UMSN Advancing Health IT by Adding EHRs to Clinical Simulations in Graduate Education

Electronic health records (EHRs) have modernized patient care in hospitals and clinics around the world. Simulations for students to learn and practice realistic health care scenarios have revolutionized learning environments. But the integration of EHRs into simulations is challenging and lagged behind other innovations -- until recently.

Drs. Abbott and Nelson are leading the pilot program at UMSNAcute care pediatric nurse practitioner students at University of Michigan School of Nursing (UMSN) are piloting a new program using EHRs during class simulations in UMSN's Clinical Learning Center. UMSN Associate Professor Patricia Abbott, PhD, RN, FAAN, FACMI, is leading the project with Clinical Assistant Professor Kathryn Nelson, DNP, RN, CPNP-AC/PC, and two UMSN students. They’re working with a team from U-M’s Medical School and Medical School Information Services.  “If nurses want technology to work for them, they must be involved in the process, and that means knowing more than just pushing a button,” Dr. Abbott told the students.

Simulations are a key component of UMSN's education for undergrad and graduate sWhile EHRs become more common in health care, there is a shortage of nurse practitioners skilled in health care information (HIT). This project is intended to help prepare students as highly qualified nurse practitioners who can effectively interface with HIT in their daily work. More importantly, they will be equipped to be leaders within health care systems.

“Educating health professionals to use an EHR is just a piece of the puzzle,” says Dr. Abbott. “Nurses need to know what is happening under the hood and why. As a clinical decision is being considered, knowing where that data comes from, who entered it, and what it really means is vital to safe and effective care. As patient portals, sensors, and the Internet of Things including devices such as fitness trackers, increasingly infuse information into the patient record, understanding your data’s trustworthiness is imperative.”

In the pilot program, EHRs are integrated with traditional patient care

For the pilot, the team is using Veterans Health Information Systems and Technology Architecture (VistA), the open-source HIT system used at Veterans Affairs. VistA for Education (VFE) as adapted from a prior Health Information Technology for Economic and Clinical Health (HITECH) Act grant and is being adapted specifically for use in simulation labs across the U-M campus. 

“EHRs are integrated into our health care systems and the daily workflow of nurse practitioners,” says Dr. Nelson. “We are excited to use VistA EHR as a tool in simulated clinical scenarios to give nurse practitioner students hands-on practice with important skills like communication, clinical decision making, order entry, billing, and coding.”

In the News

The Associated Press recently featured the hands-on, highly valuable simulation exercises and education that are a key component of UMSN's program.