Advanced Information Management and the Application of Technology
Kelly DeLynn Grange
Western Governors University
7/20/2020
Advanced Information Management and the Application of Technology
Health information systems or HIS are central to today’s healthcare sector and can be accessed either by the service provider or by the individual. Electronic Medical Report (EMR), Practice Management Software, Master Patient Index, Patient Portal, Remote Patient Monitoring (RPM), and Clinical Decision Support cover several aspects of HIS. This paper is based on the advantages and disadvantages of health information networks.
The advantages and disadvantages of Health Information System
Usability
Usability is the level with which a specific user can use a product to achieve specific objectives with efficiency, productivity and satisfaction within a specific context of application. Healthcare professionals, medical technicians, employees, administrative personnel, customers and others cannot benefit theoretically from the functionality and functions of EHR systems without functional systems (Shao, 2010). There are several major benefits to a reliable HIS. Usability is streamlined, and time for patient interaction is increased. Patient information is up-to-date and secure in a sound system that allows health professionals to take proper care of them. Reliable, interdepartmental contact for patient treatment would require functional HIS and require efficient completion of instructions.
The usability of the HIS can also have its drawbacks. There could be a learning curve that nurses have to conquer. Changes in the flow of work in relation to learning a new system may result in overtime for the first few months when doctors, nurses and all hospital staff are beginning to pilot the new system. The time and money needed to ensure that the latest HIS is actually available.
Interoperability
Another key factor in the implementation of HIS is the interoperability of the system. Interoperability is the level of sharing and interpretation of specific data by methods and computers.
The benefit of a HIS with good interoperability would be the collaboration between the systems. Today’s device may not be large enough to suit the increasing needs of the facility (Wang & Li 2014). Interoperability increases the delivery and quality of healthcare through the efficient sharing of information. Through allowing the exchange of data among healthcare professionals, pharmacies, laboratories as well as other hospitals, greater quality of treatment can then be accomplished than hospitals run in a silo.
Although interoperability provides endless potential for improved patient care, it isn’t without weaknesses. Some of these disadvantages could be higher costs and misinterpretations. EHRs are an immense endeavor for every patient, in both economic implications and in computer infrastructure. The costs of interoperability may be prohibitive for smaller organizations, and they are only present in large well supported facilities.
Interoperability can still have downsides as information is shared between different systems. Data from one system are unfiltered and do not indicate critical requirements. Providers will search through hundreds of pages to find the details they need. Its final outcome is that providers have little resources and cannot use the interoperability of database. Many information systems can be used to collect information throughout a patient’s stay.
Scalability
Scalability refers to the ability for the growth of the system as the organization grows. The benefit of HIS is that it is very easy to “relearn” the system by workers, because they know the system and just have to learn the changes instead of a brand new chart program. But, if your network is not able to accommodate the rise in information and storage, the traffic will slow down considerably. If the device is inaccessible or “crashes” because of the additional workload, workers may have to turn to manual forms that causes excessive frustration and can lead to loss of important data. Scalability has disadvantages in a way. The scaling up of a system may be prohibitive because of the high cost of upgrading the network. If you scale the interfaces of a healthcare information system up, it will become slower if things are pressed. This will again lead to higher costs because of the need for more or quicker servers to satisfy health information system demands.
Compatibility
Compatibility means that apps can work with each other or with certain devices such as software versions that work with a certain desktop computer. In selecting and implementing a HIS, compatibility is another aspect to consider. Each framework needs to be compliant to ensure that all of the care team have access to information with in HIS. When a company has various health care facilities such as clinics, outpatients, treatments and labs, all the systems have to cooperate. This would enhance coordination between the different locations. When machines were unreliable in different places, information could not be easily exchanged. There would be a delay that could lead to missing appointments or doctors not being able to view diagnostic imaging on time.
For instance, we collect prenatal reports for our patients who come to the labor and delivery unit from the doctor’s office. One system can be accessed at our nursing station and the other one requires a different computer because of compatible issues with our charting system. Records from the interdepartmental practitioner’s office should be distributed or obtained. The details will be available to all employees and divisions who provide patient related care.
Regrettably, it’s not like all devices are compatible and capable of sharing data to the same network. The bedside monitors at NTC, for instance, collect essential signs and patterns for the nurse and show the values at the nurse’s station. The nurse will, however, also report the vital signs and the pulse interpretation in the medical record of the patient.
HIS impact on Documentation and Patient Care
Documentation is essential to the success of health information. The large proportion of hospital financing and insurance companies’ reimbursement is derived from the precision and concise documentation of the medical and nursing staff. The HIS will strengthen reporting as nurses will now record tests, vital signs, and medications on the bedside. When stated previously, NTC has software and bedside monitors for every room for the physician to complete their paperwork directly after an examination, procedure, or medicines have been administered in real time. This increases reporting accuracy and reduces the risk that the nurse may fail to note any suspicious observations, interactions or any other important information that is essential to the patient’s health records (Williams et al., 2016). A large majority of the records are automatically added to the medical record and of the time spent on the machine to enter information from one source to another. The electronic synchronization of information between devices decreases the probability of transcription error and the overall quality of patient care.
