Case study analysis and findings

¶ … Health Care Information Systems

Needs of both health care providers and patients must be addressed and all should be done in a confidential and accurate manner. The IT system should be designed so as to facilitate connectivity between the various departments, its diverse employees, and between the health system itself and external health systems. Only the information that deals with the needs of primary health care system should be included. This involves details of patients, details of their treatment; details of expenses and reimbursement; details of third party payers; details of hospital staff; details of medical equipment; clinical transactions; assessments; admissions; and so forth. The design objective, in other words, should be to increase information flow through integration, to improve patient care, to decrease mistakes, and to lower possibility of mistakes occurring.

Aspects illustrative of the way that a superior database can be designed can be glimpsed from the BIDMC case: BIDMC received the reputation and awards that it did due to its building a highly reliable network, server, and storage in an economical manner. Users had a common look and feel across applications that were primarily gained due to the cohesion and organizational structure of the implementation group. The clinical computing staff consisted of 250 medial and technical processionals who were divided into four groups. Each had his, or her, own specific tasks and all were skilled and knowledgeable in areas relevant to creating the database.

Emphasis of care, when designing the system, also concentrated on problems that had to be solved, not on the quality or recency of computer software systems per se. It was the usability of the program that the workers had in mind, as well as whether, or not, the system succeeded in making workflow easier and more effective.

Concentrating on these objectives and working in unison to predict and solve problems created a superior web-based healthcare system.

2. The critical problems that the healthcare information system should aim to eliminate are threats to security of data system, particularly of patients' names and details and of disease in connection with patients. Firewalls must be in place. Privacy, confidentially, and security must be indefensible. One of the main problems in designing an information database is that the information of specific fields (such as treatments in connection with a particular disease) often changes. Data values, too, (such as those accorded to a patient's treatment) may be, unintentionally, duplicated. Data consistency and stability must be ensured, redundancy should be kept at bay, anomalies should be eliminated, and maintainability and currentness of the database should be ascertained. Other problems include poor naming standards: labeling should reflect the subject and topic in order to aid usability. Each and every aspect of the system should be carefully labeled and all supported with sufficient documentations to clearly explain the concept.

More so, the system itself and designing of the system should be clear. BIDMC, for instance, revolved around the online medical record (OMR), which, itself was divided into two parts: 1. The one dealing with patient-centered information, 2. The other occupied with clinician-centered information. Each system was divided into specific tabs that were distributed amongst particular topics. Since the volume of data was enormous, only careful attention to the workflow and user needs could enable this system to work. Attention to the ongoing needs and environment and clarity of the design is important since the database must keep up with the most recent information on a regular and consistent basis.

For these reasons, too, all stakeholders must be on the same page, so for instance Markson's group had to wait for consensus from a certain department before building the software but this consensus resulted in a much safer, more standardized process.

3. Unique challenges that face this company. Are they different from challenges in other environments?

Challenges to this company might have been unique in that their IT system was homegrown and customized for their particular hospital environment. In this way, they had challenges that other companies may not have had, such as having to know when to halt implementation and which software packages to install.

On the other hand, even though they employed a vender for only a short time, they did not run the risks of security and infiltration in database that another company may have had. Possibly, too, devotion of their team may be ascribed to the fact that their system was home-grown.

4. Some of the key systems and IT initiatives that I would recommend to company

I would recommend tools that will improve the services that physicians and other health-care workers (including the nurses) are providing. Updated technology may include video conferencing, electronic records storage and informational webinars as well as forums, blogs, and a confidential system where patients and employees can drop opinions and recommendations for change. The hospital may also implement a means of keeping in touch with the public, and another system that would serve as its research base for conducting research on the hospital itself (e.g. surveys to monitor popularity of doctors or average wait time of patients for appointments). There may also be an outreach, education, and marketing guide, as well as outreach campaigns to help recruit and interact with health care providers and third party payers. Meaningful use, privacy, and security should be the buzzwords of implementation of these programs.