Literature Review Assignment: The Use of Clinical Systems to Improve Outcomes and Efficiencies

Literature Review Assignment: The Use of Clinical Systems to Improve Outcomes and Efficiencies

Literature Review Assignment: The Use of Clinical Systems to Improve Outcomes and Efficiencies

Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

Most healthcare organizations have incorporated clinical systems into their practices to improve efficiencies and outcomes of care. While a wide range of clinical systems has been implemented in the healthcare sector, this paper will focus on electronic health records (EHR). It will review articles about using electronic health records (EHR) to enhance the quality of care provided to diabetic patients.

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Annotated Bibliography

Zghebi, S. S., Rutter, M. K., Ashcroft, D. M., Salisbury, C., Mallen, C., Chew-Graham, C. A., … & Kontopantelis, E. (2018). Using electronic health records to quantify and stratify the severity of type 2 diabetes in primary care in England: rationale and cohort study design. BMJ Open, 8(6), e020926.

The study conducted by Zghebi et al. (2018), focuses on using electronic health records in primary care to minimize the severity of type 2 diabetes. In this article, Zghebi et al. (2018) have discussed the significant increase in the prevalence of type 2 diabetes mellitus (T2DM). The percentage of diabetic individuals raised from 4.7% to 8.5% in 1980 and 2014, respectively. Approximately, 422 million adults were diagnosed with diabetes in 2016. The risk for mortality and morbidity are higher among people struggling with diabetes than those without this condition. For this reason, the high prevalence of diabetes poses a financial burden on healthcare systems and the affected individuals worldwide. Therefore, electronic health records (EHRs) have been implemented into primary care to minimize the severity of diabetes, thus improving adverse clinical outcomes of patients diagnosed with T2DM.

The study findings indicate the implementation of electronic health records in primary care setting minimized the severity of T2DM. In particular, EHR improved various domains used to evaluate the level of their disease severity, including the HbA1c levels and complexity of anti-diabetic treatment regimens. Additionally, EHR improved severity variables, including vascular complications, patterns of treatments, and the number of comorbidities. Thereby, the lesson learned from this article is that the implementation of EHR reduces the severity of various diabetes elements among individuals diagnosed with T2DM.

Patel, V., Reed, M. E., & Grant, R. W. (2015). Electronic health records and the evolution of diabetes care: a narrative review. Journal of diabetes science and technology, 9(3), 676-680.

In this study, Patel et al. (2015), evaluates the impact of electronic health records (EHRs) on diabetic care. This study states that the prevalence of diabetes in the US is approximately 10%, with more than $240 billion annual costs. Consequently, the US national government focused on implementing technology to improve the quality of diabetes care countrywide. Specifically, electronic health record (EHR) innovations were adopted by healthcare organizations to facilitate diabetes management by improving the quality of outpatient care of T2DM patients.

The study findings indicate that the EHRs has improved the quality of care on a large population of diabetic patients. The improvement in care was measured through a decline in hospitalization cases associated with diabetes and reduced cost of diabetic care. Two EHR-enabled tools facilitated these benefits, including diabetes registries and Clinical decision support (CDS). Diabetes Registries provided comprehensive and structured patient data such as diagnosis codes, laboratory test results, and pharmacy medication records. This data was used to assess the quality of care provided to a particular subpopulation of diabetic patients and the additional resources and clinical benchmarks required to improve care and patient outcomes. Secondly, Clinical decision support (CDS) systems contributed to improved diabetic care by guiding clinicians to provide patient-centered care based on individual patients’ characteristics obtained from the EHR. In addition to supporting visit-based care, the study findings reveal that EHR improved the quality of diabetic care by supporting self-management. Clinicians developed personalized web-based self-management support systems using data that was obtained from EHRs. This system enabled diabetes patients to track and interpret data about various aspects of clinical diabetes care, including dietary, intake, glucometer readings, and the level of physical activity. Finally, the quality of diabetic care was improved by integrating EHRs into care systems to support secure electronic messaging between the care team and diabetes patients. In turn, electronic communication enables clinicians to address various concerns that are raised by the patients outside the visit, thus advising them on the most appropriate action to prevent diabetes-related health risks and further complications.

The lesson learned from this article is that technology plays a significant role in reducing the annual cost of care. In particular, the cost of diabetic care is lowered substantially by implementing electronic health records (EHR) in healthcare organizations, which improves the quality of outpatient care of T2DM patients.

Azizi, A., Aboutorabi, R., Mazloum-Khorasani, Z., Hoseini, B., & Tara, M. (2016). Diabetic personal health record: a systematic review article. Iranian journal of public health, 45(11), 1388.

