Most of us have heard the term “digital divide,” and many of us are familiar with the move towards electronic health records (EHRs) in the workplace. However, very few hospitals or medical offices are discussing the real-life implications of those two facts merging in hospitals and medical offices across the country where nurses who have limited computer experience are suddenly being asked to do electronic charting.
According to the US Census Bureau, only 56.9% of black and 58.3% of Hispanic households had internet access in their home, compared to 76.2% of all non-Hispanic white households, in 2011. This means minority households are currently falling on the wrong side of the digital divide. That being said, 26.8% of the nursing students in baccalaureate programs from 2010-2011 were minorities, according to the American Association of Colleges of Nursing, which means we have a significant percentage of nurses who will be entering the workplace with the potential of having limited computer experience. In the past, that wouldn’t have been a problem, considering most medical offices used paper charts and filing systems. However, with the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, medical offices and hospitals are being strongly encouraged to adopt EHRs as quickly as possible.
According to the HITECH Act, medical offices that do not use an EHR in a “meaningful way” by 2015 will start to incur penalties, beginning with a cut of 1% to Medicare funding in 2015 and increasing to 3% in 2017. After that point, medical offices may also be subject to additional financial penalties.
What does that mean for today’s nurses? Based on government reports, 72% of office-based physicians used electronic medical records (EMRs) or EHRs in 2012. In Massachusetts, that number goes as high as 89.2%. In order to qualify for funding and avoid penalties, offices must have met “meaningful use” objectives in 2012, including electronically tracking all orders, vital signs, medication allergies, medications taken, patient demographics, and smoking status.
Any of those items sound familiar? The same things nurses have been entering on paper charts for decades are now being entered electronically. In short, this means if you haven’t already begun using an EHR or EMR on the job, you will probably see one soon. And if you’re just starting out, the chance of finding a nursing position without needing to use one on a daily basis is dwindling incredibly fast. For some, that could mean using a piece of hardware or technology for the first time. But the transition doesn’t need to be scary. So, how exactly can you prepare for the change?
First of all, it’s important to understand that the EHR/EMR industry comes with support—and lots of it. If you’re currently at a job that’s implementing an EHR system like Cerner, Epic, or Allscripts, and you haven’t already done so, ask for training. Almost all EHR companies offer comprehensive training during the implementation process, and it’s expected that staff will attend those sessions. If for any reason you cannot attend a session the first time around, don’t hesitate to ask for additional training or inquire about what tutorials and materials might be available for you to review. There are entire support and training departments within each of the large EHR companies. Those departments are available to make your transition easier, so don’t be afraid to use the resources made available to you.
For the thousands of nursing students who will be entering a largely electronic workplace, what other preparations can be made? Many nursing instructors have decided to face the issue head on. By providing nursing students with access to an academic EHR in the classroom, instructors can help make the transition easier for students when entering the workforce. After all, nurses have enough to worry about during their first week in the field.
Computer programs like EHR Tutor, based in Parma, Ohio, can be purchased by nursing schools and used as a daily teaching tool in the classroom. For example, when discussing vitals or medications, students can look at charts done for electronic patients and analyze that data. Students can also chart information themselves, just as they would on paper, which can then be submitted to the instructor for grading. Schools with access to iPads or laptops are also allowing students to use programs like EHR Tutor during clinical rotations to chart real information under fake patient names. That way, by the time students are on their own, using EHRs will be just as comfortable as pen and paper.
EHRs and EMRs are here to stay. For some nurses, that may present a tremendous challenge. However, there are many tools available to nurses who may be feeling a bit overwhelmed. By using those resources (like using academic EHRs in the classroom and asking for additional training in your workplace), we can ensure that our nurses and future nurses make the transition to EHRs as painlessly as possible. That way, our nurses can spend more time focusing on the important things—the patients.
Nikki Yeager is a freelance writer and software trainer based in New York City.
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