What computer-based system is designed for collecting storing manipulating and making clinical information important to the healthcare delivery process?

Today’s health care workplaces require nursing and technology to go hand-in-hand. It’s all around, all the time—whether it’s electronic health records, computerized infusion pumps, digital drug delivery systems, or any of the other technologies that are now being used in hospitals and other health care settings.

But all these new computer systems can be intimidating to nurses, especially if they’ve been away from nursing for several years and have to get up to speed on a number of new systems all at the same time.

Cheryl D. Parker, PhD, RN-BC, CNE, President of the American Nursing Informatics Association—“an organization of professional nurses and associates who are committed to integrating nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing and informatics practice”—has some advice for them:

“Stop resisting change. Change and technology are constants in today's world, and longing for the 'old days' is a waste of time,” says Parker. “In my 40+ year career as a clinical nurse and informatics nurse specialist, I have seen so many nurses fight change when—with half the amount of energy, they could learn what they needed to know and move on.”

Nursing tech types

Here’s a rundown of the types of technology in nursing being used today:

Clinical information systems: This is an umbrella term that refers to an information system designed for collecting, storing, manipulating, and making available clinical information important to the health care delivery process. “It may be a single system such as a radiology or lab system, or multiple systems such as the electronic health record,” says Parker.

These systems bring together an organization's patient records, lab results, pharmaceutical data, medical research resources, and other information, providing nurses and other health care professionals with integrated tools to help them input, retrieve, and analyze data.

Electronic Health Records (EHR): Digital patient records provide instant access to a patient's medical history, improve communication between health care professionals, and offer flags/alerts to prevent conflicts over prescriptions and tests.

Today’s nursing students are well versed in EHRs by the time they graduate, says Marissa Bartmess, BSN, RN, a student in the BSN to PhD nursing program at the University of Tennessee-Knoxville. “With each clinical experience at a hospital, we were trained with electronic health records. I received some sort of EHR training every semester,” says Bartmess.

Medical devices: Devices such as infusion delivery systems and ventilators often have “electronic brains” that assist nurses by flagging problems and helping to avoid errors.

“Some systems can analyze a variety of subtle changes in patient data that could indicate the beginning of a potentially life-threatening event and alert the nurse and/or physician immediately," Parker says.

In certain specialties, nurses are working with even more sophisticated medical devices. Nancy Colobong Smith, MN, ARNP, CNN, National Director of the American Nephrology Nurses Association, was the lead nurse on the first FDA human trial of the wearable artificial kidney (WAK), a device that helps to make dialysis and easier, more frequent, and more portable for patients.

“There are perspectives that nurses bring from their experience at the bedside while caring for, teaching, and supporting patients in caring for themselves,” says Colobong Smith. "These perspectives are valuable and enrich the creation and development of new technology."

Mobile devices and apps: Smartphone-based hardware and software technologies can help nurses communicate via voice/text, access the EHR and other applications, research conditions, monitor patients, inform clinical decision making, provide education for health care professionals, and serve as a barcode device to check medication doses.

Ambulatory care nurses are using digital technologies to allow patients to receive timely care at their convenience, whether at home, work, or in assisted-living facilities, says Debra Cox, MSN, RN, CENP, Past President of the American Academy of Ambulatory Care Nursing.

“For example, nurses are providing video visits to patients to assess wound-care progress, providing cognitive behavioral therapy coaching for depression recovery, and facilitating interdisciplinary rounding with a dialysis patient and family at a distant clinic site,” says Cox.

Drug retrieval-and-delivery systems: These utilize several technologies, including barcodes and automated dispensing machines, to ensure that patients receive the correct medications and dosages.

“Technology doesn't get tired and forget to check a dosage against the patient's weight,” says Parker. “I have been a registered nurse for over 40 years, and I would certainly not want to go back to the old days. Having barcoding technology to serve as my second pair of eyes to ensure correct medication delivery is something I wish had in years past.”

Tablet computers, wall-mounted PCs, and mobile carts: These computer-based tools allow nurses to enter and retrieve information housed in a facility's information systems without leaving a patient’s bedside. The systems can operate wirelessly and connect to applications and databases containing care guidelines and other clinical resources.

Join today's nursing workforce

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Clinical Information System (CIS) is a computer-based system that is meant to gather, store, and alter clinical data on patients. These systems may be used at single locations or across entire healthcare systems. The purpose of CIS is to integrate, collect, store and manage data from a number of sources to support healthcare operational management, support policy decisions and manage patient data. 

CIS has many benefits, including the automation of tedious manual activities, increased accuracy due to reduced human error, traceable records available from many sites of care at the same time, and connection with other bedside equipment and information systems. The built-in error checking and knowledge-based methods should also result in a more secure and high-quality clinical process. The CIS electronically captures the data and possibly makes it available to a wide range of systems. This eliminates the need for manual data input or transcription, while also making the data available for a variety of reasons such as clinical, corporate, and research reporting.

Some CIS’s are designed for specific use, with one such example occurring in the Intensive Care Unit (ICU). In this case, the CIS can communicate with the several computer systems found in a hospitals, such as pathology and radiology. It consolidates data from all of these systems into an electronic patient record that physicians may access at the patient's bedside. As a result, it can improve communication between clinicians, provide relevant data for clinical decision makers, encourage quality improvement, provide real-time, accurate data to aid in clinical research and provide clinicians with patient x-rays and scans in a more timely manner.

CIS can also provide clinical information in a well organised system, and reduces error through the use of legible, electronic information. This can lead to reduced human error and increased patient safety. 

Clinical Information Systems differ from Electronic Health Record (EHR) systems.

EHR contains information about a person's health, including test results, treatments and past medical history. It is also intended to exchange information with other electronic health records so that other healthcare professionals may have access to a patient's medical information.

CIS is highly specific, and stores and manages information that is directly collected from caretaker and service providers, while the EHR provides a more generalised patient medical record that aids in informing clinical care. EHR’s contain a wider amount of information encompassing a variety of health topics and include other health professionals. 

EHR and CIS systems can collaborate to give a more complete picture of a patient's health. EHR systems may draw information from CIS systems to provide precise information to decision-making clinicians, allowing them to better treat their patients. These CIS and EHR advantages are enhanced by cloud-based EHR systems, which can send this information to clinicians regardless of their location. The integration of these two systems will provide consumers with a more responsive healthcare experience.

Despite its benefits, CIS can present some barriers, such as a high cost of acquisition, healthcare institutions lacking the technology, clinician resistance, and could present privacy and security concerns if not utilised correctly.