Introduction
The introduction of technology into the healthcare industry has many benefits for providers and patients alike. However, the process of implementation may also bring some problems if a healthcare organization does not account for various regularity requirements or fails to conduct a thorough analysis of its structure. This report assesses the advantages and disadvantages of installing a health information system (HIS) into a recently merged healthcare firm, focusing on its impact on patient care and privacy, organizational efficiency, and its adherence to the HITECH and HIPAA requirements.
HIS Analysis
System Advantages and Disadvantages
HIS is a system that helps healthcare organizations manage their operations, including the storage of patient history, test results, and prescription requirements. It is structured in a way that allows all levels of administrative and medical personnel to access required patient information from a variety of devices such as tablet computers and smartphones (Wager, Lee, & Glaser, 2017). This system can result in positive and negative outcomes in four ways. First of all, the usability of HIS can be defined as an extent to which physicians and the staff can use the system during their work (NIST, 2017). For example, HIS can help speed up the admission process. However, the low usability of the system may disrupt the workflow of the staff if employees are not trained properly.
Second, interoperability – the ability of connected devices to exchange and interpret data, can impact the success of the implementation. HIS can have high interoperability and can be used on different types of devices simultaneously. However, this aspect depends on the program itself, and some other applications may not be fully compatible with the installed system. Thus, low interoperability may lead to disruptions in the working process, causing data loss or misinterpretation. For instance, the staff may not understand information because of the way it is presented on all devices.
The third aspect is scalability, and the ability of the installed system to support information exchanges and store large data quantities, use a variety of devices without sacrificing the speed of operations. HIS can have high scalability if the organization invests inappropriate options such as wireless technology and cloud storage. High scalability may be useful for large companies. Nevertheless, it may be more expensive to pursue such flexible systems. On the other hand, low scalability may result in devices working slowly to retrieve data and the hospital being unable to have all vital information about patients ready for use. Scalability may also affect other factors, as both usability and interoperability may benefit from fast speeds of data transfer and expanding cloud storage.
Finally, the compatibility of HIS is another important factor that needs to be considered prior to implementation. High compatibility implies that the installed system will operate together with other programs such as the electronic health record (EHR) and clinical decision support (CDS), allowing healthcare workers to use the gathered information for other useful applications (Najaftorkaman, Ghapanchi, Talaei-Khoei, & Ray, 2015). As a contrast, low compatibility means that HIS will not operate with other programs, making the system very limited in future opportunities and lowers the possibility of future innovations. Thus, high compatibility is a definite benefit of the system. It should be noted that all workers engaged with these systems have to be properly trained because their lack of understanding and skill may negate all benefits of HIS and turn them into barriers.
Impact on Patient Care and Documentation
HIS will significantly affect the organization’s documentation and patient care. First of all, as a result of a successful implementation, the amount of paper-based documents will decrease as most information and records will be digitized. This means that the amount of waste will be reduced as well, including not only paper but also other supplies that were required for writing. HIS can replace patient records about previous history and prescriptions along with administrative documents needed for admission. Thus, the speed of patient care may increase as the standardized procedures will be digital. All documentation, being stored in digital form, can be sent to other specialists, pharmacists, insurance workers, and patients themselves, possibly improving communication between stakeholders.
Nurses and clinicians will be able to access the same information for one patient without the need to explain any details, guaranteeing fewer mistakes in the process of care. Furthermore, as HIS requires all data to be entered in a particular way, the possibility of errors also decreases. Thus, all documentation will be stored in one place, accessible to all important stakeholders. Paper-based documents may be eliminated completely with time, providing all healthcare specialists with a unified source of information that does not produce waste or requires personal meetings and unreliable and unsafe ways to transport documents.
Changes in Quality of Care
HIS can provide health care workers with all relevant information about patients. This system collects data about administrative processes and patient care, allowing specialists to update it if necessary (Wager et al., 2017). For example, nurses may access patients’ test results and include new ones, which the system can compare to show the changes. Then, physicians may see this updated information almost instantly and use it to guide their work. Similarly, pharmacists will get access to the part of data that is needed for the patient’s prescription, seeing new requirements, not from other sources but the same place as other providers. Thus, the quality of care will increase, as all healthcare providers are receiving the same high-quality, trustworthy information.
The characteristics of HIS mentioned above show how this system may impact patient outcomes. As nurses and physicians will use the same source of information for their activities, the possibility of mistakes during treatment will decrease, reducing the rate of adverse outcomes. Moreover, the level of misunderstanding among different employees may also be lowered as a result. Two nurses working with the same patient will not get access to various documents with unclear wording or missing test results. Moreover, procedures will be less likely to be done twice because each one will be recorded by the system. The protection of data is another possible outcome that guarantees patient safety. As digital documents will be stored under the protection and accessed by essential personnel, other workers will not see a patient’s personal data. If all nurses are adequately trained to use HIS in the workplace, the quality of care provided by them will improve.
HIS Benefits
Quality Improvement
The existence of all patient data collected in one place can help the organization to produce reliable reports with statistics and measurable characteristics of activities. For example, quality improvement (QI) information about the speed of the admission process may show how many staff members are working efficiently and what can be done to bring everyone to the same level. As a result, the admission time may be improved, serving more patients every day. This outcome can also lead to higher patient satisfaction levels, a better status of the organization, and fewer complaints about slow or ineffective procedures.
Another way for the organization to use QI data deals with patient outcomes and preventive care. For instance, if HIS records such measures for patients as regular screening or testing, a staff member may monitor these reports daily or weekly and contact patients to remind them about the upcoming procedures. Thus, patients’ rate of readmission and their overall health may become better if they do not forget about regular check-ups. Furthermore, they may be diagnosed and treated in time, leading to better patient outcomes.
