With technology becoming more advanced, new applications are being innovated on an annual basis for use in various sectors. Health care is no exception. Used as an umbrella term, Electronic Health Records is used to describe medical records, charts, and medical record. Before the migration into Electronic Health Records, nurses wrote on paper maintained in folders and only a single copy was available. However, the development of computer technology has laid a great foundation for the development of Electronic Health records. The use of EHRS has made patient’s information ready to access and changed the general health care. This applies to respiratory therapy as well. Individuals in the respiratory profession also have to keep up with the latest and newest technologies particularly electronic charting in health care. This research paper focusses on current issues of respiratory as a profession and respiratory therapy such as the need for electronic charting and its cons and pros in the delivery of health care.
The Need for Electronic Charting in Respiratory Therapy
Usually, the clinical environment is data-intensive. Based on a recent finding, there are over approximately 200 categories of data that have to be reviewed for decisions to be made (Ford, 2015). Realistically, respiratory therapists may not be able to synthesize all of that data and make accurate estimation outcomes of various options. Processing of vast clinical information is challenging in managing services as a respiratory profession. Among the challenges that drove the need for electronic charting in respiratory therapy include changes in reimbursement and the reformation of the national health care. An electronic chart allows a respiratory therapist to do more with less paperwork to better manage resources, easily report financial and clinical outcomes, and conveniently capture information that supports improvements made in the health care industry.
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Current Issues
With the recent focus of the use of electronic charts in the current health care delivery model, clinicians have been forced to evaluate their roles as well as the future needs of their professions. Advanced innovations such as the use of electronic charting and have affected respiratory therapy as a discipline of healthcare. Consequentially, the profession of respiratory care has been forced to evolve to meet the needs of the clinical workforce in the future. As a critical sector of allied health care, it is worth noting that respiratory therapists; has gradually grown over the years. In a most recent survey by the conducted in 2014 by the American Association for Respiratory Care (AARC), figures reveal that over 170,000 Respiratory therapists were licensed to deliver respiratory care in the U.S. (Ford, 2015) Based on the figures, this was a 19% improvement back in 2009.
Traditionally, most of the respiratory therapists were employed in hospitals particularly in the emergency and the Intensive Care Units department. In addition, they did a lot of paperwork in keeping medical health records of patients. However, with the expansion of health care from acute to chronic care, there has been an impetus to manage patients even outside hospitals. Thus with collaboration with the Affordable Care Act, respiratory therapists have adopted electronic charting which has helped reduce costs, prevent hospital readmissions, and increase self-management and education as well.
(Were, Boucher & Beachey, 2015) reveals that as of 2015, the AARC established a task force whose role was to identify the changing roles of respiratory professionals based on the change in mode of health care delivery particularly electronic charting. Based on the reports of the task force, it was found out that independent respiratory therapists’ delivery of enhanced care was facilitated by availability of electronic charts other than baggage of paperwork. Further the findings reveal that the future in respiratory profession calls for more competency with evidence-based medicine knowledge as well as the ability to effectively collaborate with other teams in the delivery of health care to help effectively manage respiratory complications. It is also worth noting that there are anticipations that the future roles of Respiratory therapists will be autonomous. Therefore, they will need to possess skills that will enable them assess patients both in and outside hospital care settings. Other skills necessary for the evolving profession in respiratory therapy include recommendation and discontinuity of therapy and contribution to successful patient outcomes including reduced lengths of hospital stay. Furthermore there is evidence that the use of electronic charts in delivery of health care has improved the outcomes of patients.
Advantages of Electronic Charting
Compared to traditional paper charting, electronic charting has some pros. Research indicates that in some instances there are instances of decreased medical errors and cost-saving while in others there are not. However, there is evidence that the use of electronic charts results in significant reductions of both invasive and noninvasive ventilation and hospital days for patients with respiratory complications and asthma, COPD as well (LaRoche, Hinkson, Thomazin, Minton-Foltoz & Carlbom, 2016). It is worth noting that in the United States, care delivered to COPD patients is done by respiratory therapists. In a recent study, authors hypothesized the use of electronic medical record screening tool to identify how they would impact on the length of stay and readmission rates. In the study, respiratory therapists generated patient’s reports through the use of electronic records to search admission notes for COPD and asthma cases. The findings of the study revealed that the use of electronic charts decreased the rates of readmission. In addition there was significant reduction of responses by subjects with COPD diagnosis (LaRoche, Hinkson, Thomazin, Minton-Foltoz & Carlbom, 2016).
