Health Information Management System: Sohar Hospital Coursework

Introduction

According to Sadler and James, the world is experiencing rapid advancement in information technology; the developments have been implemented in profit and non-profit making organizations; Sohar Hospital under the Ministry of Health, aims at offering quality medical services. In the efforts of improving its processes, the Ministry of Health decided to adopt a health information-management system (HIMS).

When implementing the system, the hospital considered some factors likely to affect the implementation of the new information management system. Health information-management system (HIMS) is a computerized system used in medical facilities to facilitate the flow of data and information within the organization for fast and effective decision-making.

The system handles both patient information as well as general medical facility information (Sadler and James, 2003). This paper discusses the factors that were considered when implementing a health information-management system (HIMS) at Sohar Hospital.

Brief history of the hospital and the need for change

Sohar Hospital was established in 1997 as facility of Oman Medical College; the hospitals aim at improving the welfare of North Batinah Region (from Suweiq to Shinaz) through research and development in the medicine industry. The hospital situated inside the college; it aims at offering students better learning as they practice medicine in the hospital.

Since its incorporation, the hospital has been operating a manual record and information keeping system; however, after considering some factors, a decision was made to adopt a computerised information management system.

In health facilities, the use of technology has taken center-stage in the efforts of improving quality, timely, and accurate medical services. Areas that information technology has been adopted include record management and information management; patient’s information has also been computerized

Overview of Factors that lead to the change

Information in a medical facility is of crucial importance, management of information at Sohar Hospital is a priority of the management, however before the implementation, and there has been case of misleading information and delay of service delivery with lack of information being given as the answer.

The computerization was aimed at improving service delivery in the facility; it aims at improving the current conditions by developing information management systems to enhance service delivery (Carr, Hard and Trahant, 1996).

Change management is a process where the management learn, understand and critically think about alterations they are supposed to make in an organization so as the general performance of the organization is improved (Newman, 2001). In the case of medical facilities, changes are aimed at improving service delivery and improvement of general welfare of the communities.

With the invention of computers and information technology, software’s that can manage information, has been developed. When adopting such systems, then there will be new methods of handing, keeping, collecting, interpolating and retrieving information.

The new system will involve the use of computer hardware and software. To translate effectively from traditional information management systems to computerized systems, medical facilities need to adopt an effective change management policy (Newman, 2001).

According to Armstrong, 2008, change is undertaken for different reasons, depending with the nature of change and the organization involved. The following were the reasons why the change was effected at Sohar Hospital:

• Improve current working condition and strategies
• Adopt a different way of doing things; this would increase service delivery at Sohar Hospital
• Make new combinations of resources in an organization
• Adopt new technology, that could handle information more effectively and efficiently
• Change of business, target market, production formulae, management, job schedules, job description among others
• Have a different human resource management system, computer system among others (Hiatt and Creasey, 2003).

In heath facilities’, the sole aim of the change to be discusses is to have an effective information management system and ensure that, technology has been used to facilitate provision of quality services.

Health Information management system (HIMS) Change management policy

Before Sohar Hospital adopted a health information-management system (HIMS), management had to understand that the system could only succeed if the employees are positive about the change. This calls for gradual process of implementing the change. The facility’s culture is one of the factors that can affect the change negatively or positively. The change agents should understand this well before implementing the change program (Hayes, 2010).

