Question

Health informatics impact in pre-op, intra-op and post op patients

Answer 1

Health informatics impact in pre-op, intra-op and post op patients

answer :

introduction

Health Informatics is the integration of health technology and information systems in order to integrate patient data and patient health information with the various aspects of the patient's health care in order to improve the quality of healthcare.

The health Informatics has electronic health records as its base and clinical decision support softwares integrated into the patient monitoring systems which provide options for safe patient decisions and care.

Management of the surgical patients is very critical as it requires efficient management of the pre-operative patient factors, intraoperative patient monitoring and postoperative patient care. The entire journey of the patient through the surgical procedure has to be vigilantly monitored and all the areas of vulnerability, medical errors and mistakes in the healthcare has to be addressed in order to attain positive patient outcomes. This is possible by accurate standardized patients health records and clinical care documentation, uniform patient data sharing and patient clinical monitoring systems and softwares that are an integral part of the health Informatics.

The impact of health Informatics in the preoperative, intraoperative and postoperative care of a surgical patient is tremendous and positive and adds to the safety and quality of the patient care.

The advantages of increased patient care quality and safety ,increased peri operative administrative functionality and increased compliance with the standards of the accreditation processes are observed due to the implementation of the health Informatics in the perioperative patient care

The preoperative impact:

The electronic health records EHR provides for the accurate documentation of all the information that is critical to the planning of the surgical procedure and the preoperative assessment of the patient including the patient's clinical assessment ,patient's medical history, patient's laboratory investigations and radiological investigations, preoperative physician orders, history of medications, allergies and immunizations.The clinical decision support systems help in the preoperative patient care by sending alerts and reminders.

for example:

For a patient AB who is being prepared for hernia surgery,the electronic health records may provide information about the allergy of the preoperative patient a to particular antibiotic and the clinical decision support systems will alert the care provider to the presence of the allergy and provide with alternatives for antibiotic administration prior to the surgery. The preoperative patient checklist for AB can be assessed by the care provider easily in order to ensure the completeness of the preoperative patient preparation

The intraoperative impact:

The electronic health records provide an uniform platform for the integration of the entire patient information including the laboratory reports and the radiological reports. This information can be assessed by the the planning surgical team easily in order to plan the surgery efficiently and also be utilised during the surgical procedure in order to refer to the anatomical preoperative findings of the patient. The health Informatics also provides for effortless collaboration between the specialists during the course of the surgical procedure in case of difficulties and complicating surgical challenges and provides the reference basis for the surgeons with the integration of the basic surgical procedures and related information as a part of the clinical decision support systems software. The intraoperative patient monitoring of the vital parameters including the infusion of the various anaesthetic drugs, the related drug warnings, doses, allergy becomes error-free by the use of health Informatics integrated into the intraoperative patient care systems.

The entire surgical care team including the surgical nurses, the operating surgical team and the anaesthetic team are unified with easy,accurate and uniform Information sharing regarding the patient due to the integration of the health Informatics into the intraoperative patient care.

Thus the health Informatics has a tremendous positive effect on the intraoperative care of the patient and makes the surgical procedure safe for the patient by providing error-free information and promoting team Information sharing and coordination and team colloboration in the stressful atmosphere of the operating room

for example For a patient AB who is undergoing the hernia surgery, the anesthetic team may use health Informatics to calculate the dose of anaesthetic medications safe for the patient and the surgical team may use the health Informatics to confirm the side of the the hernia and the associated anatomical relationships intraoperatively to plan the placement of the mesh by referring to the pre-operative radiological investigations during the course of the surgery.

The postoperative impact

The health Informatics play a key role in order to integrate the patient data postoperatively which helps in the postoperative patient monitoring and  provide an easy reckoner referral to the entire preoperative patient medical history, patient investigations, and the surgical procedure which has  been performed including all the patient allergies,drug reactions, surgical findings, intraoperative complications and drug doses with post operative orders This makes it easy for the postoperative team to take care of the patient as they  get an insight into the entire preoperative workup of the patient. The presence of complete information on a uniform platform helps in integrated patient care and avoid the errors which can occur due to lack of communication and documentation.

The monitoring of the postoperative patient is very important in order to avoid complications. This becomes easy by the clinical decision support systems. An alarm/alert set into the system can warn about the altered laboratory or patient vital signs,clinical parameters and corrective actions can be taken. The health Informatics are integrated with a ready reckoner to the laboratory abnormalities and their corrections. These systems are provided with patient age and weight based easy calculations by the use of standardized software.

for example: For patient AB, the use of health Informatics may help the nurse to get an alert to the presence of acidosis in the ABG and also possible ways of correction of the acidosis with the dosing calculation of the sodium bicarbonate that should be given based on the patient's ABG and the anion gap.

The ease of communication between the patient and his family, between the patient and the care providers is enhanced on account of provision of all the patient related information on a single platform.

The health Informatics systems also provides fo easy accurate transfer of patient records and procedures for purposes of billing, insurance purposes and adds to the ease and accuracy of the post operative patient discharge instructions,patient education and medications and also aids provision for information in legal matters.

Thus,the use of health Informatics has a positive impact on the post operative care and patient education and discharge planning as it provides the provider with complete patient information, reminders about the relevant teaching points and alerts to the patient's complications.

The application and integration of health Informatics into the intraoperative, pre operative and post operative care of the patient is very advantageous to provide quality care to the patient which is without errors and helps in preoperative patient planning, intra operative surgical team coordination and patient care and post operative patient monitoring and patient care thereby causing a positive impact on the holistic surgical patient care.

A few disadvantages of the health Informatics and aspects of negative impact need to be mentioned in order to rationalize its application to the pre operative ,post operative and intraoperative patient care and caution the user with respect to the possible negative impacts.

The health Informatics are not a substitute for clinical decision making and clinical patient assessment. The replacement of clinical diagnosis and personal patient interface to desktop diagnosis and electronic patient interface should not create bias or cause confusion in the mind of the provider while assessing the patient .The information got from health Informatics is not a substitute for sound clinical assessment of the patient and has to be integrated with the clinical information of the patient.

For example: for patient AB, the clinical decision support system may alert the care provider to the use of the painkillers at the scheduled time but clinical assessment of the patient may reveal that the patient is very comfortable and rested and does not have any pain and does not require the scheduled dose of the analgesic drug.

The use of clinical judgement in order to interpret the health Informatics information is very important in order to provide quality patient care. In addition, fatigue factors related to the alarms and the alerts created by the clinical support decision support systems are prevalent which can hinder the effective rendering of the patient care by the healthcare team.

Conclusion:

The use of the health Informatics has a positive impact on the preoperative and postoperative care of the patient and helps to provide a uniform platform of communication between the multiple care providers for the patient.

The advantages of increased patient care quality and safety ,increased peri operative administrative functionality and increased compliance with the standards of the accreditation processes are observed due to the implementation of the health Informatics in the perioperative patient care

However they do not replace a sound clinical judgement and integration of the health Informatics with clinical judgement and knowledge and its judicious use is advised in the critical areas of intraoperative ,preoperative and postoperative care of the surgical patient which has rapidly changing patient's milieu interior and physiology.