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The first article to be reviewed is titled “Impact of clinical registries on quality of patient care and health outcomes: Protocol for a systematic review”. In the article, Hoquem et al. (2016) examine the impact of national and regional clinical quality registries (CQRs) on patient outcomes and healthcare efficiency. The authors use such methods as PRISMA-P, checklist, and inclusion/ exclusion principle to support their findings and conclusions.
The aim of the research is to respond to the need for a cost-effective system that is able to enhance the quality of care and improve patient outcomes. Thus, CQR is viewed as an effective information technology tool for a clinical setting. The register is defined as “the file of data concerning all cases of a particular disease or other health-relevant condition in a defined population such that the cases can be related to a population base” (Hoquem et al., 2016, p. 1). The registry, in its turn, is described as “the system of ongoing registration to the register” (Hoquem et al., 2016, p.1). Clinical registries are used to collect and systemize medical data from patients observed at or admitted to a healthcare facility.
The article provides adequate evidence to prove the effectiveness of CQRs. For instance, the study conducted by Stey et al. in 2015 demonstrated the increase in the quality of surgical care after the implementation of clinical registries (as cited in Hoquem et al., 2016, p. 2). Additionally, the application of the Registry for Ulcer Treatment (RUT) in Sweden resulted in a decrease in unnecessary antibiotic treatment from 71% to 29% (Hoquem et al., 2016, p. 2). Overall, the study concludes that clinical registries might supply valuable performance feedback and positive outcomes, ensure the quality and efficiency of care, and decrease the treatment costs.
Another article concerned with the impact of clinical systems on outcomes and efficiencies is “The digitization of patient care: A review of the effects of electronic health records on health care quality and utilization”. The scholars investigate the effects of the adoption of electronic health records (EHRs), its benefits for medical care, and financial implications. The article defines the EHR as a “digitized medical chart” used to “gather, manage, and share digital information” (Atasoy et al., 2019, p. 488). The adoption of EHRs facilitates the search and access to patient data by healthcare professionals, helps to avoid medical errors, and increases performance transparency.
The study offers sufficient evidence to support the positive impact of EHRs on patient care efficiency and outcomes. The work provides an “interdisciplinary overview and synthesis of literature, drawing on work in public and population health, informatics, medicine, management information systems, and economics” (Atasoy et al., 2019, p. 487). For example, the research by Buntin et al. conducted between 2007 and 2010 demonstrated that 62% of studies mentioned positive consequences of EHR adoption, while 30% reported “mixed results with positive overall findings” (as cited in Atasoy et al., 2019, p. 490). Moreover, according to Jones et al., 56% of articles in 2013 reported positive effects of EHRs on decision support systems and, thus, clinical efficiencies, in EDs and ICUs (as cited in Atasoy et al., 2019, p. 490). Finally, there is strong evidence that EHRs decrease the risks of drug-drug interactions and medical errors. Thus, the research concluded that the implementation of EHR improved clinical efficiency and outcomes by providing transparency and easy access to patient data.
The third article for review is “Choosing wisely clinical decision support adherence and associated inpatient outcomes” by Andrew M. Heekin, John Kontor, Harry C. Sax, Michelle S. Keller, Anne Wellington, and Scott Weingarten. The study examines the impact of clinical decision support (CDS) on patient outcomes and financial efficiency. A total of 26,424 encounters were observed and analyzed in the study over a period of 3 years (Heekin et al., 2018). The data for the research was collected from various sources, including data from EHR, clinical, and claims data containing information on demographics, diagnoses, admission, and discharge.
The results of the study reveal improved patient outcomes and the financial effectiveness of CDS. Firstly, the length of hospital stays for adherent encounters decreased by 6.2% compared to non-adherent ones (Heekin et al., 2018). Secondly, the odds of 30-day readmissions were 1.14 times lower in adherent encounters (Heekin et al., 2018, p. 366). Thirdly, the total direct costs were 7.3% lower in the adherent group (Heekin et al., 2018, p. 366). Finally, the rates of complications 1.29 times lower in adherent patients (Heekin et al., 2018, p. 366). All in all, the research demonstrated that the patients from the adherent group had shorter lengths of stay, lower rates of complications and readmissions, and lower financial expenditures.
