Conduct a search for recent within the last 5 years research focused on the application of clinical systems. The research should provide evidence to support the use

Assignment: 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.

In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.

To Prepare:

• Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
• Resources:

Required Readings:

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

Chapter 14, “The Electronic Health Record and Clinical Informatics” (pp. 267–287)

Chapter 15, “Informatics Tools to Promote Patient Safety and Quality Outcomes” (pp. 293–317)

Chapter 16, “Patient Engagement and Connected Health” (pp. 323–338)

Chapter 17, “Using Informatics to Promote Community/Population Health” (pp. 341–355)

Chapter 18, “Telenursing and Remote Access Telehealth” (pp. 359–388) Dykes, P. C., Rozenblum, R., Dalal, A., Massaro, A., Chang, F., Clements, M., Collins, S. …Bates, D. W. (2017).

Prospective evaluation of a multifaceted intervention to improve outcomes in intensive care: The Promoting Respect and Ongoing Safety Through Patient Engagement Communication and Technology Study. Critical Care Medicine, 45(8), e806–e813. doi:10.1097/CCM.0000000000002449

HealthIT.gov. (2018c). What is an electronic health record (EHR)? Retrieved from https://www.healthit.gov/faq/what-electronic-health-record-ehr

Healthcare Information Management and Systems Society. (2018). Electronic health records. Retrieved from https://www.himss.org/library/ehr/

Rao-Gupta, S., Kruger, D. Leak, L. D., Tieman, L. A., & Manworren, R. C. B. (2018). Leveraging interactive patient care technology to Improve pain management engagement. Pain Management Nursing, 19(3), 212–221. doi:10.1016/j.pmn.2017.11.002

Note: You will access this article from the Walden Library databases.

Skiba, D. (2017). Evaluation tools to appraise social media and mobile applications. Informatics, 4(3), 32–40. doi:10.3390/informatics4030032

Grading Rubric

ASIGNMENT:

• Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
• Identify and select 5 peer-reviewed articles from your research.

The Assignment: (4-5 pages)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:

• Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
• Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples

Expert Answer and Explanation

Clinical Systems in Nursing Practice

The application of clinical systems in nursing practice has been hailed to improve efficiency and assist in improving patient outcomes. Other than being used for curative medicine, clinical systems also show great promise in preventive medicine. This paper will carry out an evaluation of evidence on how remote patient monitoring systems (RPMS) can be used in preventive medicine, for patients with diabetes.

Article by Vegesna et al. (2017)

The first article selected which provided evidence on the application of RPMS was an article by Vegesna et al. (2017). The article focused on the application of non-invasive digital technology to remotely monitor patients. The researchers noted that there has been increasing adoption of RPMS as part of the standard regimen in disease management. In addition, the authors also noted that the patient information collected by the RPMS systems played a major role in improving decision-making.

From the findings collected, it was noted that non-invasive RPMS played an assistive role in preventive medicine. For example, a patient’s vitals like heart or respiratory rate can be monitored and in case of any abnormality, measures can be taken on time to correct that abnormality. In terms of efficiencies, Vegesna et al. (2017) indicated that using non-invasive RPMS could automatically transmit patient data at time intervals to the care provider without necessarily requiring the patient to manually do so, for example, figures on blood pressure levels.

This will allow the care provider to make prompt interventions when needed without being delayed by the manual transmission of information. From the findings, it can be seen that non-invasive RPMS can be useful in assisting diabetic patients to improve their outcomes by giving prompt preventive interventions before adverse events occur.

Noah et al. (2018)

The second article selected was a study by Noah et al. (2018) which evaluated the impact of RPMS on clinical outcomes. The authors also indicated that there was a lot of promise in the field of healthcare informatics, especially in line with the application of wearable non-invasive biosensors to capture and track patient information passively which could assist in advancing precision medicine.

The findings revealed that the application of RPMS showed early signs of improving the outcomes of patients with various conditions like diabetes, chronic obstructive pulmonary disorder, Parkinson’s disease, to list a few. Outcomes were improved by encouraging good lifestyle behaviors and prompt interventions based on the feedback data collected by the RPMS.

In terms of efficiency, it was identified that RPMS allowed the easy collection of patient data that could be used to provide interventions that can facilitate behavioral change in patients, for example, change in diet, in case of changes in BMI. From the information collected in this study, it can be learned that RPMS are facilitative tools that can assist patients to have a positive behavior change based on passively captured data on their health status.

Gómez et al. (2016)

The third article selected n the application of RPMS was an article by Gómez et al. (2016). The article linked the use of mobile technology as a facilitating factor in the adoption of RPMS. The authors noted that health care workers have recently taken advantage of the benefits of mobile technology and smart devices to further advance their application of RPMS in clinical settings.

