1. Pullen, Richard L. Jr. EdD, MSN, RN, CMSRN, CNE, CNE-cl, ANEF

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Q: What are the types of health information technologies?

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A: Health information technologies (HIT) promote safe practice environments by reducing and preventing errors, reducing costs, expanding access to care, protecting information in the medical record, and enhancing patient satisfaction.1,2 HIT involves the storage, processing, retrieval, analysis, and exchange of data using computer systems and is correlated with the patient's clinical status by the nurse to determine the priorities of care.1-3 Using HIT enhances communication, critical thinking, clinical reasoning, and decision-making to promote workflow efficiency and care coordination. Selected HIT processes include the following:1-6


1. I.V. smart pumps. These pumps have a database of medications with normal concentrations, typical doses, interactions, and a calculator. Pump software alerts nurses if there are any contraindications with medications. For example, a medication that's about to be administered by the nurse may cause an additive effect to another medication the patient is receiving leading to an adverse reaction. Another example is that the dose that's about to be administered isn't within a safe range according to the patient's body weight.


2. Smart beds. These beds track patient movement, weight, and vital signs while promoting comfort and safety. Alarms on the bed can notify nurses that a patient is trying to get out of the bed. Nurses are likely to spend less time frequenting a room to check on the patient.


3. Electronic health record (EHR). The EHR and associated electronic medication record enable nurses to retrieve data, provide care expeditiously, and spend more time with the patient.


4. Clinical decision support systems (CDSSs). These computerized programs are integrated into technologies such as the EHR and I.V. pumps and prompt the nurse to provide an evidence-based point of care based on patient data. Prompts for medication calculations, dosage, interactions, therapeutic range, allergy, diagnostic lab and imaging, and an algorithm for triaging patients are common CDSSs. CDSSs underpin the nurse's critical thinking with data to determine care.


5. Telehealth. Telehealth allows the patient to stay in their own home while being assessed by the provider. The provider can perform a basic assessment and determine if the patient needs to come in person for additional follow-up. The provider should also evaluate a patient's level of competency with computers.


6. Computerized disease registries. These databases house information about the morbidity and mortality of disease processes to identify strategies to help individuals achieve an optimal state of wellness.


7. Computerized provider order entry. A provider sends medication or treatment to another health professional. This reduces the need to interpret illegible handwriting, eliminates the need for paper, and promotes patient safety.


8. Intranet and internet communication.


a. Facility intranet. Allows a facility to be paperless, communicate and collaborate among the interprofessional staff, and provide care and services more expeditiously.


b. Electronic health information exchange. The electronic transmission of data improves care coordination among the interprofessional team, eliminates unnecessary repetition of procedures and tests, reduces costs to the patient and healthcare system, and promotes patient engagement.


9. Consumer health information technology applications.


a. Self-management systems. The provider can monitor specific information remotely, such as heart rate and rhythm, BP, blood glucose, and oxygen saturation. Communication between the provider and patient can address any issues through this wireless process. These applications can also notify the patient when they should contact their providers.


b. Electronic personal health records. These detailed medical records conform to a standardized national format and can be used to communicate patient information across many healthcare facilities. A patient may receive an abbreviated version of their health record from a patient portal.


c. Peer interaction systems. Human beings need social interaction. Technology is an important tool for nurses to communicate in social and professional settings because it allows them to communicate and share patient information with other healthcare providers. Cell phones with video and text messaging, online discussion groups, teleconferencing, and social media platforms are different ways that people use to engage with each other.


10. Robotics. In the future, nursing robots may take on assistive roles, such as taking vital signs or serving a meal tray, in hospitals, long-term-care facilities, and homes to assist with patient care and combat loneliness, particularly in the older adult.


11. Speech recognition. Speech recognition takes the spoken word and translates it into text. This expedites information placed in the EHR. It also allows patients with physical challenges to function more fully when using the computer.


12. Voice banking. This is the creation of a digital copy of a person's voice before they lose the ability to speak.2 Patients can then use an assistive device that enables the typed word to be vocalized.


13. Informatics. This integrates all forms of technology in clinical practice with information science and computer science to manage data, sometimes called "big data."



A complement to quality care

HITs are tools used to promote communication, efficiency, and safe, quality patient-centered care and are designed to complement the nurse's decision-making in the delivery of care. Nurses and patients should have a warm, caring relationship with clear communication. The patient must always know how important they are to the nurse. For example, nurses shouldn't make patients feel as if they're being placed into a secondary position to the technology the nurse is using to document care. Interaction and relationship-building between the nurse and patient remain crucial.




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6. Hartzband D. The evolution of infrastructure and applications required for current and near-future-HIT. In: Information Technology and Data in Healthcare: Using and Understanding Data. Productivity Press; 2021:73-103. [Context Link]