Sohar Hospital change management program had the following objectives:

• The strategy ensured that the change to be implemented was adopted in the minimal time possible; the system ensured that members of staff would embrace the system and be willing to work with the new system.
• To ensure that during the time of transition, services within the medial facility will not be adversely affected. During this time, the hospital should enact policies that will facilitate continued quality service provision (Kotter and Schlesinger, 2008).
• The strategy ensured that the process had been supported by every member of staff and the issues brought about by the system looked into.
• Management of information regarding the changes; change involves a lot of communication and educating of staffs of the new system and way of doing work as it is expected to be done (Drucker, 1983)

Sohar Hospital Change management strategy and procedures

The change as adopted by Sohar Hospital involved three main stages they are:

Phase 1 – Preparing for change

Under the phase, the most important functions that were undertaken were preparation, assessment and development of the best strategy to implement within the medical facility. Health Information management system (HIMS) systems come with different functionalities and can be adopted for a number of uses. The facility should take enough time and consider experts input on the right system to implement (Kanter, 1983)

Planning factors

When Sohar Hospital decided it would implement a health information-management system (HIMS), then change agents were developed to pioneer the process. They were mandated with the role of analyzing the current situation in the organization and devising the best health information-management system (HIMS) tool to implement.

The staffs likely to be affected by the system and top management were given detailed analysis of what the organization want to do. At this stage the management brain stormed the effect of the program with the employees and let the employees learn how they will be affected (Bandt and Haines, 2002)

The preparation stage seeks to get the general approval of the management after understanding the change to be effected. Other members of staffs not directly affected by the change may get some hints on what is likely to happen (Wheelen and Hunger, 1998).

Internal factors analysis

At this level, the change agents were actively involved in assessment of the current business operation; so as they can establish the main areas that need to be targeted. When a new system is being implemented, there are chances that the normal operation of business will be affected (Mintzberg, 1989).

However, a well though change system should be planned in a way that medical services will still be offered as the change process is in progress. For this reason, the implementation team analyzed the current system so that they can know the areas that need to be initiated and those that can wait.

An effective plan is the one that will translate the business to the new system at the minimal time possible. The best strategy will not destruct normal operation of a facility (Bruce and Fottler, 2005)

The cost and the duration that the process is likely to take were assessed and the management and the people were prepared in good time to embrace the change coming to the organization. The project was operation like a project; there were periods set and performance indicators developed.

In Sohar Hospital, the members of staffs are both medial and support staffs, when a health information-management system (HIMS) is implemented, it is likely to affect the operation of all the sectors. For example, nurse and pharmacists were required to key in some data and the information and technology department maintains the system (Conway and Briner, 2005)

Strategic factors considerations

At this stage, the change agents had information on the change that needed to be implemented, the operation of the current system and the impacts that the change was likely to bring to the operation of Sohar Hospital; the change agents are line managers and outsourced system experts (Garengo, Stefano and Umit, 2005). After taking time and pondering over the issues, the change agents chose and implemented the best alternative.

At the initial stages, a lot of support of the decision was required to ensure that the whole organization or the departments concerned have adopted understood the change structure effectively.

It is not always that a decision made bring the expected results; thus, feedback from the people on the ground and the general performance of the business should be considered, so as areas that needs special considerations recognized. In-case an area that needs improvement has been recognized, it should be addressed appropriately (Garengo, Stefano and Umit, 2005)

The best strategy adopted addressed the monetary, time, space and delivery procedure that the change took. In the case of health-information management system (HIMS, the team ensured they had gotten the right place to acquire hardware and software for the exercise, they had all policies and strategies that they aim to attain set out clearly and precisely (Eccles and Nohria, 1992).

At this stage, the change agents took the first general sensitization exercise, up to this point, the member of staff not directly affected by the change, did not have adequate information about the change, all they were aware of is that the organization is aiming at developing a new system (Abdelhak, Sara and Hanke, 2011).

At this first meeting, the Sohar Hospital management had the role of explaining to the members of staff on the change to come. The staffs were explained on the effect that the change would have on their careers; they were allowed to ask as many questions as possible and allowed to offer their views.

After the meeting, the change agents gave the organization time to settle. During the “settlement” period, any fears raised by employees were addressed accordingly. It was also expected that as staffs discuss, they would come up with more issues that need to be addressed. The change agents were in the forefront addressing various issues as raised by staffs (Legge, 2004).

