Electronic Health Records and Nursing: An EHR Implementation Story
Carol Taylor, FPN, Primary Care Provider (PCP) | May 8, 2013
This is the third blog post in a National Nurses Week series about how Electronic Health Records and nursing have evolved over time and how Health IT is helping nurses provide coordinated care to their patients.
The vast, rugged landscape of southeastern New Mexico may seem like a different planet for those living in other parts of the United States. But 11 years ago, I made the long trek South and West and I now call Hobbs, New Mexico home.
How RECs helped me implement my EHR
I am one of more than 20,000 nurse practitioners (NPs) working with a Regional Extension Center (REC) like the New Mexico Health Information Technology Regional Extension Center (NM HITREC) to adopt, implement and meaningfully use an electronic health record (EHR) system. My practice is appropriately named Rural Health Care, LLC (RHC), and we recently implemented and demonstrated meaningful use of an EHR system.
I wanted to share with you some statistics about electronic health records and nursing in rural areas. In the US, nearly one quarter (22%) of the more than 35,000 primary care nurse practitioners in the United States work in rural areas; many operate independent private nursing practices similar to mine.
Due to a variety of federally funded programs, many rural NPs like me are now meaningfully using health information technology. And in my case, RECs were essential in providing me and more than half of all those rural primary care NPs assistance in adopting EHRs.
I was eligible for EHR incentive payments
As an NP I am eligible for the Medicaid Incentive Payment Program, which provides up to $63,750 over six years for eligible providers to adopt and demonstrate meaningful use of an EHR. My reasoning for implementing the EHR was to stay ahead of industry IT trends; but to be perfectly frank, I would not have done it without the incentives.
I have seen the benefits of EHRs
Since implementing the EHR system, however, I can see that the benefits extend far beyond the incentives. In my practice, the EHR has improved patient outcomes due to integrated standards in the system.
- Simple clinical guidelines pop up when entering the diagnosis “diabetes.” These prompts facilitate the care of diabetic patients with current evidence-based techniques. This is just one example of the better patient care enabled by committed providers who use EHRs.
- When e-prescribing, the system prompts us with safety alerts such as drug-allergy interactions and drug-to-drug interactions. The process just simplifies prescribing and renewals.
We found assistance when challenged by the EHR implementation
While I have realized multiple benefits from my use of the EHR, implementation was not without difficulty. The process can be especially challenging for less-sophisticated computer users.
We attended the HITECH Workforce Program classes
To bridge this knowledge gap, we turned to another ONC-funded program, the HITECH Workforce Program provided by Midland College in nearby Midland, Texas. The HITECH classes enhanced our understanding and experience concerning the whole EHR process and provided education on how to solve both technical and staff situations that sometimes pop up.
We relied on the NM HIT Regional Extension Center
Another key in overcoming implementation challenges was the assistance provided by NM HITREC. I would have quit if it weren’t for NM HITREC. They have been a valuable resource in helping me get to meaningful use, and one out of five providers they work with is an NP, so they understand our needs.
NM HITREC provides education directly to these NPs using trusted sources, including other nurses. They are really helping to ensure that electronic health records and nursing are evolving based on new technological advancements.
We are now the only independently operating NP in the county that has achieved meaningful use
My successful EHR adoption is a real-world example of the results that can be achieved when you combine the drive of a hardworking NP with the practice transformation resources provided by local HITECH Workforce and REC programs. This combination was critical and I’m sure it contributed to the fact that we are the only independently operating NP in the county that has achieved meaningful use of an EHR (so far!).