Advanced Information Management and the Application of Technology
David Odige
West Governor University
Advanced Information Management and the Application of Technology
The use of technology in health care is an inevitability given the numerous advantages that it offers to patient care as well as the organization. The use of technology in health care is also affected by certain disadvantages. The work of the informatics professional is thus to ensure that an organization is able to maximize the benefits while limiting the disadvantages that such systems pose. The key advantages and disadvantages of using the health information system (HIS) are related to issues of usability, interoperability, scalability and compatibility.
Usability
Usability definition encompasses various evaluation methods that are intended to understand the experiences of the users for the purpose of the creation of useful and user-friendly products. Currently, there is a gap that exists between the usability of electronic health systems and the optimal usability of the same. Among the advantages of HIS is the ability to have various screen displays at once. This feature allows the personnel to be able to cross-reference different issues or even multitask (Rizvi et al., 2017). However, the disadvantage of such a feature is the increased susceptibility to errors due to multitasking. Another key advantage is the spelling checks and grammar offered by the systems. This helps with the elimination of errors in the health care setting and allows the clinicians to be able to customize their notes. However, the disadvantage of the same is that autocorrecting may lead to error as it may change a word to something that the clinician did not mean. The use of HIS has also been associated with an increased cognitive burden. Clinicians usually work under the pressure of time and urgency of needs. When HIS fails to model the clinicians' cognitive models it increases the probability of errors (Johnson, Johnston, & Crowle, 2011). Among the ways it does this is by failing to cluster test results and thus increase the cognitive burden.
Interoperability
Interoperability is essential because it allows the sharing of clinical data electronically within the entire health organization. The key advantage is that it allows professionals to have relevant and recent clinical data that they can use to make a clinical judgement (Perlin et al., 2016). The information availability allows for prompt decisions making within the facilities. It allows for the safer transition of care and can be used to save costs as the information on a test is in the system and the patient may not require to do another test for example a test to determine the blood type. Among the key disadvantages of operability is the fact that HIS does not provide the context for the information provided (Iroju, Soriyan, Gambo, & Olaleke, 2013). Therefore, the clinician seeking to use the data available may not be able to fully understand the circumstances that led to the scenario in question. The use of different terminologies by different systems poses a significant disadvantage is it limits the communication between the different professionals that need the data.
Scalability
Scalability is important due to the fact that as the organization grows and experiences an increase in patients, the data handled through the system will also increase. Scalability that allows for smooth growth of the organization without having to make major adjustments that might affect the delivery of care. The system also becomes more efficient with the addition of more resources (Ahmadi, & Aslani, 2018). A system that is scalable remains responsive to the change in the organization. The disadvantage of scalability is the increase in costs for the organization as it tries to connect different parts to one and ensure that the system is able to adjust to the changes experienced within the organization. Trying to connect the different parts may also lead to a duplication of efforts which contributes to the high cost.
Compatibility
Compatibility is essential because it allows for the interoperability of the system. A health information system must be compatible with other systems in the market. There is a regulation by the FDA that stipulates the features that an electronic system must have to be compatible with others. This extends to the medical computers as incompatibility may affect the installation of software that is needed as well as the addition of other hardware.
The health information system will have a significant impact on the quality of patient care and the documentation of patient record. HIS promotes the availability of clinical data that can be used by clinicians to make prompt decisions that save the patient’s life. In health care, there are situations where time is an important resource and the ability to get a patient’s medical history at the touch of a button improves health outcome. The use of HIS has been proven to reduce the cases of medical errors through the provision of accurate information for use by clinicians. Interoperability means that the clinician is able to get data from all the professionals that are attending to the patient from different departments. The data is also available on the computer improving communication and reducing instances of misunderstanding due to issues such as handwriting. The documentation of patient information is also an effective and efficient way of saving time when the data is needed and space that is needed to store the information.
Benefits of the System
HIS can be a critical tool in quality management within a health care system. The electronic system assists with data collection that is used in the identification of existing problems (Silow-Carroll, Edwards, & Rodin, 2012). Without accurate data, clinicians may try to fix something that is not necessarily broken and in doing so make a situation worse. Data allow for the management of the incidence and prevalence of a problem and the population that is most affected by the same. It helps measure these problems in a manner that provides statistical implications in patient care. The lack of data can lead to solving a symptom as opposed to the larger problem within the hospital setting. For example, in the case where a patient has prescribed a medication that they are allergic to due to the failure of alert systems in the patient’s medical records. The lack of data may result in the organization placing blame on the physician as opposed to identifying that the allergy alert has failed and, therefore, clinicians are left to make a clinical judgement based on the information that is available to then. Along with the identification of a problem, the use of data from the electronic systems allows for the adoption of a corrective approach and evaluates the effectiveness of the approach. Among the key advantages is that data allows for extrapolation and, therefore, the organization can be able to anticipate some future changes. The trend on a graph can be used to determine whether the adopted approaches are effective or clearly note points of variances. The QI data can also be applied in determining the prevalence of hospital-acquired infections. The facility can then initiate the needed protocol to reduce the impact and the occurrence of these infections by taking the necessary steps. The QI data is useful as it is accurate and details the patients that are most affected and this helps determine the key causes of the infections.
A system will protect the privacy of the patients as it is a legal requirement that must adhere to by all systems providers and health care organizations. There are various strategies that have been put in place to ensure that the privacy of the patient is protected such as confidentiality of the information and ensuring that unauthorized persons do not get access to the information. Regulations that require the encryption and destruction of the data during start-up are key in ensuring that when a system is hacked or someone steals it and starts up the data is protected. Audits also ensure that the organization is mandated to keep tabs on who access the information and this helps flag out any malicious activities. Systems also came with data loss prevention strategies that take up the form of firewalls or access control. Failure to protect patient’s privacy is punishable under the law and this ensures that organizations do so to avoid financial losses in litigation as well as the loss of reputation.