The least aspect of the work of growing nurses is redundancy. Data structures are designed for children, and the appropriate use of data is made to enhance their degree of care (Wu, 2014). We know that documents are important, we are irritated when the program is slow, or material is not flowing. A good medical professional should evaluate the EMR and collect all the medical details that are needed. A sound HIS device should be safe and compliant with all HIPAA regulations. Real-time data should be available in all departments requiring access to the patient record. A health HIS should be user friendly and easy to use so that the healthcare professional can spend less time documenting and more time providing patient care.
Patient care and information
EHR can help patient health, productivity and effectiveness improve the quality of care, minimize medical errors, support decision taking and explain adequacy of care through patient level measures. EHR fosters the efficient cooperation of every member of the team to enhance the quality of care and to promote successful patient outcomes. Healthcare professionals can now administer orders remotely without having to write orders from anywhere in the hospital in a written chart of the patient.
The goal is to invest more time on patient care and less time on redundant charting. Particular intake concerns may trigger specific directives, such as medical or social care assessments. Throughout the admission process, the patient’s home medications must be checked and placed in the HIS. Checks within the HIS will run all medications through the pharmacy to check for any interactions or adverse effects with prescribed medications. Every collected piece will be analyzed to see how patients respond to other medicines or therapies. Such insight will contribute to better patient care and treatments.
An EHR in an HIS enables nurses and doctors to better organize themselves with patient information and to interpret the information for care quality planning. For example, every patient had a paper chart prior to the shift to EHR in which the patient’s notes were handled by all members of the healthcare team during the day. Lose sheet pages in the diagram could lead to lost or incomplete patient care records. All patient information can be used electronically to communicate between healthcare providers and to inspire the quality of healthcare through coordinated information sharing.
Benefits of HIS to the Organization
Measures to boost consistency (Quality Improvement Measures)
We now have certain benefits through HIS introduction, and in particular through the electronic health record. Specific health and security indicators can be monitored when attention is needed to alert necessary healthcare providers. Why do we support our hospitals as nurses to assess what we do with our patients? How can we control the processes that function or not? The NDNQI (National database of nursing quality indicators) maintains a statistical base that includes clear facts to justify all interventions to increase the standard of treatment for our patients (Xiao, 2014). The NDNQI monitor’s indicators for patients like patient falls, the prevalence of ulcers and pain assessment and re-evaluation, urinary tract catheter-related infections, and central line catheter-related infections of the bloodstream. Besides, the NDNQI tracks information relating to staff, such as R.N. training and certification, R.N. satisfaction, and the vacancy rate for nurses. It is necessary to review and model the sepsis screen and stroke screen per change to meet NDNQI specifications. There is also a policy of evaluating pain at any time and taking pain medication within an hour. Every four hours, we test every patient with a urinary catheter for any symptoms that could infect the urinary tract. The HIS would allow the data monitoring and analysis facility to detect any needs or patterns. Identifying individual patterns will contribute to legislative improvements and will enhance health treatment and outcomes.
HIS also collects data using a Patient Safety Index (PSI), which ‘reflects potentially avoidable safety events for improved patient care (IQI), ‘including mortality indexes, use indicators, and volume indicators for key hospital assistance procedures. HIS is also the only way to collect data (Williams et al., 2016). The hospital quality indicators look at items such as cesarean delivery rates, cesarean birth, acute stroke mortality, and coronary artery bypass graft volume. These IQIs can help in the identification of possible problem areas. The data collected from the typical hospital discharge provides the facility with an insight into the quality of care their patients receive. The PSI aims to improve the quality of health treatment by identifying possible risks, specifically when the individual is subjected to medical services. Indicators for patient safety include the use of surgical items, sepsis, postoperative bleeding or hematoma, and central line infection related rates. The HIS monitors and alerts the users/manufacturers to these monitoring controls to resolve the problem to provide safe and consistent treatment.
In conjunction with other services, the data gathering for each of these standard acts is benchmarked. They can be used by the public when looking for an institution for their particular health needs.
How HIS meets HIPAA and HITECH Security standards
E-Patient Health Information (E-PHI) protection is a priority of any facility. The acronym HIPAA refers to the 1996 Health Insurance Portability and Accountability Act. This act shall define the protection specifications of patient documents such as electronic medical reports and identified health details. This has five parts or “titles,” but the one concerned with health records is Title II, which “changes authority to create national health sector requirements for online transactions in the U.S. Department of Health and Human Services (Wang & Li, 2014). Healthcare organizations will also maintain online access to health records to continue to cooperate (Greevy, 2017). HITECH stands for Economic and Clinical Patient Services Information Technology; it became legislated in 2009 and concentrated on the electronic health report and its use and protection.
