READ- PROS

• Reduces medical errors
  The use of EHR's decreases medical errors through its built in safety alerts. For example, following the 5 rights of medication administration will prevent medication errors, but if a nurse scans a medication that is not in the patients MAR, an alert will pop up to prevent the nurse from giving that medication. This technology can and has saved lives. 
• Provides data for research
  By using EHR's to document patient assessments, we can easily gather data that will help guide research in areas that demonstrate a need for improvement. For example, decreasing fall rates by checking that all safety interventions are in place when charting. Through information technology, researchers can track individual statistics such as scanning rates for medications among nurses.
• Improves quality of care
  One of the major benefits of EHR's is that patients now have their medical records at their fingertips. The ability for patients to view notes, results, and images from their phones or computers facilitates continuity of care and allows patients to be more involved with their healthcare. In addition to the previously mentioned safety checks that reduce medical errors, EHR's allow for secure messaging between the interdisciplinary team that makes for faster and higher quality delivery of care. If a there is a change in patient status or an order needs to be clarified, the nurse can message the doctor or pharmacist directly from the EHR and get a response in seconds. 

CONS

• Concerns for security and privacy
  As with everything that involves using the internet and technology, there comes the risk for a security breach or a misuse of private information. It is important that the healthcare providers do not discuss private patient information outside of the EHR. No one should access a patients electronic chart unless they are providing direct care or have a specific reason like billing to access private information, but unfortunately this does happen (although trackable thanks to IT, one of the benefits that helps correct unethical practices). 
• Potential loss of productivity
  Having to learn to use the EHR and spending a lot of time documenting takes away from direct patient care and can cause a loss of productivity in the medical provider. I work on a telemetry floor and many times I am caring for 6 patients at a time. It takes me well over an hour to accurately document initial assessments for all 6 patients, which must then be re-assessed every 4 hours. 
• Financial concerns
  EHR's are expensive. Especially if you have a "good" version of the EHR in use. For example, in my year working as a travel nurse I worked at 3 different hospitals that use Epic for their EHR. Yet, not all those were the same version of Epic. I could tell which hospitals invested in a more advanced form of the EHR, which I believe promotes efficacy amongst providers. Ultimately, that is a decision of hospital administrators and is a concern for them financially. 

2. Refer to the Stage 3 objectives for Meaningful Use located in this week’s lesson under the heading Meaningful Use and the HITECH Act. Select two objectives to research further. In your own words, provide a brief discussion as to how the objective may impact your role as an APN in clinical practice.  

• Ability to track “actionable” (i.e., suggested action is embedded in the alert) CDS interventions and user responses to interventions, such as: a) How often an alert has fired b) What immediate actions the user took (when those options are presented in the context of the alert) c) Optional reason for overriding alert.

  As mentioned earlier in the discussion, one of the pro's of EHRs is that data can be used for research. This means IT can track how many times an alert was triggered, how many times a medication override was done and for what reason. Tracking this information helps improve the quality of patient care because researchers can use the information to come up with ways to prevent overrides and possible errors. As a future APN in a clinical practice, this will help me manage staff and monitor quality control. 

• The EHR is able to assist with follow-up on orders to improve the management of results.

  When a request is made to pharmacy for a missing medication, the EHR will notify when the pharmacy staff acknowledged the request and the progress of that request can be tracked as well. This helps reduce unnecessary phone calls or messages amongst staff which reduces productivity and improves delivery care. The EHR can also provide order sets for certain things like blood administration which improves patient safety. For example, type and screen with confirmation, verification of consent, and a two nurse sign-off. 

Instruction- Grammar, Spelling, Syntax, Mechanics and APA Format. Responses needs to be substantive (adds importance, depth, and meaningfulness to the discussion) Provided scholarly sources. 2 paragraphs