The adoption of HIS confers numerous advantages to an organization that impacts standardizing documentation, reducing waste, increasing productivity and improving human and capital resources. The adoption of the electronic system allows for the standardization of documentation within a health care facility. This is beneficial as it allows for interoperability with all the professionals having access to a standard process which eliminates the need for guesswork and offers clarity. Standardization ensures that there is a method that is followed. For example, filling out a patient’s evaluation form on the electronic system requires that there some fields that are mandatory to fill out. Such a field provides crucial information that can be used by clinicians. However, allowing different clinicians to have different standards of recording such data invites chaos as they may fail to record what is considered as important might appear to be a small issue. The system also creates alerts when the standard has not been followed. HIS increases productivity in various ways such as through the elimination of errors that might result from miscommunication across an interdisciplinary team (Hoover, 2016). Productivity is also enhanced through improved responsiveness which is attainable due to the availability of relevant and recent data that allows for prompt decision-making. Cost reduction as a result of reduced medical errors and responsiveness is also a representation of productivity (Bar-Dayan et al., 2013). The system reduces waste through the reduction of the paper that is needed for the physical storage of patient information. HIS is electronic with every data being stored and backs up in a cloud and, therefore, there is no need for physical storage which may require too much paper and thus an environmental issue. The human capital that is required to manage the data also decreases as the need for clerks is eliminated as the systems are easy to manage. It also leads to the improvement of the human resource welfare through ways such as reducing the cognitive burden for professionals by clustering of tests and through the ease of acquiring information.
The use of electronic systems in health care has raised key concerns relating to the issue of privacy of protected health information (PIH). The use of electronic systems is faced with certain risks key among them being the possibility of the data getting hacked or accessed by unauthorized personnel. Therefore, it is a requirement under the law that all systems conform to the HIPAA and HITECH regulations. The conformity especially relates to the issues of data storage and data backup and recovery. HIPAA requires that an organization has the physical and technical safeguards including limited facility access with access controls in place. Among the requirements is having an offsite clouding system that will help with the storage of the information (Lawley, 2012). HITECH laws require the encryption and destruction of data at startup to protect against the access of the information by unauthorized sources. The security strategies are meant to ensure that there are data loss prevention, secure file sharing tools and network security solutions such as firewalls. HITECH regulations also require that there is an audit to determine the people that have had access to PIH and the patient can also be notified about the people to who their data has been disclosed to. It is a requirement that all health care organizations ensure that the PIH is backed up and recoverable in case of data loss. This is ensured through the stipulation that requires offsite storage of the PIH. Cloud storage is thus fundamental as it helps with the backup and recovery of the information.
Stakeholders
The implementation of a health information system requires the participation of key stakeholders in an organization. These stakeholders including the facility superintendent, the head of nurses, the head of physicians and the finance department. The head of the physician and the head of nurses play a key role in outlining some of the features that they want to be captured by the system. They provide key insight into the usability of the system that the organization seeks to acquire or develop. For example, the two leaders can request that the system is able to cluster certain tests and also agree on some of the terminologies to be used to ensure that the system is able to meet the needs of the nurses and the physicians. The two leaders are also essential in the coordination of training of the personnel on how to use the systems and manage the change process in their respective departments. The top leadership the medical superintendent plays a key role in signing off on the introduction of the health information system. He is also tasked with updating the hospital’s board of management on the issue and getting them to sign off on the development of the project. Another key stakeholder is the finance department as they are in charge of allocating the financial resources needed and are also in charge of acquiring the system. The finance head is able to do a cost-benefit analysis and ensure that the hospital is able to get the best available system at the least possible costs. The finance department is also conversant with the laws of procuring such a system and will ensure that it meets all the legal requirements. The four stakeholders need to work together to ensure that they are able to capture the needs of the organization and the system that will be acquired will be sustainable to meet changing organizational needs.
Evaluation
The evaluation of the success of a health information system can be achieved through various ways including conducting surveys as well as the use of analytical tools. The advantage of using a computerized system is that there are usually analytical and diagnostic tools that help in determining the optimal operation of the system. For example, the analytical tool may be used to determine the success rate of the firewall in preventing malicious viruses as well as attempts to hack the system. This will be in line with the HIPAA standard of confidentiality and privacy of health information. The analytical tool can also evaluate the reduced rate of various unwanted events such as allergies to medicines due to medication errors. Besides the analytical tools, there are also other evaluation techniques such as a follow-up survey to capture the experiences of the nursing personnel. This is important as it helps evaluate whether the system has achieved usability. The survey will help determine ways through which the system has helped improve health care and areas that require improvements. The American Nurse Association (ANA) requires that the system adopted by health care organizations is centered on patient care, improved health outcomes and the data and imformation should be accurately recorded, collected, protected, stored and utilized. ANA requires the systems adopted are able to promote the health outcome of the patients. As such the organization needs to ensure that the HIS is patient-centered to effectively meet all the requirements by ANA. Another key standard to adhere to is that of The Office of the National Coordinator for Health Information Technology (ONC). ONC has been pulishing the Interoperability Standards Advisory (ISA) that ensures interoperability standards and implementation specifications are adequately met. Therefore, the system must effectively meet these interoperability requirements as spelt out in ISA.
References
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