The integration of the Internet of Things with RPMS has facilitated relay of information in real-time from the patient to their care providers allowing prompt responses and decisions to be made thus improving the efficiency of clinical decision-making. Similarly, by relaying real-time information, the doctors can make life-saving decisions on site, which would have otherwise led to adverse events due to the waiting period before physically accessing a care facility.

From this, it can be seen that facilitating technologies, like improved network coverage, especially in rural areas where access health care facilities is limited, using RPMS could prove to be life-saving in case of medical emergencies.

Article by Katalenich et al. (2015)

The fourth article selected was an article by Katalenich et al. (2015) who considered the application of RPMS in patients with diabetes. The study was purposed at assessing the effectiveness of an automated diabetes RPMS in glycemic control. From the evidence collected from the study, it was ascertained that the application of an RPMS system for diabetics in a period of six month period had similar results when compared with usual care in improving glycemic control.

However, it was interestingly noted that the RPMS had a positive impact on the quality of life among the observed patients when compared to usual care. This means that the patients after having been enrolled in the RPMS, they engaged in positive lifestyle behaviors like eating healthy and increasing their uptake of physical activity.

The application of RPMS was noted to be more cost-effective as compared to usual care given that expenses like transportation expenses to access health care facilities were eliminated. From this study, it can be learned that while the effectiveness of the RPMS and usual care in glycemic control is the same, RPMS had a significant impact on lifestyle changes than usual care, which would mean that in the long run, the overall patient health outcomes would be better as compared to those placed in usual care.

Article by Lee et al. (2018)

In this article, the authors pointed out the application of telehealth systems in monitoring HbA1c levels in type-2 diabetic patients. The authors indicated the need to have a monitoring system that could be used to effectively manage diabetes and prevent adverse complications. Therefore, the developed system had to ensure that the glycemic levels in the blood would be maintained to be as normal as possible thus the proposal of having a RPMS.

From the findings collected, it was established that telehealth RPMS proved to have a small but positive effect in improving HbA1c levels of patients with type-2 diabetes. In terms of efficiency, the information gathered from the study noted that there was faster transmission of vital patient information and in turn prompt interventions when using telehealth RPMS, thereby, enhancing effectiveness in preventing adverse events, for example, prolonged periods of hyperglycemia among patients with type-2 diabetes before receiving the correct intervention.

From the information gathered, it can be learned that using a telehealth RPMS can prove to be useful in improving patient outcomes in terms of controlling HbA1c levels and preventing adverse events in patients with type-2 diabetes.

Conclusion

From the reviewed literature, it can be seen that RPMS is a clinical system with great promise in improving the outcomes of patients with diabetes. RPMS can enhance better glycemic control, can facilitate the adoption of positive lifestyle behaviors, and also assist in preventing adverse health events among diabetics. Similarly, the approach also proved to be efficient in continuous monitoring of patient data that could facilitate continuity of care and delivery of prompt interventions. Therefore, it is an approach that should be considered alongside other standard interventions.

References

Gómez, J., Oviedo, B., & Zhuma, E. (2016). Patient monitoring system based on internet of things. Procedia Computer Science, 83, 90-97. https://doi.org/10.1016/j.procs.2016.04.103

Katalenich, B., Shi, L., Liu, S., Shao, H., McDuffie, R., Carpio, G., … & Fonseca, V. (2015). Evaluation of a remote monitoring system for diabetes control. Clinical therapeutics, 37(6), 1216-1225.
https://doi.org/10.1016/j.clinthera.2015.03.022

Lee, P. A., Greenfield, G., & Pappas, Y. (2018). The impact of telehealth remote patient monitoring on glycemic control in type 2 diabetes: a systematic review and meta-analysis of systematic reviews of randomized controlled trials. BMC health services research, 18(1), 495. https://doi.org/10.1186/s12913-018-3274-8

Noah, B., Keller, M. S., Mosadeghi, S., Stein, L., Johl, S., Delshad, S., … & Spiegel, B. M. (2018). Impact of remote patient monitoring on clinical outcomes: an updated meta-analysis of randomized controlled trials. NPJ digital medicine, 1(1), 1-12. https://doi.org/10.1038/s41746-017-0002-4

Vegesna, A., Tran, M., Angelaccio, M., & Arcona, S. (2017). Remote patient monitoring via non-invasive digital technologies: a systematic review. Telemedicine and e-Health, 23(1), 3-17. https://doi.org/10.1089/tmj.2016.0051

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