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The electronic treatment administration (eTAR) electronically monitors and records resident medication and treatment administration. In other words, paper MARs and TARs are replaced by electronic versions. The software conveniently and easily keeps track of medication orders and deliveries and easily generates reports. With security features like patient photos and barcode technology, eTAR ensures maximum protection for residents and healthcare staff members.

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eTAR for an Interprofessional Care Team/Stakeholders 

The collaboration of interprofessional teams and all the involved stakeholders are crucial as it ensures positive outcomes and helps in improving patient safety, and experience of care. Collaboration between specialists from various fields is recognized as being essential to providing patients with high-quality care. Many patients today, particularly ones having chronic diseases, have complex symptoms that need immediate collaboration between healthcare providers from various medical specialties. 

It is important to integrate information, share knowledge and expertise, and work as a team from different locations to collaborate effectively. Tools like eTAR, which are part of EHRs systems, are used for a variety of purposes, including coordination, collaborative effort, and shared decision-making. They are viewed as an important method for providing high-value care (Colicchio et al., 2019). 

EHR can support multidisciplinary collaboration during ward rounds in the hospital. This is dependent on addressing certain broader design issues, like the social ergonomics of the devices involved, the inclusion of paper records, and assistance in enhancing information systems. EHRs provide various opportunities for care coordination. It also facilitates in integration and collection, access, and use of patient data. They also allow for the replacement of healthcare professionals in clinical decisions. 

eTAR could assist medical professionals in increasing their shared understanding of patients’ medical timeframes. Additionally, the availability of portable notes increased medical specialists’ awareness. Interviewees in outpatient clinics noted that the orchestrating affordance made it easier to refer patients between specialties because all of the hospital’s specialties were integrated into the EHR (Bardram & Houben, 2018).

The effective use of the eTAR system was also found to have an impact on record quality. For healthcare professionals to perform timely diagnosis and treatment without delays, a standardized, user-friendly eTAR format allows for quick data entry. The standardized eTAR also supports referral processes between hospitals and enhances clinics’ ability to create medical records. The use of the eTAR system in hospitals is favored by nurse informaticists who work in collecting and putting information in the system (Vehko et al., 2019). They have favorable opinions about its use and quality. They think that by accurately recording patients’ personal information, EHRs can streamline their practice and workflow. The use of EHRs, their quality, and users’ satisfaction were found to be positively correlated (Acharya & Werts, 2019). 

Enhanced Information System Workflow Promote Safe Practice

The effective use of eTAR has several benefits regarding workflow, safe practice, and quality outcomes. The workflow enhanced by e-TAR technology will allow clinicians to manage patient prescriptions easily. This will also help in the clinical decision-making process of the organization which will increase the standard of care. The technology will help nurse informaticists to reduce errors in data entry. It aids healthcare providers to reduce medication errors. This enhanced workflow will help patients to read, print, and send their medical information to providers through a patient portal that will give them access to their medical records. It enhances patient quality outcomes and enables patients to act as their advocates. The workflow will help in the reconciliation of medications that assist patients and clinicians. It will be simple to retrieve and update a medication list created from the eTAR at each patient visit (Lin et al., 2019).

The enhanced information system promotes safe practice as information about residents, medications, and treatments is instantly accessible to nursing staff due to bar code technology in eTAR (Gomes & Romão, 2018). Barcoding not only saves staff manual clicks but also automates the comparison of the next treatments. Additionally, bar code lessens the time required to enter the medical information into the software and also helps in reducing human errors. The automated validation check of the treatments or medications decreases the administration of medication or treatment errors (Yaqoob et al., 2021). This system also improves quality outcomes in the following ways:

• The eTAR system’s follow-up reminders eliminate forgotten or delayed medication
• Direct management of medication and treatment orders by the staff is possible from the eTAR administration screen
• During a Med Pass, the medications can be stopped, reordered, or put on hold by using this approach.
• If replacement medications are required, the dosage is automatically updated 
• Able to add emergency and notification-based backup medications and treatments to eTAR as needed.
• The administration screen conveniently shows all resident information, facilitating the healthcare staff to confirm the 5 Rights for the medication which include the Rights regarding the medicine, patient, amount, route, and time (Hunt & Chakraborty, 2020).
• During or after administration, the healthcare staff can review or add documentation.
• Staff members are provided with the resources they need to efficiently manage emergency stock medications and medical directives.

Strategic Plan of the Organization or Practice Setting

The eTAR technology supports the strategic plan of the organization as it aids in the development of a financially viable medical practice setting. Even though advanced technology and training investments are necessary for the implementation, a fully functional eTAR system can result in long-term savings in many different areas as well as improved business. eTAR has a positive return on investment. 

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eTAR can increase patient safety and healthcare quality by enhancing legibility and communication between medical professionals and patients. The majority of users of electronic medical records are nurses, who make up 50% of the healthcare workforce and represent the largest group of healthcare professionals. The use of electronic medication administration records is supported by evidence. They are more productive, reduce adverse medication events, and foster patient safety. A significant decrease as compared to previous studies, between 2.8% and 16% of medication administration errors were reported after the use of this technology (Stolic et al., 2022).

The practice setting will also get benefit from the eTAR technology. Due to the use of this technology, there will be a reduction in documentation time by healthcare providers. The team members of the practice setting will have improved communications. Clinical staff members of the practice setting also used eTAR to create “huddle sheets” that listed patients’ appointments and problems. Functions in eTAR that are used by the healthcare team as communication tools include patient problem lists, to-do lists, and task assignments. There will be a decrease in the workload of the staff members of the setting (Anandkumar, 2021). 

eTAR improves workflow and organizational productivity with increased patient care. Numerous steps should be adopted by the healthcare staff for the implementation of a new system. A testing protocol is needed to be set up before putting the new system in use. This will help in the identification of any confusion or issues from the staff members in implementation. The implementation of the new system will depend on the effectiveness of the strategy that is planned for it. It will ensure workers’ satisfaction (Aguirre et al., 2019).