One more article investigating the impact of clinical information systems on efficiency and patient outcomes is “Using patient portals to improve patient outcomes: Systematic review” by Han et al. The study aims to gather and critically appraise evidence of patient portals’ positive impact on psychobehavioral and clinical outcomes by providing a systematic and comprehensive review of the topic. The authors conclude that patient portal interventions “lead to improvements in health knowledge, self-efficacy, decision making, medication adherence, and preventive service use” (Han et al., 2019, p. 1). Clinical outcomes, such as the results of physical exams and laboratory testing, are also affected by the use of patient portals.
The researchers present adequate evidence to support their findings. Firstly, patient portal interventions resulted in a “significant increase in patient knowledge of a health condition” and “achievement of behavioral goals” (Han et al., 2019, p. 7). Secondly, there were positive clinical outcomes related to the control of a patient’s blood pressure, glycemic index, and cholesterol levels. For instance, diabetic patients using portals indicated positive differences in lab test results compared to the control group patients without clinical systems support. Finally, the participants receiving portal interventions successfully achieved their weight loss goals. Overall, the article demonstrated the effectiveness of patient portal interventions for behavioral and clinical outcomes.
The fifth article to be reviewed is titled “Impact of remote patient monitoring on clinical outcomes: An updated meta-analysis of randomized controlled trials”. The study is concerned with the analysis of the impact of remote patient monitoring (RPM) devices on patient outcomes. Wearable biosensors might be integrated into “a variety of platforms including watches, wristbands, skin patches, shoes, belts textiles, and smartphones” to obtain patient data and share it with healthcare providers (Noah et al., 2018, p. 1). The research aims to gather empirical evidence supporting the efficacy of RPM devices and their positive influence on clinical outcomes.
Data collection and analysis of 27 studies observing patients with cardiovascular disease, pulmonary conditions, and obesity provided the authors with the conclusive results of RPM devices usage. For instance, RPMs were successfully employed by community nurses to care for patients suffering from heart failure and chronic obstructive pulmonary disease. The study by De Dan Miguel et al. has shown that the application of telehealth devices contributed to fewer hospitalizations, ER admissions, and shorter hospital stays, while also reducing the costs by $2931 per patient (as cited in Noah et al., 2018). According to Pedone et al., the observation of 99 participants demonstrated that the implementation of RPM devices resulted in a lower risk of exacerbations and subsequent hospitalizations (as cited in Noah, 2018, p. 3). All in all, the article’s systematic review provided sufficient evidence for the positive impact of PRM devices on patient outcomes and cost reduction.
Atasoy, H., Greenwood, B. N., & McCullough, J. S. (2019). The digitization of patient care: A review of the effects of electronic health records on health care quality and utilization. Annual Review of Public Health, 40, 487–500. Web.
Han, H. R., Gleason, K. T., Sun, C. A., Miller, H. N., Kang, S. J., Chow, S., Anderson, R., Nagy, P., & Bauer, T. (2019). Using patient portals to improve patient outcomes: Systematic review. JMIR, 6(4). Web.
Heekin, A. M., Kontor, J., Sax, H. C., Keller, M. S, Wellington, A., & Weingarten, S. (2018). Choosing wisely clinical decision support adherence and associated inpatient outcomes. AJMC, 24(8), 361–366.
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Hoquem, D. E., Kumari, V., Ruseckaite, R., Romero, L., & Evans, S. M. (2016). Impact of clinical registries on quality of patient care and health outcomes: Protocol for a systematic review. BMJ Open. Web.
Noah, B., Keller, M. S., Mosadeghi, S., Stein, L., Johl, S., Delshad, S., Tashjian, V. C., Lew, D., Kwan, J. T., Jusufagic, A., & Spiegel, B. M. R. (2018). Impact of remote patient monitoring on clinical outcomes: An updated meta-analysis of randomized controlled trials. NPJ Digital Med, 1. Web.