The data storage integrity guidelines are focused on the Security Rule, which refers to EHR physical, administrative, and technical safety. This law outlines the regulations but does not provide concrete steps to comply with the service. It is very important to verify that EHRs are secured by their development, reception, shipping, storage, and privacy (information not altered or destroyed). The implementation will therefore take action to protect against risks and results to be reasonably planned (Alshamari, 2016). Safety should be enforced, and the facility shall ensure that staff complies with the regulator guidelines to prevent improper use or exposure. The facility shall set down strict rules and procedures to avoid, identify, handle, and fix all security breaches and preserve data from inaccurate modification or degradation to satisfy its data integrity requirements.
Another critical aspect of a patient records network is computer retention and recovery. The principle to protect such data is that a system preserves backup data in various ways, including physical methods, like tapes and a storage cloud, at least three separate backup versions in two different medium forms and at least one other reserve (O’Dowd, 2018). The patient health care records will be backed up in compliance with clear protocols and procedures to guarantee that the information is held secure. A reliable network (host) should be used for storage to avoid threats against data obtaining a virus or malware. The majority of vendors provide substitution and recovery processes if the facility uses them. Backup and recovery systems are independent but operate jointly to ensure that the data is impaired with minimum downtime (Wu, 2014). The program needs to consider the data produced or frequently accessed (such as EHR documentation) that may need more regular backups. Older records can simultaneously be backed up on a less often basis.
Every healthcare system must rebound from unexpected circumstances that might jeopardize HIS. The operations of a hospital are always up to patients and staff. When there is downtime, the order must be re-established with minimal stationary interruptions as quickly as possible. Recovery is given with a broader fault window in an office or ambulatory environment. In case of a system-wide failure, any facility covered by HIPAA needs a contingency plan that will allow for continued access to PHI (Williams., 2016). The preparations will also include an emergency management plan, a computer retention plan, and a disaster recovery plan. Throughout the recovery phase, the current device data backup should be used, and downtime processes should be held to a minimum if necessary.
How HIS Protects the Patient’s Privacy
Confidentiality of patients and privacy are essential aspects of quality care. Personnel education by Health Care modules or in-person education days can cover security breach prevention measures, HIPAA regulations, ethnic responsibilities, and the reporting process for breaches or non-compliance. Annual training is necessary and mandated by law for all workers to protect patient privacy in the EHR.
The Patient Privacy Act and the 1996 set of standards are protected by the Health Insurance Portability and Accountability Act. The law permits people to ask if their confidential medical history is recorded, electronically or verbally. (Wu, 2014). The legislation provides the latest scientific history, which advises about specific procedures for patients. HIPAA requires a practitioner to reveal details about the patient to families or associates in the case that an individual is unaware, whether the nurse believes it is in the patient’s best interest or not.
Significance of incorporating HIS into production systems of an Organizational
Enquire every nurse for their least favorite part, and most of the time, documentation is the answer. Nevertheless, things have changed a bit with the introduction of the electronic health record. The EHR enables structured details to be generated using models and flowsheets to project the outcomes within a given limit, which will significantly reduce the time needed for mapping and increase employee efficiency. The principle of standardizing documentation and introducing an EHR would guarantee that all patients receive reliable and efficient quality treatment. The organization can benefit from standardization, as every healthcare provider uses the same tools, documentation sheets or directives (Alshamari, 2016). Using the same language in EHR facilitates improved interdisciplinary communication and increases the probability that each patient has positive results. Any nurse who admits or discharges in, for instance, the New York Trauma Center has the same sheets and screens for admission or discharge includes a set of queries, tests and information for each patient, to be sent each time.
Implementing an EHR would increase performance and profitability by waste reduction. Nurses documented everything on paper before switching to electronic charting systems. There was no cost-effectiveness in the amount of paper waste each day before the computer graphics. The system’s ability to code and diagnoses ICD 10 offer another advantage of an EHR in terms of waste reduction. The ability of the EHR to code appropriately determines how much the services are reimbursed. The EHR should ensure that double diagnoses are not made and that providers enter a suitable code to increase revenue. The EHR can however benefit from reports running and customized billing to provide an accurate bill for patients and their insurers.
