REPLY TO DISCUSSION THREE references NEEDED.

Learning Goal: I’m working on a nursing discussion question and need guidance to help me learn.

MN 581

Unit 9 Discussion

Shelly Dillon

In my clinical experience, the electronic medical record (EMR) is eClinical Works (eCW). I am quite familiar with this program as previously I had been the superuser for this program in another position. But even without that experience, I would say that eCW is an easy program to use for charting. It is not as friendly to chart review. I often have trouble finding where information is located. I taught new users how to use the EMR. It was easily taught and did not take an overt amount of time to become proficient.

Meaningful Use and several federal mandates created incentives starting in 2009 to have healthcare providers and organizations to use EMR systems (Anumula & Senelli 2012). The Center for Medicaid and Medicare (CMS) provided incentives for certified programs that improved efficiency and safety with the following functions: reduction in medical errors, improved availability of medical records, reminders and alerts, clinical decision-making support, and e-prescribing functionality. If these goals and were not met the CMS could impose up to a 5% decrease in reimbursement (Daugharty, 2021). Due to these mandates, the percentage of pediatricians using EHRS increased from 58% in 2009 to 94% in 2016. However, those with full pediatric functionality in 2016 were only 16.9% (Temple et al., 2019).

eCW does a nice job with some of the safety features including medication reconciliation, dose calculations, and immunization tracking. It also allows providers to place notes and get alerts they create. It does not have development tracking in this particular version my precepting clinic uses. They utilize paper for the Bright Future ASQ and MCHAT. They do have smart forms for the PHQ0 and GAD7 that go into the EMR flowsheets. Growth charts are easily available pulling from the vital sign input from that visit and other data from the organization to include walk in clinic or other visits.

One of the top “life� hacks I learned from my preceptor is that eCW is much earier to use if templates are utilized effectively. All 3 of the pediatric providers in my precepting clinic use the same templates for charting to help standardize the pediatric wellness visits to include development questions, education, and anticipatory guidance. Having these templates available to me as a student was a very beneficial experience in charting in this clinical rotation. It gave me great insight into future charting efforts I will pursue.

References:

Anumula, N., & Sanelli, P. C. (2012). Meaningful Use. AJNR. American journal of neuroradiology, 33(8), 1455–1457. https://doi.org/10.3174/ajnr.A3247

Daugharty, K. (2021) What is the EMR mandate? Retrieved from https://www.recordnations.com/2020/03/what-emr-mandate/#:~:text=The%20Electronic%20Medical%20Records%20(EMR,fund%20healthcare%20professionals%20using%20EMR.

Michael W. Temple, Blake Sisk, Lisa A. Krams, Joseph H. Schneider, Eric S. Kirkendall, Christoph U. Lehmann (2019) Trends in Use of Electronic Health Records in Pediatric Office Settings. The Journal of Pediatrics,(206) pp 164-171. https://doi.org/10.1016/j.jpeds.2018.10.039

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