The promise of the electronic health records (EHR) has always been that it will make the health care system work better for patient care (Ross, 2016). However, in this case study, there was a breakdown in communication and there could have been a negative account if the patient did not have a nursing background. Without a nursing background, Annie would have not known what the diagnosis of dysuria meant, why her urine was sent for a culture, and what the antibiotic sent in was for. Since, she did know all these things, she knew she had a urinary tract infection and needed to take the antibiotic to rid of it.

Breakdowns in Communication

The fast-paced environment of health care contributes to communication failures between health care providers while impacting patient care and patient flow (Driscoll & Gurka, 2015). In this case study, it states that there were no phone conversations with anyone from the APRN’s office after Annie’s well visit. Also, it did not mention anything regarding a note from the APRN or the nurse regarding why her urine was sent for culture and why she needed an antibiotic. We should always assume that the patient does not have any medical background and write as much information is necessary for him/her to be able to understand why a lab result was done and why he/she needs a prescription. Delay in treating Annie’s urinary tract infection could have occurred due to this poor communication if she wasn’t a nurse.

At my women’s health practice, this scenario is very common, however, with better communication between our office and the patient. The patient usually has a urinalysis done at her yearly appointment in our office, we run the sample, and depending on results it may need to be sent for a culture. We notify the patient of this at her appointment. Then, when the culture results are back, if she has MyChart we send a note regarding what the culture grew and what antibiotic was recommended by the provider if necessary. We get notifications if patients do not read their notes within 24 hours and then a phone call is made to her to follow up. Also, at the appointment, our providers ask the patient if she has MyChart and informs her that she will get her results that way then.

Meaningful Use Stage 2 Requirement

For a successful completion of fulfilling a meaningful use stage 2 requirement, the Centers for Medicare and Medicaid Services (CMS) states there must be secure electronic communication between the patient and health care provider, electronic medication tracking, and facilitated patient access to their electronic medical record (EMR) (Barnhill & Spicer, 2016). In this case study, I believe the APRN’s office fulfilled a stage 2 requirement. There was a secure EMR that was utilized, it appears computerized provider order entry (CPOE) was utilized since Annie got an automated call from her correct pharmacy stating a prescription was ready for pick up, and Annie had easy access to her EHR in which it states she received an email alerting her that there was new information in her electronic record which she was able to view. Even though I believe by definition they fulfilled the requirement, I believe they did not fulfill their duty of adequate communication with the patient.


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