DNP role in specialty care: starting an autonomous psychiatric practice in Miami using Electronic Health Record (EHR) technology

Advanced Practice Nurses (APNs) in the state of Florida face multiple barriers to practicing autonomously. The Nurse Practice Act in Florida requires a collaborative agreement with a Medical Doctor, Doctor of Osteopathic Medicine or a Dentist in order for the APN to be able to practice. Collaborative agreements, often called protocols, require a fee to be paid to the collaborating physician. This increases the fixed costs of the practice and is a financial burden that is not experienced by similar practices in other states. The project explores challenges of starting an autonomous APN psychiatric practice in South Florida using Electronic Health Records (EHR) with the goal of alleviating current health care disparities among Hispanics in the community. Results conclude that in spite of the multiple barriers faced by APNs in the state, it is possible to provide appropriate, quality, integrated, patient-focused health services while maintaining financial sustainability and incorporating technology in the process.