After addressing the issues of concern at individual and departmental level, a final meeting was called for to air out any doubt or clarify any issue that the member of staff feel was not addressed appropriately during the previous meetings. The meeting opens up to stage two.

Phase two: Managing change

At this stage, Sohar Hospital medical and non-medical staffs were psychologically prepared for a change, the staffs were waiting the new move and the resources for the change process had been mobilized. The stage has the following activities:

Implementing the change and system

The management team did put-up the hardware and software that the facility was adopting; health information-management system (HIMS) is a computerized system that calls for massive training of staffs. The system was first implemented in an “artificial” internal environment where the staffs were trained at a similar environment.

Training was gradual and involving all the staffs who would work directly and indirectly with the system. The training was allocated maximum time since the success of the project was dependent on how well the staff grasp the operation of the system. This also offered the employees the time to have a hand-on experience on the new system.

They learnt more about it and made improvements on areas that might have been overlooked when the system was being developed. If the program is seen as a better one, then the final stage of implementation is done. In this stage, the manager should gather all relevant data and facts (Stephen and Timothy, 2010).

The system was likely to be used by doctors, nurses, information team, pharmacists, record keepers; training was structured in a way that all the members had adequate time to go through the system.

The agent of change realized that staff understanding of the system would go a long way in realizing benefits likely to be acquired from proper information management using health information-management system (HIMS) (Garengo, Stefano and Umit, 2005).

New system and old system differences factor

When all things were set to go and attitude of employees towards the perceived change was gauged as positive, then the new strategy of managing information was launched. Before switching the old information handling system, the new system and the old one should be ran concurrently to test the new strategy as employees learnt and adjusted to the system (Fred, 2008).

Taking the new system into operation was gradual and seen to be getting force from the old system. In the initial stages after the launch, the old system was used 75%, then to 50% and twenty five percent: before a 100% adoption of the new system, a meeting with the staffs was called for; the meeting offered the first feedback and evaluation of the system.

Here staffs were encouraged to air their views on the systems and recommend of any change they would like to see done on the system. This offered the change agents a chance to effect some changes and make clarification that would assist in understanding and usability of the new system (Nugent & Vitale, 2004).

Switching to the new system

At this stage, all operations were interlinked and integrated with the new system and the old one was switched off. All the employees were supposed to adopt the system. Improvement of the system was the major thing that follows this.

Phase III: Reinforcing change

With the new system in operation, the management assumed the role of ensuring that the staffs would have a continued support and do not find the traditional method as an alternative to keep or transmit any health information. There were individual and micro group focused training aimed at improving the usability and acceptance of the new system.

Any issues and misunderstandings were polished at this stage as employees learnt more about the new system and its operations. Note at this stage, the old system was completely off (Hansen and Gammel, 2008). The change implementation team were off-loaded their task and the system was managed like any other business process.

The following are the most common processes that are undertaken in this stage:

Feedback interpolation

The management developed mechanisms to get feedbacks from the system and staffs and use the information to improve the system further. The policies and methods were put in place to ensure that the operation and the effect that the new system has brought can be gauged.

Using the feedback information, improvements were done to the system and incase there are staffs who might have been troubled by the system, their issues and standpoints are looked into. The most important thing to note is that there is no looking back so all employees has no option other than adopting the new system (Barbara and Jocelyne, 2006)

Monitoring and controlling

When health information-management system (HIMS) project was running and undergoing different stages to accomplish the main goal, there was need for monitoring and control. Monitoring did not mean supervision only however, it includes ensuring that all things are done right, it was where a manager offers guidelines, and measures stage results and appraise the outcomes of the project.

The stage was important since it helped keep the project in course; incase there was any deviation between the expected result in a certain period, the difference were analyzed early enough so that a solution can be sort.

Information technology gadgets and software need to be updated and improved with time to facilitate their optimal benefit to the organization; the management has the role of overseeing the improvement and ensuring that the systems is working to the good of the organization as had been anticipated (Garengo, Stefano and Umit, 2005).