HITECH and HIPAA Security Standards
In order to meet the requirements of the HIPAA and HITECH (Health Information Technology for Economic and Clinical Health), the system has to protect patient data. The Security and Privacy rules included in the HIPAA (Health Insurance Portability and Accountability Act) reflect the necessity to keep data confidential, safe, and accessible to certain personnel only (Lord, 2017). According to the Act, all information received, created, or transmitted by the organization has to be protected from identifiable threats, including breaches and disclosure (“Summary of the HIPAA,” 2013). All employees must comply with the rules. Unauthorized persons cannot have access to confidential information. To keep data safe, the organization must install and maintain security measures such as firewalls, passwords, and physical barriers to information and assign a security official to be responsible for these procedures (Lord, 2017). The organization’s staff has to be trained to use HIS appropriately.
A data backup plan can rely on portable media storage devices (DVDs or CDs) or other storage systems. All information has to be backed up regularly, including older versions of saved data and storage located inside and outside of the hospital (Lord, 2017). The organization has to ensure that data will not be lost during accidents. For this purpose, a disaster recovery plan and an emergency mode operation plan have to be developed. These plans can be considered as compliant to the HIPAA standards if they include a description of all actions that need to be taken during an emergency and a list of specialists responsible for them (Lord, 2017). While these guidelines do not provide a detailed explanation for creating this plan, it notes that all recovery procedures and data transfers also have to follow the privacy and security standards mentioned above.
Patient Privacy
An installed system that follows all security requirements will be able to protect patient data from unauthorized use. Its limited physical access to information, along with digital protection, will keep the data safe from other hospital visitors, organizations, and non-related personnel. While paper-based documents can be lost or stolen, adequately protected digitized data will remain secure as it does not require transportation from one place to another. The system should be encrypted and shielded with a firewall to maintain information integrity. That way, personnel will be able to use data of only those patients with whom they work.
Organizational Efficiency
The implementation of HIS can benefit the effectiveness of the organization. First of all, the amount of paper-based documentation will be highly limited, reducing waste. Additional materials and office supplies will become unnecessary, leading to higher financial savings. Moreover, the digital system will store information in a standardized way, decreasing the possibility of misunderstandings and errors. Thus, nurses and physicians may notice an increase in productivity as they will know which information is available to them at any point in time. The introduction of HIS will require personnel training, which will result in nurses and administrative personnel becoming acquainted with computers, increasing the status of the organization. Employees may feel empowered to use the latest technology and express more satisfaction with their job than before.
Standardized documentation introduced by these systems will simplify processes requiring paperwork, giving the staff forms that can be filled and processed quickly. Furthermore, HIS is a direct investment in the hospital’s capital resources, including devices, software, and storage. As this system can have many benefits for the quality of care and worker’s efficiency, it can also optimize the use of other capital resources: equipment, property, and programs. For instance, data analytics can show which facilities are underutilized and can be repurposed or improved.
Stakeholder Roles
In order to work on the system’s implementation, four essential stakeholders have to be considered. First of all, the financial side of all operations needs to be handled with the guidance of the Chief Financial Officer (CFO), who can locate available funds and decide which technological decisions are accessible for the organization. CFO’s expertise in financial operations and available capital resources will provide a foundation for choosing the best option. Next, medical department leaders will play a significant role in the process of implementation by engaging personnel and collecting feedback from employees. Their practical experience may show which areas of integration are more successful than others, as they will create regular reports about the staff’s progress.
Third, nurses and clinicians can also significantly affect the outcomes of the system’s installation. Their professional knowledge and level of technical literacy skills may accelerate or hinder the process, as they will be the ones to operate the installed system. Finally, the designated security team and its appointed official are directly connected to the procedures of HIS installation. This group of people will introduce the system to other employees and maintain its integrity and security at all times. Their expertise should include the knowledge of the HIPAA and HITECH standards and ways to ensure compliance to make the system effective and safe.
Evaluation
After the system is implemented, it has to be assessed according to professional organization standards. To support the process, guidelines from Mercy Hospital are taken as an example. First of all, according to the standard of ethics, the system has to preserve a patient’s confidentiality by securely storing the information. In this case, one can measure this aspect by comparing the rate of information mishandling before and after HIS’ implementation. Secondly, the standard of quality of practice can also be used, as HIS will require nurses to document all information in a standardized way. The progress of the implementation can be measured by the rate of mistakes that nurses and other personnel make using HIS and their computer literacy.
Conclusion
The implementation of HIS is a complicated process that needs resources and collaboration of all employees, including medical, administrative, and managing personnel. However, although the process of introducing it may be challenging, the benefits of a computerized system are plentiful. HIS may increase the company’s efficiency and influence patient outcomes positively. By following the HIPAA regulations, the organization can ensure that patient data always stays secure and confidential. HIS is a system that is essential for a clinic if it wants to remain relevant in the field of healthcare.
References
Lord, N. (2017). What is HITECH compliance? Understanding and meeting HITECH requirements.Digital Guardian. Web.
Najaftorkaman, M., Ghapanchi, A. H., Talaei-Khoei, A., & Ray, P. (2015). A taxonomy of antecedents to user adoption of health information systems: A synthesis of thirty years of research. Journal of the Association for Information Science and Technology, 66(3), 576-598.
National Institute of Standards and Technology [NIST]. (2017). Health IT usability. Web.
Summary of the HIPAA Security Rule. (2013). Web.
Wager, K. A., Lee, F. W., & Glaser, J. P. (2017). Health care information systems: A practical approach for health care management (4th ed.). San Francisco, CA: Jossey-Bass.