Introduction
Databases are widely used for maintenance of huge data over large networks. Medicine field is also taking advantages of information system at different hospitals and clinics. Secondary databases are used to store and maintain huge amount of patient’s record and their treatment history. Secondary database or SDS is a database base which is attached to main database so that if the main database in unavailable or goes offline, SDS can be used instead. Numerous DBMs system that supports SDS has ability to recognize and switching to secondary server within few seconds if main DBMA goes off. It is very important to know the difference between data and information before moving ahead. Data are raw facts which include individual elements; data has no authenticity, reliability. In contrast information is a data which is combined, compiled interpret into some meaningful fact. Information at hospitals includes patient’s data, treatment details, diagnosis, test information etc.
Data & information both are important as data provides information for further processing. There are three types of data with respect. to patient i.e. Primary Data, Aggregate Data and secondary Data. Primary data sources include patient’s health records, Secondary database resources include registries and database, Aggregate data includes data on groups of individual that do not identify specific individuals (Beer and Essential, et al. 1993).
Uses of Secondary Database
There are numerous uses of secondary data which are as follows:
- Secondary data helps a lot to maintain healthcare operations.
- It plays an important role in performing research.
- It helps in identifying Patterns and trends in Patient care
- It supports long term planning and budgeting
- It provides benchmarking information.
Secondary data helps a lot to numerous professionals in every field but secondary data users are taking lots of advantages which include: Secondary data facilitates Healthcare managers, Quality managers, Researchers, Public health agencies, State and federal databases. It also helps in collection of vital statistics such as birth and death rates by local government. Few registries and their information are required at very initial step are some follows: Disease registries, Case definition, Case findings. Disease registries are collection of secondary data of patients with a specific diagnosis, conditions and procedure. Case definition provides description of registry to database. Case findings are used for identifying process and status of patient who has been treated for the condition same as registry subject. Secondary databases include number of registries which are as follows:
- Cancer registries
- Trauma registries
- Birth defects registries
- Diabetes registries
- Implant registries
- Transplant registries
- Immunization registries
Health Care Databases
National and state administrative databases Healthcare Integrity and Protection Data Bank (HIPDB), Medicare Provider Analysis and Review File (MEDPAR), National Practitioner Data Bank (NPDB), Healthcare Integrity and Protection Data Bank (HIPDB), State administrative databases.
Deploying secondary databases are easy but time to time maintenance keeps them in working condition in long run. Data quality issues involve Validity of the data, data reliability, data completeness, and data timeliness (Kathleen LaTour and Shirley, 2006). Data Security issues involves Audit trails, protection from viruses, Encryption. Uniformity in data collection is very important and has great significance in overall process. Data collection is one of the most crucial step among all on which performance of secondary Database at hospitals and clinics highly depends.
Describe the secondary data system that is utilized at a selected hospital or facility. Include its data elements, why collected, purpose for the database. Identify the method by which the data is collected and processed.
Metropolitan Hospital is one of the most leading hospital and training software and medical research center which have 840 beds and 65,000 inpatients and treat 130,000 outpatients per year. It was founded in 1875; it’s located in New York affiliated with New York medical college. It represents oldest American partnership between Hospital and private medical school in United States. It has three standalone and remote sites which help in maintaining all data of patients in single database. Recently they have shifted in new building and they shifted their Database in secondary systems in order to improve system performance and facilitate their patients and office staff. In past years, hospital staff used paper record to keep track of patients and their treatment which was difficult to maintain. Staff used to face lots of difficulties in finding data of particular patient of past seven years from a huge pile of patient’s record. In recent years, managers realized the need of secondary database at hospital for the convenience of staff and in order to make their service better than earlier. Management & Strategic planning plays an important role in organization’s success (Itchy, 1983). The current method of finding and keeping records of large volume of patient was not according to the needs of hospitals. There was a strong need of implementing computer based system in order to achieve high goals in less time. Then they contacted NEC PBX; one of the most leading firm for deploying secondary database at hospital. Their immediate requirements were to maintain patient’s data in proper way, provide a centralized electronic directory in order to facilitates consultants and patients, improve response time for emergencies, integration and updating existing system, improving payment system, handling of emergency environment in easy steps.