Also, the use of electronic charting in respiratory therapy has improved productivity in the profession. Handwriting an assessment of a patient is time consuming and at the same time unstructured. Certainly other nurses in other departments from which the patient may be receiving treatment will follow varying orders. With an Electronic Chart, however, the different nurses can go through the form quickly and fill their sections. This significantly improves productivity. A recent study carried out at the University of California medical center reveals that the use of Electronic Chart had a significant shift in the daily and area-to area demand for respiratory care services in the center (Ford, 2015). The Electronic chart has helped maintain the ability to have a varying workforce, and utilize staff members such that there is minimal idle time or spent in filling paper charts. Instead that time is spent in monitoring patients and maintaining a productive workforce. Having electronic charts helps monitor the work demand sequentially improving the management of the entire hospital allocation of staff members. Data in the charts also help identify where and when a certain procedural therapy was done. (Ford 2015) reveals that this helps determine costs incurred per procedure hence lowering the costs while at the same time delivering high-quality respiratory care.
Another tangible benefit associated with electronic charting is an improved ability to conduct research. Since patients’ information is stored electronically, they can be easily extracted and use in studies. This has led to a more quantified analysis that has helped identify evidence-based practices in respiratory therapy more easily. In addition it has helped the public health sector to use the aggregated data to produce research that is beneficial to society.
Studies focusing on patient safety have also found out that electronic charts have a significant impact on reduction of medical errors. In a recent study, scholars found out that the use of electronic charts is associated with approximately 55% reduction of medical errors (Ford, 2015). Therefore the use of electronic charts in respiratory therapy will significantly help in the reduction of errors that could otherwise be made through paper charting.
Disadvantages of Electronic charting in Respiratory Therapy
Despite the growing literature on the benefits of electronic charting in respiratory therapy, potential disadvantages associated with the technology have been identified. These include risks of patient safety, privacy and security concerns, and temporary loss of focus and productivity.
In his study Papadakos (2014) reveals that as respiratory therapists use more devices the potential for getting distracted grows. The explosion of technology, particularly electronic charting creates an environment where health care workers have to respond to a patient based on notifications. Studies in medical literature support that this is a growing concern because of the potential of failure of the system as well as being too keen to wait for notifications such that the focus on quality patient care is lost. This challenge can be resolved by educating the staff on the dangers of over-reliance on technology particularly alerts and notifications that may distract our focus hence impacting negatively on patient safety. In addition, the educational and policy changes initiatives should be regarded at their core as requirements for being a professional in the field of respiratory therapy. Rather respiratory therapists should be taught electronic etiquette.
The risk of patient privacy violations is another potential drawback of electronic charting in the field of respiratory therapy. There has been increasing the electronic exchange of patient information. However the federal government has put in place policy regulations and measures that ensure the patient’s data and information in respiratory therapists’ records are secure (Smith, Endee, Scott & Linden, 2017). One of the requirements for all electronic charts is that they should have an audit function that ensures the identification of each operator and every aspect of various patients’ medical records. Although privacy and security concerns have continued to be issues of concern many steps are being taken to ensure that electronic charts are in compliance with laws that ensure the privacy of clinical information.
In conclusion, the electronic charts have altered the respiratory therapy profession such that it has therapists have to meet some requirements to fit in the changing model of health care delivery. Implementation of electronic charting by respiratory therapists is critical for quality delivery of health care as well as reduced costs of procedures. Despite the few cons, electronic charts are important in the profession of respiratory therapy as well as the current issues in the field as highlighted.
References
Ford, R. M. (2015). Therapist-Driven Protocols: New Incentives for Change.
Papadakos, P. J. (2014). Electronic distractions of the respiratory therapist and their impact on patient safety. Respiratory care , 59 (8), 1306-1309.
LaRoché, K. D., Hinkson, C. R., Thomazin, B. A., Minton-Foltz, P. K., & Carlbom, D. J. (2016). Impact of an electronic medical record screening tool and therapist-driven protocol on length of stay and hospital readmission for COPD.
Smith, S. G., Endee, L. M., Scott, L. A. B., & Linden, P. L. (2017). The future of respiratory care: results of a new york state survey of respiratory therapists. Respiratory care , 62 (3), 279-287.
Werre, N. D., Boucher, E. L., & Beachey, W. D. (2015). Comparison of therapist-directed and physician-directed respiratory care in COPD subjects with acute pneumonia.
