Evaluating EHR-Integrated Digital Technologies for Medication-Related Outcomes and Health Equity in Hospitalised Adults: A Scoping Review.

The purpose of this scoping review is to identify and evaluate studies that examine the effectiveness and implementation strategies of Electronic Health Record (EHR)-integrated digital technologies aimed at improving medication-related outcomes and promoting health equity among hospitalised adults....

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Published in:Journal of Medical Systems Vol. 48; no. 1; pp. 1 - 20
Main Authors: Murthi, Sreyon, Martini, Nataly, Falconer, Nazanin, Scahill, Shane
Format: research systematic review tables/charts Journal Article
Published: Springer Nature 8/23/2024
Online Access:View this record in EBSCOhost
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      dt: 8/23/2024
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      pub: Springer Nature
      place: New York, New York
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        atl: Evaluating EHR-Integrated Digital Technologies for Medication-Related Outcomes and Health Equity in Hospitalised Adults: A Scoping Review.
      aug:
        au:
          Murthi, Sreyon
          Martini, Nataly
          Falconer, Nazanin
          Scahill, Shane
        affil: https://ror.org/03b94tp07 School of Pharmacy, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
      sug:
        subj:
          Electronic Health Records Evaluation
          Digital Technology Evaluation
          Medication Errors Prevention and Control
          Health Services Accessibility Standards
          Health Care Delivery, Integrated Standards
          Outcomes (Health Care) Standards
          Hospitalization
          Human
          Adult
          Scoping Review
          Medline
          Embase
          CINAHL Database
          Inpatients
          Health Screening
          Early Diagnosis
          Predictive Value of Tests
          Quality Assessment
          Decision Support Systems, Clinical
          Patient Safety
          Health Inequities
          Adult: 19-44 years
      ab: The purpose of this scoping review is to identify and evaluate studies that examine the effectiveness and implementation strategies of Electronic Health Record (EHR)-integrated digital technologies aimed at improving medication-related outcomes and promoting health equity among hospitalised adults. Using the Consolidated Framework for Implementation Research (CFIR), the implementation methods and outcomes of the studies were evaluated, as was the assessment of methodological quality and risk of bias. Searches through Medline, Embase, Web of Science, and CINAHL Plus yielded 23 relevant studies from 1,232 abstracts, spanning 11 countries and from 2008 to 2022, with varied research designs. Integrated digital tools such as alert systems, clinical decision support systems, predictive analytics, risk assessment, and real-time screening and surveillance within EHRs demonstrated potential in reducing medication errors, adverse events, and inappropriate medication use, particularly in older patients. Challenges include alert fatigue, clinician acceptance, workflow integration, cost, data integrity, interoperability, and the potential for algorithmic bias, with a call for long-term and ongoing monitoring of patient safety and health equity outcomes. This review, guided by the CFIR framework, highlights the importance of designing health technology based on evidence and user-centred practices. Quality assessments identified eligibility and representativeness issues that affected the reliability and generalisability of the findings. This review also highlights a critical research gap on whether EHR-integrated digital tools can address or worsen health inequities among hospitalised patients. Recognising the growing role of Artificial Intelligence (AI) and Machine Learning (ML), this review calls for further research on its influence on medication management and health equity through integration of EHR and digital technology.
      pubtype: Academic Journal
      doctype:
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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