Health information technology project implementation and outcomes

Health Information Technology System

Hospital Information Technology System

Over the years, improvement of service provision within this medical institution has been of massive essence. This has led to the establishment of a number of measures to enhance service delivery one of which constitutes the development of a variety of information systems within the organization. The information technology system under consideration here was established with the view of enhancing operations within all the departments of the hospital. It covers the needs of all those who visit the establishment which offers both inpatient and outpatient services. This facility is a government hospital. Its stakeholders therefore include the state, the patients, the staff and other Non-Governmental Organizations who provide auxiliary services to the hospital among others. The number of departments within the institution and taken care of by this system are numerous and include; the finance, communication, records and housekeeping, laboratory, emergency, marketing departments just to mention a few.

Application of the System

This Hospital information Technology System is generally aimed to serve administrative functions. The system has facilitated the conversion of all the administrative services from the initial paper-based format to a more efficient electronic format (Shekelle, Morton & Keeler, 2006). The system helps in providing leadership, enhancing coordination of activities and ensuring the fulfilment of goals within all the departments and therefore the organization at large. all operations from the hospital that range from the admission of a patient within the hospital, creation and maintenance of a patients records, management of employee records, financial operations, communication and decision making within the hospitals and records management are handled within the IT System. By facilitating the administration of services within the hospital, the IT System has proved of benefit not only to the service providers and staff within the institution but also to the inpatients, outpatients and the rest of the stakeholders.

Rationale for the Implementation of the System

According to Suzanne Felt-Lisk, the fact that Information Technology in the Healthcare Sector gives institutions massive prospective in the improvement of their quality goes without saying. Information Technology generally fixes the gap that exists in service provision and goals accomplishment within institutions. These the feature does through, among other things, enabling healthcare institutions provide services that are safer, more effective and in a timely manner (Felt-Lisk, 2006). As such, the capacity to enhance quality and help organizations move from low quality service provision to an improved level of service delivery basically propelled the hospital to implement this system. The problems which existed with the initial system basically made the introduction of an IT system inevitable.

First and foremost, the manual system of administration was basically slow and this led to the loss of time unnecessarily, for the patients, the staff, the stakeholders and the entire institution (Shortliffe & Climino, 2006). Because of this, the facility failed to take care of the threshold number of patients, leaving many to seek medical services form other health care institutions. Further, the staff had to work overtime in handling all the patients who visited the organization. One cannot fail to mention the fact that the number of staff required with the manual system in place can sometimes be very overwhelming for institutions (Shekelle et al., 2006). Secondly, the manual systems provided very limited room for transparency and accountability from all the stakeholders to the hospital (Felt-Lisk, 2006). Considering the fact that the capacity for records managers to locate some records was limited by the system, most individuals took advantage of the system. As a result of this, the firm lost colossal financial resources owing to the capacity of the perpetrators to go free with the availability of the manual systems. Patients in some cases failed to provide appropriate information in respect to their health history and this in some cases led to inappropriate decision making and misdiagnosis for some of them. All the parties suffered some avoidable loss due to the unavailability of a system that would facilitate accountability.

The paper-based system also proved to promote insecurity especially as regarding the management of hospital records (Cummings, 2006). Although much was done to ensure that the records were safely placed in the records management department, nothing more would be implemented to ensure the ultimate security of all hospital records. In addition, no backup system existed to provide something for the institution to fall back too whenever loss of hospital information occurred at another point (Olmeda, 2000). Alleviating these risks demanded that a more sophisticated, efficient and workable system be established within the hospital. The implementation of IT Systems proved to be the only way of solving these problems which was to be achieved through the automation of paper-based records. Further, the organizations management realized that the system would do much more in reducing the bulk within the records management offices and other departments of the institution. By converting the data to electronic form, the organizations knew they would manage to not only create back up but also reduce on the space and equipment required to store information (Shortliffe & Climino, 2006). Generally, the Information Technology System gave hope for the organization in enhancing all operations within the hospital, facilitating decision making, saving costs and ensuring efficiency.

Deciding on the Implementation of the System

The decision to implement the Information System within the Hospital environment did not happen in a vacuum as some serious considerations had to be made by various stakeholders within the organization. Various criteria we reemployed on settling for the decision that the hospital specifically needed an Information System for administrative purposes.

The problems and inefficiencies brought about by the manual system was the first trigger for the idea of the implementation of the automated system. In spite of the fact that the paper-based system served to aid in the administrative roles of the organizations, the results were sometimes unimpressive owing to the inefficient nature of the structure. Owing to this need, the organization sought to find an alternative for the system and with this, the idea of automation was born. Following this conception, the organization, through a number of channels conducted research on the viability of the Information Technology System. Irrespective of the availability of some opposition, with respect to the cost of implementation of the system, the research results widely commended the implementation of the automated system within the health facility.