Not only does the patient staff benefit from the introduction of a program, but it may also support the managerial positions of the hospital. There can easily be more than 750 staff at each hospital, for example. This would not be very time consuming and human resources important to hold all employee files on paper (Williams et al., 2016). The HIS section of the EHR focuses on the organization’s logistical and operational dimensions and roles, including financial ties. However, to implement a new program, the use of an EHR requires an adequate expenditure of personnel and training. While it might be expensive to start with the capital resources required to finance new equipment and computers, and personnel education, the efficiency difference over time would help with the EHR. Computer and software upgrades can improve productivity and interface at bedside and allow employees to spend more time on bedside with the patient.
Essential Stakeholders roles needed to form an interdisciplinary team
The Specialist in the development of EHR.
In order to implement the new EHR, the specialist supports dynamic knowledge and expertise. The specialist will develop a workflow in order to make the new EHR more effective. This stakeholder can provide practice suggestions and be a resource for all staff members to help debug and solve problems with the new system by configuring the system that provides details about what can be added and excluded.
Members of the clinical team
The clients who use the new program are doctors and nurses at the front line. Such people are end consumers and allies of their employees in the switch to the new EHR systems. These end users have input on the new system as they use the system for their everyday work. In order to facilitate the successful EHR transition, the clinical staff can suggest where a new system is sorely missing or must be more user friendly.
Nurses in the Department of Quality Management
Quality management staff are concerned with improving the quality and efficiency of all patients’ interventions and treatments while maintaining the organizational and legal specifications. These nurses examine all documents, in order to ensure they satisfy the requirements of the hospital and the patient, in accordance with paperwork guidelines (Williams et al., 2016). These nurses evaluate the completeness, clearness and concise nature of all standard assessments to ensure that all patients receive safe, effective and high-quality care. By ensuring that reporting complies with the corporate, federal and state required standards, the nurse will contribute to the effectiveness of the EHR.
The Super Users
These professionals are the employees who have been trained for the new system. Growing department will have several personnel available for troubleshooting or solving any problems or questions related to the use of the EHR at any time. Typically, super users are more knowledgeable in technology and enjoy IT. Super-users help ensure that the new system is confident and safe to all by fostering best practices and uses of EHR by their employees.
Plan for evaluating the success of the Implementation
A discussion should always commence with the implementation of a new system change. The Hospital Authority will be consulting with all workers directly impacted by the introduction of the new EHR about the latest transition. Discussions regarding the new system, for example, will begin several months before the actual date and illustrate the positive improvements that the new system would bring (Alshamari, 2016). The participation of all workers in the dialogue and making sure that all employees are conscious that a positive transition would minimize the fear of change and will therefore spread potential resistance to change. To make the transition to the new EHR seamless and effective, workers can receive crucial information during staff meetings about the new program and planned management training, prior to the shift.
The administration will start discussing the new EHR with all clinical staff before the new date with the new system. The new EHR system will provide tuition reimbursement and simulations to allow medical personnel to navigate the new software. In the preparation, the performance of the new program will be ensured by many scenarios and simulations of work flow.
The concept of an organizational standard must be understood in order to assess the success of the implemented EHR. Many health professional organizations promote IT programs and propose EHR specifications used to assess the overall performance of an HIS enterprise. For example, the ANIA, the Alliance of Nursing Informatics, and the Healthcare Information and Management Systems Society (HIMSS) provide foundation, guidelines, competence and strategies to deal with significant health issues, to name a few.
The ANIA has various organizational standards such as the inclusion in existing patient security efforts of EHR related patient safety initiatives and the improvement in the use of scannable barcode patient identifying a patient who uses them to administer medicines incident reports. An identification band with such barcode is given to each patient admitted to the hospital to help identify the patient and to ensure secure and high quality treatment during the administration of the drug (Hearld et al., 2014). The health of patients and measures of quality can be tracked regularly by means of Dashboard reports from the IT team. If the existing measurements obtained do not follow the expectations and requirements of the hospital, the nursing managers and the management may use the details to determine where the interaction takes place on the bedside. This provides the medical preparation and education that the hospital personnel need in order to ensure safe administration of medicines. Therefore, improvements and reductions in medication errors per month or quarter can measure the success of the implemented EHR.
Healthcare professionals can generate reports to determine whether the CPOE is successful and see a decrease in medication errors or double orders. This would be effective in the overall administrative functioning of the hospital as a result of the immediate entry of orders and records, through billing and coding.
Critical incidents for patients may be audited to assess the effectiveness of the program by quality control nurses. The Quality Team, for example, can report the number of falls per month, review health care documents related to fall risk assessments, implement interventions, and successful interventions to prevent falls (Hearld et al., 2014). If the system shows a decline, the system that allows nurses to intervene is effective.
The success of a transition is crucial for conducting surveys of personnel directly affected by the EHR system. Clinical feedback can provide an abundance of insight into the daily functions and the overall workflow efficiency of the new systems. The IT team can assist in synthesizing and analyzing if systems are successful or must be adapted so as to increase workflows through the collaborative efforts of clinicians and stakeholders.
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