Introduction
The application of evidence-based practices in the healthcare system has overseen the introduction of new methods of care provision being extended to patients. A major invention in the area of care for the elderly in the society can be attributed to the application of Electronic Medical Records. The usage of EMR/EHR has been possible majorly due to the fact that a lot of research has been extensively used and applied to the generation of knowledge to support the already existing bodies of knowledge. Such researches have been instrumental in improving the care that is given to patients in most health care settings (Coorevitss et al., 2013). However, for such studies to be applied in the healthcare process, it is imperative that their validity and credibility be checked to ensure that the acquired bodies of knowledge are useful and can be incorporated into the already existing health care procedures and whether they will be useful in ensuring desirable patient outcomes. As such, the application of EHR has been beneficial in the healthcare settings since it makes easy for patient information to be conveniently availed to clinicians, therefore, taking very minimal time for treatment to ensure desirable patient outcomes coming from the treatment regimen (Coorevitss et al., 2013). EHR records are also essential since they make billing faster, therefore, hastening the treatment process hence improving patient outcomes.
One of the vulnerable groups of individuals who should be taken care of in healthcare settings is the elderly whereby the usage of evidence-based and scientific methods is supposed to be incorporated in the care. Therefore, the study Advice for Decision Makers Based on an Electronic Health Record Evaluation at a Program for All-inclusive Care for Elders Site was done with the objectives of providing evidence-based information to Program of All-Inclusive Care for the Elderly (PACE) with the objectives of examining how EHR diffuses in clinicians to assist the elderly in day care sites, impacting the levels of satisfaction that clinicians derive from the usage EHR and the impact that EHR has on the patient functional outcomes (Sockolow et al., 2011). There is the need to have a proper insight on how EHR is assisting the elderly outside the traditional acute hospital setting so that evidence-based decisions concerning their health can be made.
This critique paper looks at the major topics of the article including the background of the problem, the objectives of the study carried out, the methodology that was employed in carrying out this study, the results from the methodology employed to the extent data analysis, the discussions about the results, the major limitations of the study and the conclusions.
Protection of human participants
The study setting was carried out in Philadelphia where the participants of the study included patients and clinicians (Sockolow et al., 2011). The clinicians who were given an overview of what the study would entail included nurse practitioners, nurses, LPNs, occupational therapists, physicians and social workers. The clinicians availed their written unforced consent to the researcher whereas the patients gave out their oral consent to the researcher (Sockolow et al., 2011). To ensure the participants’ confidentiality, both the patients and the clinicians were not physically identified which made it easier for them to participate in the study. As such, the participants were not forced to participate in the study. Approval was gotten from the University of Pennsylvania and the School of Public Health at John Hopkins University (Sockolow et al., 2011).
Data collection
This study being a quantitative one means that, there are both dependent and independent variables involved. The dependent variable is the decision making based on the application EHR (Sockolow et al., 2011). The major independent variables are diffusion of EHR, the satisfaction that clinicians derive from the application of EHR in the clinical process and the expected functional outcomes from the study (Sockolow et al., 2011). The collection of data involved using an EHR audit log which was used to determine the frequency and the application of the software by the clinicians during the study process, surveys carried out on the clinicians about their satisfaction levels and questionnaires administered to patients which assessed their locomotion, hygiene, mobility, feeding, dressing and the usage of assistive devices (Sockolow et al., 2011). These methods of data collection were preferred by the researcher since they reduced the issue of subjectivity from the data collected. It also gives a wider base from which data could be collected to address the three independent variables involved in the study. The data was collected in a period of between 11 months and 17 months commencing from October 2007 (Sockolow et al., 2011). The sequence followed during the process involved taking between 1 to 2 hour sessions to determine the diffusion of the EHR into the health care settings involved, 30-minute interviews which were useful during the surveying and the usage of 16-question open-ended questionnaire that clearly spelt out the requirements for clinician satisfaction (Sockolow et al., 2011)
Data management and analysis
Data analysis was mainly focused on the independent variables that made up the scope of the study. To determine the diffusion of EHR parametric and non- parametric analysis was conducted using ANOVA and Kruskal-Wallis software (Sockolow et al., 2011). Variance studies were done to make a comparison of the frequency of the two observational time periods. Statistical analysis was done using STATA software. On clinical satisfaction, the Wilcoxon signed-rank test was used to match survey responses between the two time-periods which the study was conducted (Sockolow et al., 2011). T-tests were used to determine whether there were any instances of clinician satisfaction from the application of EHR. On patient functional outcomes, ADLs were checked to check on the total possible score likely to co0me pout of the questions that were asked to the participants. Activity sub scores ranged between 1 to 7 while adaptive sub scores ranged between 1 and 2. Graphical analysis was also involved in this analysis where ADL scores from the two time periods were compared (Sockolow et al., 2011). To reduce the effects of biasness, a concurrent qualitative study was also conducted and the results compared to come up with augmented results concerning the study.
Findings
Conclusion
This study has provided a framework under which decisions on the usage of EHR can be used to address the needs of the elderly in the society to ensure that they come out with desirable outcomes and also lead to clinician satisfaction. It is important to incorporate the usage of EHR in nursing practice to determine the level of satisfaction patients are likely to get.
References
Coorevits, P., Sundgren, M., Klein, G. O., Bahr, A., Claerhout, B., Daniel, C., & De Moor, G. (2013). Electronic health records: new opportunities for clinical research. Journal of internal medicine, 274(6), 547-560.
Sockolow, P. S., Weiner, J. P., Bowles, K. H., Abbott P., & Lehmann, H. P. (2011). Advice for Decision Makers Based on an Electronic Health Record Evaluation at a Program for All-inclusive Care for Elders Site. s
