The patient journey through the healthcare system has evolved over the past half-century. While the end goal of providing quality patient care to achieve the best outcomes is still the end goal, how that care is delivered has dramatically changed. Healthcare providers are improving patient care through technology, leveraging its unique capabilities to create a more efficient, safer, and improved patient experience.
Even while technology is improving outcomes, the best patient care still requires the human element. Hospitals that are able to balance technology with the personal touch maximize the effectiveness of their care and deliver the optimal experience for both the patient and the caregivers.
Healthcare Information and Management Systems Society (HIMSS) recognizes the need for this balance, believing nurses must have the capability to “understand and direct the balance of patient care with the technology systems and organizational structure that supports this balance…It is important to integrate nurses’ perceptions, beliefs, and knowledge in the use of new technology and how nurses implement this technology into their daily nursing practice.”
The nurse’s greatest value is in his or her ability to “know,” the article states. They have firsthand knowledge of the patient’s needs. They spend the most time with the patient, asking questions, offering guidance and, of course, providing direct care. Their intuition, experience, and knowledge may never be replaced by technology, but technology can enhance their ability to provide excellent care.
Electronic Health Records
When we consider improving patient care through technology, we often think first of electronic health records (EHR). The EHR was one of the biggest improvements to patient care, digitizing and consolidating the patient’s medical records in one place and making those records readily available to healthcare providers. Because the EHR includes so much about the patient, such as patient demographics, progress notes, symptoms and diagnoses, current medications, vital signs, medical history, allergies, laboratory data, and imaging reports, the healthcare provider has a complete picture of the patient. Electronic records greatly improve the physician and nurse workflow, streamlining care and providing caregivers with instant patient data to drive better, more timely decisions.
According to the Centers for Medicare and Medicaid Services, the EHR technology improved patient care by:
- Reducing the incidence of medical error [sic] by improving the accuracy and clarity of medical records
- Making the health information available, reducing duplication of tests, reducing delays in treatment, and [sic] patients well-informed to make better decisions
The EHR was so successful in driving such improvements, most physicians now utilize EHR to store and share patient records. In 1996, the Health Insurance Portability and Accountability Act (HIPAA) made it mandatory for physicians and hospitals to shift to electronic systems in order to comply with patient privacy and security regulations. Today, patients have peace of mind knowing their records are secure and their data is helping their care providers deliver the best possible care.
Automated Medication Dispensing Cabinets
Improving patient care demands hospitals and medical facilities focus on patient safety. Medical errors cause more than 250,000 patient deaths every year in the United States, making them the third leading cause of death. Technology is helping healthcare organizations reduce medical errors, particularly when those errors are related to medication mistakes.
Automated medication dispensing cabinets (ADCs) provide technology-controlled storage, dispensing, and tracking of medications. They have become a mainstay in most hospitals for the efficiency they bring to nurse workflows and the safety they promise. But, as one report states, “their capacity to reduce medication errors is controversial and depends on many factors, including how users design and implement the systems.”
ADCs have, in large part, replaced the manual distribution of medications via older model medication carts. These carts stock medications in bulk and allow nurses to retrieve patient medications quickly, however, without proper protocols in place, it is impossible to ensure the right medications and dosages are accessed. Further, the pharmacy has no efficient way to track medication usage and medications are often wasted, stolen, or “borrowed” for other patients.
The advantage of ADCs is that they contain technology that makes them more secure and tracks access for better patient care and greater pharmacy control. There is one potential risk factor, however. The technology in the ADCs enables nurses to easily override the safeguards to prevent medication errors. Unfortunately, overrides have become so common, many nurses are unaware of the risk those overrides introduce. Instead of improving patient care through technology, they add another potential safety hazard.
Point-of-Use and Pass-Through Cabinets with Embedded Technology
Improvements over traditional ADCs are point-of-use cabinets and pass-through cabinets. The point-of-use cabinet is a secure cabinet located inside of the patient’s room. The pass-through cabinet is located in the wall of the patient’s room between the room and the hallway. It can be accessed from the hallway and the patient room, enabling pharmacy technicians to efficiently load and secure the cabinet from outside the patient room and nurses to securely retrieve the medications from inside of the patient’s room.
Both the point-of-use cabinets and the pass-through cabinets have embedded technology that provides medication and inventory control to improve medication management. The software enables nurses to retrieve medications at the patient’s bedside instead of walking back and forth to an ADC centrally located on the patient floor. Only authorized staff can access the cabinet by using a password or other authentication technology to log into the system.
The software records medications dispensed to the patient and instantly uploads that information to other hospital systems, such as EHR systems, eMAR systems, billing systems, and those used in the pharmacy. With this real-time data, the pharmacy is able to monitor and verify proper medication dispensing. Beyond facilitating secure access to medications and tracking dispensing, the software also inventories medications and monitors expiration dates. This greatly reduces the risk for improper dispensing of medications, medications being out of stock, and dispensing medications that have lost efficacy or pose a danger to patients.
The Ideal Balance
Even with such innovative technology, healthcare facilities must still provide personal care. Nurses are on the front lines and want to provide the best patient care possible. By giving them the tools and technology they require to deliver that care efficiently and safely, hospitals are empowering them to improve patient care.
According to Modern Healthcare, higher pay isn’t what nurses cite as their number one desire. Instead, they say what they want most is a safer workplace for themselves and their patients. With their workloads at an all-time high, they need technology to enable them to be more efficient without sacrificing patient safety.
Hospitals must continue to invest in an integrated technology architecture that includes point-of-care tools that give nurses what they need to provide an excellent patient experience. The EHR system is only the first step. Integrating additional technologies, such as the point-of-use and pass-through cabinets with embedded software, ensures patient safety is put front and center. Improving patient care must begin and end with patient safety. Yes, efficiency is critical, but giving nurses and patients a safe environment in which to work and receive care is the priority.
The key to any of these technologies is to establish the proper processes around them to optimize safety. As with the ADC overrides mentioned above, if processes aren’t in place to limit overrides to emergency cases only, for instance, the technology will only fail to bring the intended safety features. If, on the other hand, nurses become more comfortable retrieving medications from the patient’s bedside, the risk of making a medication error is greatly reduced.