New York, told Nurse Zone.

“It’s very important to have nurses,” Guy said to the news source. “They are strong patient advocates and are able to look at problems and workflows through the eyes of the different caregivers on the health team.”

Nurses don’t have to pursue a career as an informaticist to help the practice and patients use EHRs more efficiently. Nurse Zone explained that as EHRs are upgraded and grown in scope, the roles for nurses do too. Many nurses have expanded their roles in practices by adapting to the new EHRs and have been rewarded for it with larger salaries.

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