Issue link: https://nnumagazine.uberflip.com/i/198033
For HIT to provide high-quality patient care, two premises would have to be valid: 1. All patients are pretty much the same. 2. Any variation can be anticipated by software designers. RNs know better. Every patient is unique. Because humans are infinitely complex and variable, each patient needs to be assessed and cared for by a thinking, skilled professional—that is, by a human being. To defend your role in patient care against routinization, you first need to understand how each type of HIT prioritizes profit by • controlling RNs and • treating patients like machines. Section 2: the core technologies Three technologies make up the skeleton of HIT: • electronic medical records and electronic health records, • clinical decision support systems, and • the health information exchange. These technologies support and sometimes incorporate many others, and between them they manifest most HIT problems. 1. electRonic MeDicAl RecoRDS (eMRS) AnD electRonic HeAltH RecoRDS (eHRS) orientation Electronic records are the backbone of HIT. All other technologies rely on them directly or indirectly. EMRs are accessible only within a single institution, such as a hospital or HMO network. EHRs are accessible to multiple institutions. But the two terms are often used interchangeably. Here, "EMRs" refer to both types of electronic records. The advantages of EMRs over paper charts are advertised loudly by HIT companies, hospitals, and politicians. They can be searched more easily and accessed from multiple locations, and they may reduce certain types of errors. But because hospital management controls the purse strings, EMRs are designed, above all, to increase hospital profits. For this reason, they threaten patient care. EMRs increase management's ability to control RNs through surveillance, division, routinization, deskilling, and displacement. They deprofessionalize RNs, preventing them from exercising their professional judgment to decide what's best for their patients. © Copyright IHSP 2009. All rights reserved. How ca n yo u be su re to be at patient 's bedside when they need you mos t? III