Azizi et al. (2016) conducted a systematic review to assess Diabetic Personal Health records (DPHR) components in Iran. Diabetes is among the four major types of non-communicable health conditions. Therefore, effective management of diabetes has raised concern worldwide. The management of diabetic care can be improved by providing the patients with the information required to facilitate self-care. A structured and standard scheme for gathering diabetic patients’ data lacks in Iran’s healthcare system. Therefore, effective collection of diabetic data to support self-care for diabetic patients can be supported by DPHR.

The study findings indicate that using Diabetic Personal Health Record (DPHR) is associated with various benefits, including improving glycated hemoglobin (HbA1c), low-density lipoprotein (LDL), blood pressure monitoring, total cholesterol control, blood glucose monitoring, and weight management. Additionally, the findings reveal the DPHR model facilitated that physician decision-making. Therefore, the lesson learned from this article is that incorporating the DPHR model into the self-care for diabetic patients has a substantial improvement on the quality of care and enhances physician decision-making processes, thus boosting the health outcomes of diabetic patients.

Graetz I, Huang J, Brand R, Shortell S, Rundall T, Bellows J, Hsu J, Jaffe M, & Reed M. (2015). The Impact of Electronic Health Records and Teamwork on Diabetes Care Quality. American Journal of Managed care, 21(12):878-84.

In this study, Graetz et al. (2015) focus on the clinical outcomes for patients with diabetes following the healthcare team’s use of EHR.  This article indicates that the implementation of electronic health records (EHRs) is among the proposed policies for improving the American healthcare system’s efficiency and quality. Consequently, the US government started issuing federal incentive payments to care providers who utilize EHRs in their clinical practices. Nonetheless, this technology has not been effective due to many organizational settings in the US healthcare system. For this reason, EHRs have been recently adopted in patient-centered medical homes. Additionally, team members’ collaboration while using EHRs during care delivery is anticipated to improve the quality of diabetic care.

The study findings indicate an improvement in patients’ clinical outcomes with diabetes following the implementation of EHRs in diabetes self-management programs. This article has reported a significant improvement in glycated hemoglobin (A1C) values and low-density lipoprotein cholesterol (LDL-C). On the contrary, the article indicates negative results in these elements of diabetes. These results were associated with work environment factors, especially team cohesion. Therefore, the lesson learned from this article is that the implementation of EHRs in diabetes self-management program improves the quality of diabetic care and clinical outcomes of diabetes patients, such as improvement in glycated hemoglobin (A1C) values and low-density lipoprotein cholesterol (LDL-C). Nonetheless, these results are likely to be compromised by a lack of collaboration among the care team. Cohesion among care providers interferes with support and quality of care provided to diabetes patients.

Overall, the implementation of EHR-enabled tools such as diabetes registries and clinical decision support (CDS) in the healthcare system improves the quality of diabetic care. The provision of high-quality care, in turn, improves the clinical outcomes of diabetic patients. Some of these outcomes include improved glycated hemoglobin (A1C) values, low-density lipoprotein cholesterol (LDL-C), blood pressure monitoring, total cholesterol control, blood glucose monitoring, and weight management. Nonetheless, the efficacy of EHRs in achieving these results is compromised by lack of collaboration among the care team since cohesion among care providers interferes with support and quality of care provided to diabetes patients.

References

Azizi, A., Aboutorabi, R., Mazloum-Khorasani, Z., Hoseini, B., & Tara, M. (2016). Diabetic personal health record: a systematic review article. Iranian journal of public health, 45(11), 1388.

Graetz I, Huang J, Brand R, Shortell S, Rundall T, Bellows J, Hsu J, Jaffe M, & Reed M. (2015). The Impact of Electronic Health Records and Teamwork on Diabetes Care Quality. American Journal of Managed care, 21(12):878-84.

Patel, V., Reed, M. E., & Grant, R. W. (2015). Electronic health records and the evolution of diabetes care: a narrative review. Journal of diabetes science and technology, 9(3), 676-680.

Zghebi, S. S., Rutter, M. K., Ashcroft, D. M., Salisbury, C., Mallen, C., Chew-Graham, C. A., … & Kontopantelis, E. (2018). Using electronic health records to quantify and stratify the severity of type 2 diabetes in primary care in England: rationale and cohort study design. BMJ Open, 8(6), e020926.

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Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
Identify and select 4 peer-reviewed research articles from your research.
For information about annotated bibliographies, visit https://academicguides.waldenu.edu/writingcenter/assignments/annotatedbibliographies
The Assignment: (4-5 pages not including the title and reference page)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography. Be sure to address the following:

Identify the 4 peer-reviewed research articles you reviewed, citing each in APA format.
Include an introduction explaining the purpose of the paper.
Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.
In your conclusion, synthesize the findings from the 4 peer-reviewed research articles.
Use APA format and include a title page.
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