Maintain a huge amount of data is always difficult as there are more chances of data redundancy and data duplication which damage database structure. Relational database is always recommended over large system as it prevents data redundancy and data duplication over large network which ensures better system performance. The team of individuals first collected data of patients from counter desk and information counter then compilation and linking step was done by team individuals. The Integrated Attended console (IAC) was introduced including directory integration to new call accounting system directory. After six months hospital staff was satisfied and service of staff had increased a lot as integrated system saves time, efforts and money. The overall system increased hospital environment a lot. The customer soon identified that the need of sharing data for the staff directory through three standalone locations via their intranet is important. Integrated Attendant console (IAC) web view was installed and it provides same view to staff members as the IAC switchboard operators. It also empowered staff with same powerful searching techniques and facilities. Method for collecting facts was highly based on inquires and session with hospital management and staff.
Purpose of Database
The purpose of deploying secondary database was to make performance better and effective in less time. Number of steps were involved in this whole scenario, data collection, registry collection, staff requirements, manager’s demands, medical experts schedule etc.
Identify the department who is responsible for directing and monitoring the system and applicable identify the titles of individuals responsible for data collection and analysis and follow-up.
Data collection, analysis and follow up were done by team individuals who deployed overall system. HIM department is responsible for number of data request. And it handles all operation of system (Expanding role of Him, 2008). User interface should be different for each department so that account department can only view account system on their screen they don’t have any concern with patient’s data and his treatment so deployment team must keep this fact in mind while developing a system.
Discuss how and by whom the adequacy, accuracy, consistency, completeness and timeliness of the data collection and reporting is managed.
HIM professionals play an important role in maintaining these systems it’s a high responsibility of HIM professional to provide quality and authentic data to its related department. The performance of whole system highly depends on information provided by HIM professional. HIM professionals are responsible to collect, analyze and organize health care data. A recent study proves that development of information technology facilitates health care field a lot. Adequacy, accuracy, consistency, completeness and timeliness of the data collection and reporting are managed solely by HIM department.
Discuss the reporting needs that exist, why collecting this particular data?
The collection of data which includes patient’s record, cancer and trauma registries, staff information, expert’s schedule was needed in order to implement a system and user interface according to each department’s needs. This data is very important to be collected in proper way as complete system highly based on ground facts of collected data.
Identify areas for improvement, additions or deletions to the system described. Summarize the role of the perceived role of an HIM professional in managing these systems. Identify the education and training opportunities for staff that are responsible for maintenance and use of the system.
There is a wide room of improvement in this system and there is a strong need of training of operators in order to increase their productivity. Training sessions and different workshop should be held by high skilled professional in order to provide best training and techniques to hospital staff in less time. Some financial support must also be provided to staff for attending different workshops and sessions. Usually, it has observed that number of hospital staff do not familiar with the use of computer system so they also need basic training of using computerized systems. There are number of courses offered by different institutions for training their staff so some financial support must be provided to all employees. HIM professionals should be little more restrictive towards object and it’s their responsibilities to solve user time to time issues.
Conclusion
Numerous hospitals do not realize the need of secondary and centralized databases at hospitals and clinics (Fox, 2003). Hospital staff faces number of difficulties in searching registry or any particular patient’s data from a huge volume of patient’s record. Field of medicine has gained lot of advantages with the growth of information technology and computerized system. Central computerized saves time, money and efforts of staff and patients. Metropolitan has gained number of advantages with the deployment of secondary database at place. HIM professionals are highly responsible for maintenance and accuracy of data. These registries and data collection helps a lot in deploying data according to user’s needs. Data and information must be authentic and arrives from reliable resources for better performance of system. There are different trends in Data collection is: collecting of data and information for deployment than ever before for improving the performance of system, Patient-based data/information is widely used for different purposes than before, demands for data/information has increased a lot from both ends i.e. internally and externally. A trend of collecting data has increased a lot and it also led an organization toward cost justification of health care (Kotter, 1995). Many patients with coronary artery disease, average length of stay for the treatment, post-pop mortality rate for different procedures, Survival rates for patients with breast cancer all these are considered necessary in order to implement an efficient system at place.
References
Expanding Role of HIM (2008), Role of HIM, Web.
Kathleen LaTour and Shirley Eichenwald-Maki, (2006), Health Information Management, 2 edition, Concepts, Principles and Practice, AHIMA.
Beer, M., R.A. Essential, et al. (1993). Why change programs don’t produce Change. In The Learning Imperative: Managing People for Continuous Innovation, edited by R. Howard. Boston: Harvard Business School Press.
Itchy, N.M, (1983). Managing Strategic Change: Technical, Political and Cultural Dynamics. New York: John Wiley & Sons.
Fox, (2003). Systems-based leadership for the transition to EHR. Paper presented at the AHIMA National Convention, Chicago.
Kotter, J.P. (1995). Leading change: why transformation efforts fail. Harvard Business Review 73(2):59–67.