A very large percentage of the stakeholders had also initially voiced their concern for the limitations posed by the manual systems. Most of them advocated for the automation of the administration systems for the benefit of all who played a part in the on goings of the hospital. Evidence provided by other organizations, especially the healthcare providing institutions also propelled the organization into implementing the IT System. These organization provided testimonies on the advantages and benefits they derived from their Information Technology Systems and how establishing such structures would be good for all future focused organizations (Shekelle et al., 2006). All these considerations coupled with the ever increasing popularity of Information Technology left the institution with no other choice but to go forward with the implementation of the idea, a decision which has to date provided great benefit for the hospital.

System Management and Stakeholder's Input in the Implementation

The mere existence of the system within an organization doesn't qualify for its absolute efficiency (Shekelle et al., 2006). Because of this, various professionals are required to ensure the functionality of the system besides working with it to achieve the goals established within the organization. Management of the Information Technology System within this organization has been significant in ensuring the efficiency and productivity of this. Much of this management role has been assigned to the hospitals Systems Administrator together with his team. Among the roles played by this team include; the introduction and integration of the system into the hospital environment, addition, removal and providing updates for user accounts, undertaking regular analysis of the system and finding out possible problems with the system and maintaining the systems network (Cummings, 2006). Other roles include, troubleshooting the system, performance tuning, provision of answers to system-based queries, facilitating system security, system documentation and conducting performance audit (Fischer, 2000).

Also of significance is the input of the various stakeholders in the development of the system. Close to all sections of the hospitals stakeholders provided resources necessary for the development of the system. The staff and some end users instigated the birth of the idea after voicing their concerns over the inefficiencies posed by the manual system of administration. The hospitals management, the government and other Non-Governmental organizations facilitated research studies on the need and possibility of implementing the Information Technology System within the health care facility. The same group also served to mobilize funds and other necessary resources for the commencement and continuity of the project once it was given a go ahead. With respect to research, the end users served widely in providing information to the field researchers who sourced ideas from them. The end users provided much direction on what was to be included in the system.

User Training

Information Technology, though not a very new concept in the contemporary world is considerably technical. This means that users of the systems associated with this feature ought to have substantial knowledge on them if they desire to be successful in using them (Cummings, 2006). Putting this element into consideration, the organization embarked on a training programme for the potential users of the system following the automation. Both the staff and the clients to the facility were trained on the use of the system. The hospitals Information Communications Technology Department facilitated this training.

Lessons were provided for users in sessions and this included both theoretical and practical training. Different end users were trained in accordance to their needs and privileges on how to use the system. The top management for instance was trained on among other things, accessing the system, retrieving public and private information and enhancing privacy of sensitive information. The records department staffs were trained on how to create, update, access, secure and retrieve records. The patients were trained on how to access their personal records and how to create passwords for their accounts while the Systems Administration Staff were trained on how to maintain the systems and how to trouble shoot reported problems among other things.

Ever since the inception of the incorporating information technology into the healthcare system, all staff had to be trained to ease the transition from pushing paper work back and forth into currently using a computerized approach into their daily business. Paper work was very tedious and time consuming; information was easily lost, misplaced or switched by mistake. However, all that changes with the use of computers that will help doctors and staff working in hospitals to collect patient information, store it, easily retrieve it in future when needed as well as facilitate smooth transfer of patient administrative and financial information to different hospitals and insurers alike. The staffs hence, have to be trained with advanced IT programs being introduced in hospitals and made mandatory for all medical practitioners. Knowledge of computer application is certainly the foundation, but the techniques of how to key in patient details, store them in separate files and facilitate interoperability was key in patient training. Doctors, nurses and administrative department working in the medical department were trained on using computers and avoid using papers to do their work (Bau 2011).

The inception of this technology in the healthcare system did not go without a few worries over the security of patient's vital information. Patient details are usually confidential and consumers feared that unauthorized access could lead to a leak of vital confidential information regarding the patients. It is for these reasons that an IT department was set up and advanced in every hospital to put up firewalls and make it difficult for outside to access the hospital database from outside. All computers within the hospital had to have security codes that were only given to the attending nurses or staff. The codes were changed with every shift making only the attending nurse to know how to access the computers. The name of the attending nurse was also registered when she or he logged into the computers as well as the duration spent and the information accessed. Legally speaking, all information given by a patient is recorded in the computers and is not changed. This prevents bias of patients when giving their financial or medical information. It reduces cases of legal suits based on negligence on the doctors. Hospitals have proof that they acted in accordance with the information given by the patient and are not liable (Bau 2011).

