In Front of the Technology Curve
Louise Miller
Physicians are adjusting to Electronic Health Records (EHRs) in increasing numbers as hospitals implement new patient documentation technologies. Yet nurses are also critical players in the in-patient experience, and their ability to use EHRs is important to the overall success of such systems.
Louise Miller, assistant professor of clinical nursing, is working to help ensure that nursing education properly prepares students for an electronic future.
The School includes EHR technology in its clinical skills laboratory, where students must learn how to document clinical activity on a mock patient record that’s housed on a real EHR system—the same one used by University Hospitals and Clinics (UHC).
The concept for Miller’s project, funded with $3,500 from the American Nurses Foundation, originated when UHC implemented its EHR from Cerner Corp.
In an attempt to determine how practicing nurses use EHRs for documentation and care planning, Miller is interviewing nurses at three Columbia hospitals— each using a different EHR—to learn “about this new way of thinking.”
“Electronic record-keeping is very different from paper notes, and we need to understand how practicing nurses go about charting and evaluating their patients with these new systems,” Miller says. “Then we can teach our students how best to approach EHRs.”
Miller says she wants to learn what details of patient care nurses document in an EHR and what details are memorized or integrated in other traditional ways.
“Nurses use to spend time writing notes and shuffling through paper charts,” she notes. “I want to know exactly how EHRs assist nurses and increase efficiency after nurses become proficient with the system.”
Miller is referring to the notable learning curve experienced by all health professionals faced with adoption of an EHR. She says integrating the EHR’s capabilities in care planning occurs after an initial period of adjustment. It’s that more sophisticated stage of use Miller is concerned with and hopes to understand in terms that can be transferred to nursing students.
“Students are flexible thinkers and we need to capitalize on that,” she says. “Nurse educators have an opportunity to introduce students to the new ways of thinking about patient care that will develop with the introduction of EHR technology. We can’t afford to be behind the curve.”