The following are the main objectives of this stage:

• Measuring the “where we are and where we want to be”; this is a measure if the ongoing of a the Health Information management system (HIMS)
• Monitoring and evaluating the project variables; the main variables of a project are cost, effort, and scope, against what had been planned (where we should be interpolation);
• In case there are issues arising then identify corrective actions to address them (How can we get on track again);
• In case, the project seems to be impossible and leading nowhere, then change the entire project (Ian and Dunford, 2005).

Resistance to the change and how it was overcame

When developing a health information-management system (HIMS), it involved deviating from the old information handling method to the new system; human resources were expected to have some resistance to the change. Psychologists refer to resistance to change as a natural reaction to uncertainty and/or unknown.

Sohar Hospital had dedicated human capital, thus in times of change, resistance to change was can be expected. When the change was implemented, employees felt more comfortable in their status quo (traditional information system) rather than change (Laura-Georgeta, 2008).

During the process, the management were the agents of change, they communicated the change they wanted implemented in the facility; the effectiveness of their communication determined the pace at which the employees embraced the change. In Sohar Hospital, communication is the system through which management and the teams transfer information.

It is both upwards and downwards. Good communication in an organization means that issues and progress of the business are discussed in a way that the target group gets the intended message. In the case of a management, that does not maintain good relations with its staffs; the management will have a challenging time trying to implement a change.

Employees will not be willing to come from their status quo and adopt the change but they will be willing to fight the change. Resistance to change when there is no communication is even higher when groups in the organization join hands together to repel the change. There will be no one who really understands the need for the change since they are a distance with the management (Kotter, 1995).

The Sohar Hospital organizational culture adopted affected the rate of change adoption: organization change is a set of belief that exists in an organization and determines how the employees interact with each other as well as how the workers respond to situations.

Culture of Sohar Hospital determined how employees perceived the change. The culture like any other society defines issues and expected responses. It is worth saying that the culture is not written down somewhere but is exists and controls the behavior of the organization (Diamond, 1986)

Leadership factors

The leadership at Sohar Hospital plays an important role in strategy development; they have the role of overseeing an effective change process. If the leaders are not ready to answer questions posed by employees as well as manage fears that the employees have, employees are likely to see the move to change as unplanned and uncontrolled. Leaders are from the top most to the supervisors (Goold and Campbell, 2002).

When implementing a Health Information management system (HIMS), the kind of leaders that are expected to have an influence include, doctor-leaders, nurse-leaders, section heads, departmental and section heads. In most cases, junior’s staffs ask their supervisors various questions regarding the change they want to implement in the facility.

If there has been no well ordinate communication, then the employees are likely to repel the change. Immediate team leaders are free with the employees and they should be willing and entertaining the change coming. If themselves they are not willing to change, the same will happen with their employees.

When communicating the decision made by an organization to change, leaders are mandated with the task of airing these new to the employees. If they do not have the right characters to be able to manage effectively the transition period (FORD, FORD and D’AMELIO, 2008)

Leaders at Sohar Hospital were mandated with the task of leading the hospital to its desired objectives; they were the change agents. In transitional period, the leaders were the one who guided subordinates to the desired path.

They made rules and policies to be followed in attaining the goals: without disregarding their subordinates. Change needs to be planned at all, times when it is being implemented and conducted in such a way that it will be accepted in the business (Jones, 2003).

Conclusion

In the ever-changing business environment, change is inevitable; the advancement in technology has led to innovation of better information handling software in medical facilities. To remain competitiveness and offer quality, timely and efficient services, Sohar Hospital needed to implement a health information-management system (HIMS).

When implementing the system, the management were actively involved in the change process, they developed an effective change management strategy; the system involved employees from the start; communication was vital for the change at Sohar Hospital l. The effective change management strategy adopted had three main stages: change preparing, change planning and change reinforcement.

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