Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies. Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.

     The use of information and communication technologies is an ever changing and growing trend for healthcare. As technology transforms the field of nursing, nurses become responsible for applying that data and technology to their practice in order to better serve their patients and increase positivity of patient outcomes. We all use technology of all types everyday during our routine shifts. Monitors, IV pumps, electronic medical records, smart patient beds, and messaging through systems such as Epic or Vocera are just a few of the “basic”, everyday use technologies used at my healthcare facility. One technology that has seen a recent increase in use at my facility is telehealth visits.

So, what is telehealth? “Telehealth involves the use of electronic communications and information technology to deliver health-related services at a distance” (New Mexico Nurse, 2021, p. 4). Whether it is our nephrologist making rounds at the hospital and taking a break to have a telehealth office appointment with his outpatients, or the eICU telehealth team checking in on a critical patient who is needing around the clock care, I see telehealth being used everyday. The additional support that a telehealth program offers to clinicians empowers us to oversee a larger population and gain insight into those patients who are at the greatest risk of needing immediate intervention (ENP Newswire, 2016). The benefits of using telehealth are exponential. Aside from improving outcomes and providing expanded access to affordable care, telehealth programs can also help “address multiple cohorts within a population ranging from highest cost patients with intensive ambulatory care and acute needs, to discharge transition and chronic patient management, to prevention and wellness for the general population. These programs use a proactive care model to clinically transform the delivery of care to address growing clinician shortages while improving patient outcomes” (ENP Newswire, 2016). While there are many clinical benefits in the use of implementing telehealth, there are also some associated risks.

One inherent risk associated with the use of telehealth is questionable data integrity. Who is ultimately responsible for ensuring the accuracy of data collected, and who is responsible for ensuring that there is not a breach of security associated with patient healthcare data? According to an article by New Mexico Nurse, “practitioners must adhere to traditional clinical standards of care, and practice within the scope of practice authorized by law. The American Telemedicine Association has promulgated a variety of practice guidelines” (New Mexico Nurse, 2021, p. 6). As nurses, and the largest group of practicing clinicians, we must hold ourselves accountable for applying and adhering to all that health care technology entails. Healthcare in times of Covid has brought renewed attention to telehealth medicine. Legislation is ongoing to promote waivers, permanently extending the ones placed for emergency care when the nation was shutdown. These waivers would remove geographic restrictions to obtaining excellent care and update the healthcare delivery system to provide the best clinical outcomes with less restrictions for both the patient and the healthcare provider.

I believe expanding telehealth and lessening restrictions to make it more accessible is one of the healthcare trends that will prove to positively impact our nursing practice. With the promise to contribute to improvements in patient care outcomes, efficiencies, and data management, it is up to nurses to promote and educate our patients on the use of this technology. Telehealth technology can improve patient outcomes and efficiency of care by making communication between provider and patient more accessible. Patients don’t have to worry about transportation or the cost to get to the doctor office. If they have questions about a new medication they have been prescribed, it is much easier to use telecommunication to reach out to their provider, ensuring increased adherence to treatment plans. “Increased engagement can also enable providers and patients to bring more stakeholders into the conversation, including family members or caretakers….Many aspects of virtual care can lead patients to feel more in control of their health care journeys. Empowering patients to decide where, when, and how they prefer to engage with their care team means they are more likely to have a satisfying care experience” (Hunt, 2021 p. 41).

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