Recommendations to improve eTAR to Support Stakeholder Needs

When the implementation is complete, there will be a possibility of an issue if there will be a lack of electrical power supply to the system. It will be suggested that a recovery plan should be in place if the new system is not available at the time. The hardware and utilities that are needed to support the new system must be included in the eTAR (Rieke et al., 2020). 

It is also recommended to have redundant processors that contain copies of data files to help in the successful operation of files. The backup plan for the new system is suggested so that the healthcare providers and other staff members do not face any difficulty. Providers are required by the HIPAA act to back up their electronic health record system and have a backup plan in place. Backup plans, emergency management plans, protocols for the system and procedures, data criticality analyses, and other elements are required to be included to protect confidential information in case of emergencies (Kluwe et al., 2020).

Another recommendation to support the stakeholder needs and to improve the system is training. The user skills assessment and training requirements should be done before implementation. An evaluation of the healthcare worker’s user skills measures their proficiency with computers (Aguirre et al., 2019). The training approach may involve choosing super-users from nurses (both healthcare providers and nurse informaticists), billing departments, etc. It should be taken into account that super-user training will take place before implementation for the chosen staff to become familiar with the system (Rodriguez-Villa & Torous, 2019).

Summary

eTAR offers ways to improve organizational effectiveness as well as safer patient care and the tools needed to meet regulatory requirements. When a healthcare organization decides to adopt a new electronic health record system, it is crucial to take the implementation process into account. Making the right choice and incorporating it into the plan can speed up the system rollout and increase success. To ensure the implementation’s success, it is important to become familiar with the strategy and comprehend the organization’s needs. The likelihood that usability will be compromised is drastically reduced by employing the best approach, strategy, backup system, and training.

References

Acharya, S., & Werts, N. (2019). Toward the design of an engagement tool for effective electronic health record adoption. Perspectives in Health Information Management, 16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6341416/ 

Aguirre, R. R., Suarez, O., Fuentes, M., & Sanchez-Gonzalez, M. A. (2019). Electronic health record implementation: A review of resources and tools. Cureus, 11(9). https://doi.org/10.7759/cureus.5649 

Anandkumar, M. (2021). Coordination and continuity through electronic medical records. Public Health behind Bars, 475–482. https://doi.org/10.1007/978-1-0716-1807-3_32 

Bardram, J. E., & Houben, S. (2018). Collaborative affordances of medical records. Computer Supported Cooperative Work (CSCW), 27(1), 1–36. https://doi.org/10.1007/s10606-017-9298-5 

Colicchio, T. K., Cimino, J. J., & Del Fiol, G. (2019). Unintended consequences of nationwide electronic health record adoption: Challenges and opportunities in the post-meaningful use era. Journal of Medical Internet Research, 21(6), e13313. https://doi.org/10.2196/13313 

NURS FPX 6412 Assessment 3 Manuscript for Publication

Gomes, J., & Romão, M. (2018). Information system maturity models in healthcare. Journal of Medical Systems, 42(12). https://doi.org/10.1007/s10916-018-1097-0 

 Hunt, S., & Chakraborty, J. (2020). Dose verification errors in hospitals. Journal of Nursing Care Quality, 36(2), 182–187. https://doi.org/10.1097/ncq.0000000000000491 

Kluwe, F., Michelet, R., Mueller‐Schoell, A., Maier, C., Klopp‐Schulze, L., van Dyk, M., Mikus, G., Huisinga, W., & Kloft, C. (2020). Perspectives on model‐informed precision dosing in the digital health era: Challenges, opportunities, and recommendations. Clinical Pharmacology & Therapeutics, 109(1), 29–36. https://doi.org/10.1002/cpt.2049 

 Lin, Y.-K., Lin, M., & Chen, H. (2019). Do electronic health records affect the quality of care? Evidence from the HITECH Act. Information Systems Research, 30(1), 306–318. https://doi.org/10.1287/isre.2018.0813 

Rieke, N., Hancox, J., Li, W., Milletarì, F., Roth, H. R., Albarqouni, S., Bakas, S., Galtier, M. N., Landman, B. A., Maier-Hein, K., Ourselin, S., Sheller, M., Summers, R. M., Trask, A., Xu, D., Baust, M., & Cardoso, M. J. (2020). The future of digital health with federated learning. Npj Digital Medicine, 3(1), 1–7. https://doi.org/10.1038/s41746-020-00323-1 

Rodriguez-Villa, E., & Torous, J. (2019). Regulating digital health technologies with transparency: The case for dynamic and multi-stakeholder evaluation. BMC Medicine, 17(1). https://doi.org/10.1186/s12916-019-1447-x 

Stolic, S., Ng, L., & Sheridan, G. (2022). Electronic medication administration records and nursing administration of medications: An integrative review. Collegian. https://doi.org/10.1016/j.colegn.2022.06.005 

Vehko, T., Hyppönen, H., Puttonen, S., Kujala, S., Ketola, E., Tuukkanen, J., Aalto, A.-M., & Heponiemi, T. (2019). Experienced time pressure and stress: Electronic health records usability and information technology competence play a role. BMC Medical Informatics and Decision Making, 19(1). https://doi.org/10.1186/s12911-019-0891-z 

 Yaqoob, I., Salah, K., Jayaraman, R., & Al-Hammadi, Y. (2021). Blockchain for healthcare data management: opportunities, challenges, and future recommendations. Neural Computing and Applications. https://doi.org/10.1007/s00521-020-05519-w