It was with increased concern on how the economy had become computerized while other important sector such as the healthcare system was forgotten. Analysts indicated that the government could save up to $81 billion annually if they adopted a more comprehensive approach of integrating IT into the system. Initial funds came from the National Conference of State Legislatures who spear headed the project. Most of the funding came from the government where in 2004; president bush initiated the President's Health Information Technology Plan. It was a ten-year plan that would provide funding to the project while make medical information open to the public to facilitate sound medical and economic decisions. Billions are channeled into the healthcare system by both the state and federal government to improve the quality of healthcare system in the country. Non- profit organizations also play an important role in funding underequipped hospitals in the suburbs to promote the use of IT in the hospitals (Pipersburgh 2011).

Annually, a budget on the amount of money to be dispersed to the healthcare system is drawn up by the government and released in intervals during the year. Hospitals are responsible for the management of the money given to obtain supplies, pay electricity bills, pay wages to hospital staff and keep the hospital running. It is the work of the hospital administration to take care of all the financial requirements of the hospital. The Agency for Healthcare Research and Quality is in charge of managing the budget drawn up for the health information technology project. They review how much hospitals per district will need in terms of buying equipment such as computers, putting up an IT department as well as upgrading and servicing the computers in the hospitals. The National Coordinator for Health Information Technology, office of the U.S. Department of Health and Human Services is in charge of overseeing the yearly budget laid out for the health sector and ensuring that it fairly distributed to all the districts in the country. The office looks at the budget provided by all the states and has the power to propose a review state legislation if the budget provided for the healthcare department is not enough (Lenert & Sundwall 2012).

The National conference of State Legislatures has played an important role in the support of this program. Motions in the house of congress have been passed to promote the inception of Information technology in the healthcare system so as to save the cost of receiving medical care. The move seemed to be expensive by legislatures went with it as it would in the long-term improve healthcare in the country and make it cheaper for citizens in the country to receive treatment. Various profit and non- profit organizations have promoted the project and provided funds to various hospitals to make it possible to hire IT staff and purchase computers so as to eradicate the use of papers in hospitals. The federal government proposed a stimulus package for the states and made the incorporation of information technology be mandatory in all public hospitals (Pipersburgh 2011).

Downtime in IT refers to the moments when the system is slow or unavailable. It can either be planned or sometimes unplanned. When such an event occurs, customers are unable to communicate with the hospital while the productivity of employees in the hospital is reduced because the whole hospital is controlled by the use of computers. When there is a system failure, it becomes very dangerous because patients can die or suffer in the process. To manage downtime, hospital management needs to run the system regularly for viruses and ensure that the system is working as required. The computers over time need to be serviced or replaced with newer models that are faster and more advanced. The quicker patients can be attended to the quicker a life is saved. An IT department is set up for monitoring the system 24/7 to ensure that nothing goes wrong and in the event that something goes wrong, the IT staff needs to repair it in the quickest time possible (Jaen 2011).

It is not enough to incorporate the use of IT in the healthcare system, but regular monitoring is necessary to ensure that operations within the hospital run smoothly. The mainframe system in the hospitals needs to be maintained and upgraded with new firewalls regularly. Hackers are coming up with new ways of hacking into computers and the firewalls need to be advanced to ensure that unauthorized access is restricted. The IT staffs go for governnemt sponsored training on new ways of maintaining the system in the hospital, how to detect hackers and how to monitor the performance of the system to ensure it is working at its best. Outsourced IT firms are hired by the government to visit hospitals every three-month to check over the efficiency of the computer system in hospitals and update them when needed (Jaen 2011).

The healthcare reform involved a number of government policies meant to improve the delivery of healthcare in various places in the country. The reform policies were meant with a number of debates over its fairness, quality, access, the amount of money the governmemt would have to spend and the right of every individual to receive healthcare. Receiving treatment in U.S. hospital is very expensive taking a significant portion of the country's GDP, putting U.S. To be the one of the most expensive countries to receive healthcare delivery. The Health information technology would go a long way in reducing the cost spent by the government, saving between $81 billion to $162 billion annually. This money could be channeled into other sectors of the economy to improve the welfare of the people. New legislations would be proposed in a bid to promote IT in the healthcare system. More funds will be channeled in the project across hospitals all the country (Clancy & Anderson, et al., 2009).