This course is 1 Contact Hour 1. Read the continuing education article.


2. This continuing education course is FREE ONLINE until April 18, 2016, courtesy of University of Phoenix School of Nursing. To take the test for FREE, go to CE.Nurse.com/ Course/CE721.


have a deep interest in helping patients as they transition across the care continuum: from hospitals to home care or skilled nursing facilities, as well as follow-up with primary care providers and spe- cialists.Nurses can ensure accurate and complete transition of care documentation to facilitate transition of care for patients.Nurses also support and teach patients in learning about their condition. One of the goals delineated in the third stage of meaningful use includes patient engagement in their care through the use of PHR. Nurses can educate patients about the importance of a PHR


After that date, you can take the course for $12 at Nurse.com/CE.


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(generally provided by your employer), please login as you normally would at CEDirect.ContinuingEducation. com and complete the course on that system.


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Courses must be completed by October 31, 2016


3. If the course you have chosen to take includes a clinical vi- gnette, you will be asked to review the vignette and answer 3 or 4 questions. You must answer all questions correctly to proceed. If you answer a question incorrectly, we will provide a clue to the correct answer.


4. Once you successfully complete the short test associated with the clinical vignette (if there is one), proceed to the course posttest. To earn contact hours, you must achieve a score of 75%. You may retake the test as many times as necessary to pass the test.


5. All users must complete the evaluation process to complete the course. You will be able to view a certificate on screen and print or save it for your records.


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OnCourseLearning is also accredited by the Florida Board of Nursing (provider # FBN 50-1489).


OnCourseLearning is approved by the California Board of Reg- istered Nursing, provider # CEP16588.


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and encourage them to request portions of their EHR, within the policies of the healthcare organization. If an organization has a patient portal, nurses can help patients sign up and provide guidance on use of the portal to enhance their care. As nurses gain experience and knowledge about interoperability, additional opportunities will arise including serving as a leader in the im- plementation of the EHR as well as other health IT initiatives. There may also be organization committees that focus on clinical quality improvement measures, documentation standards and patient engagement efforts.Nurses can participate and lead these committees to add valuable clinical input. Without taking a leadership role, nurses can simply stay aware


of local and national activities, increase their knowledge and serve as resources to colleagues. Finally, as standards and regulations continue to be defined on a state and federal level, an open in- vitation for comments from healthcare professionals will occur, thus providing another opportunity for input. Nurses should be the voice for their specialized knowledge that will influence policies and shape the future of HIE.9


Challenges and barriers Cost of ownership: There’s no question that the adoption of EHRs, HIE and full interoperability is expensive. The initial costs of simply acquiring an EHR include the purchase of expensive hardware and software and, often, the need for a third party con- sultant. Successful implementation requires ongoing education and continual training and regular system updates and maintenance that may lead to increased staffing. It takes time to train clinical users, and productivity may initially decrease, possibly resulting in decreased revenue. In addition, as the systems changes, exist- ing clinical workflowsmust be evaluated to ensure patient safety standards are maintained and workarounds are addressed. Getting everyone on board: Long-term acute care facilities


and behavioral health organizations have been slow to adopt EHR technologies; however, there is forwardmovement in some areas and states.19


Many long-termacute care organizations still


primarily use fax machines for sharing health information. In addition, wide variation in patient consent standards exist from state to state. In behavioral and mental health areas, achieving consensus about sharing of sensitive information across the continuumof care, as well as gaining access to specific inpatient and outpatient information, remains a challenge because of the Health Insurance Portability and Accountability Act (HIPAA) standards.21


The cost for developing strategies to address these


issues while implementing EHR and HIE technologies from the ground up requires an interprofessional perspective to be suc- cessful.However, for full interoperability to occur, solutionsmust be found and advancementsmade to continue tomove forward.


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