The Utilization of Health Management Information Systems within the National Health Service - Essay Example

?THE UTILIZATION OF HEALTH MANAGEMENT INFORMATION SYSTEMS WITHIN THE NHS AND ITS IMPACT ON MANAGERS AND CLINICIANS Introduction In all Western countries, rigorous attempts are embarked on to improve the utilization of Information Technology (IT) in health care (Berg, 2004). National, regional and institutional projects abound to bring the shared Electronic Patient Record (EPR) into being and to support the care process with order communication and decision support techniques (Berg, 2004, p. 1). This technological advancement is expected to aid in reducing medical errors and boost the quality of health care delivery via optimizing communication. Similarly, the widespread employment of Internet technologies and electronic patient records could improve the situation of the patient by offering him or her with pertinent medical information and access to their own records. Concurrently, it may perhaps give the government, payer and patient organizations with analogous data on the operation of individual professionals and associations. This paper aspires to tackle the Health Management Information System and how it is utilized within the NHS. Moreover, this paper also deems to identify the pros and cons in the employment of such system concentrating mainly on the discussion of its impact on managers and clinicians. Definition and Evolution of HMIS In its broadest sense, Health Management Information System or HMIS encompasses diverse concepts, methods and applications from many related fields; its genesis may be traced to multiple roots, including general systems thinking, information economics, management science, information systems development methodologies, software engineering, computer science and communication theory, medical computing, health organization behaviour, health management, policy and health services research (Tan, 2010, p. 6). Tan (2010) stressed that the evolution of HMIS over the past several decades has been largely stimulated by strategic, tactical and operational applications of diverse information technology or IT and advanced systems concepts for healthcare services delivery within an individual, group and more fittingly, an organizational standpoint. It also envisions what will be advantageous for the majority of individuals as viewed by regional or even national coalitions as made possible by the organization of electronic health information exchange infrastructures (Tan, 2010). Likewise, fuelled by public incidents and growing evidence of deficiencies in care, and concern over the qualities and outcomes of care brought about the creation of such system paying attention to issues of leadership, culture, team development and information technology at all levels (Ferlie & Shortell, 2001). This was also supported by Ballantine et al. (1998) that the introduction of new forms of competition and management into the NHS had implied a need to reform management information systems, specifically in the areas of costing and performance measurement. Due to the emerging radical, political and financial changes imposed to the NHS, a system was created to respond to such demand known as Patient Management System or PMS. A Patient Management System builds a database of patient related administrative information, from which a set of management and operational reports can be produced (Geisler & Heller, 1998). A PMS as given emphasis by Geisler and Heller (1998) is the heart of the administrative and management information systems within a hospital. The outputs derived from the PMS consists of the admission and discharge information for in-patients, out-patient management including clinic scheduling and generation of letters to patients and their local general practitioners, management of waiting lists, supporting of the contracting process which is the internal market between purchasers and providers within the NHS, support of the clinical coding processes such as ICD 9 & 10, OPCS 4 and Read Codes version 3, creation of standard returns required by the NHS Executive and the Department of Health and lastly, the PMS should also provide the interfaces to other hospital systems such as Radiology, Pathology and Maternity (Geisler & Heller, 1998). The Components of HMIS Tan (2010) stressed that to be able to understand the adaptive yet integrated HMIS, an individual must start first with distinguishing its five principal components namely, the data/information/knowledge component, hardware/software/network component, process/task/system component, integration/interoperability component and user/administration/management component. The Data/Information/Knowledge Component The data/information/knowledge component forms the central core, the content of all HMIS; it includes the specification of, organization on and interrelationship among data, information and knowledge elements necessary for the integrated HMIS (Tan, 2010, p. 8). Raw data from the fundamental building blocks for obtaining valuable information that is to be stored in any HMIS and processed data are transformed into information that functions as important output for HMIS end-users to create informed and clever decisions (Tan, 2010). The Hardware/Software/Network Component Tan (2010) described this component of HMIS as another vital part of the said system. The hardware/software/network component presents notably as it necessitates the selection operation of a range of data and process-related technologies to sustain HMIS applications and utilization. Concisely, this element entails configuring various hardware, software, user interface and communication-enabling infrastructures, associated devices and applications in such a way as to best attain effective and efficient information services integration throughout while linking individuals, groups and organizations (Tan, 2010). The Process/Task/System Component Tan (2010) described this as the core HMIS application domain infrastructure which is the domain architecture that supports fundamental health organizational processes and strategies, and offers groundwork for growing additional specialized HMIS applications. The Integration/Interoperability Component Tan (2010) depicted this element as the core HMIS personnel control infrastructure which is defined as the control architecture in which a pool of technical expertise is made accessible for the building, maintaining, and integrating all the other HMIS components. The User/Administration/Management Component This component encompasses the end-user of the information system as cited by Tan (2010), these are the ones who will benefit from the system which includes the patient himself who will gain easier access to their health records when deemed necessary, and the administration or the management of the healthcare institution who will gain control in an organized system that would aid them in achieving higher healthcare performance and patient satisfaction. The Role of Information and of Information Management within the NHS The National Health Service or NHS has invested heavily in computerised information systems in recent years in an attempt to manage the complexity of its operation and service delivery (Khosrowpour, 1999). Moreover, efficient information systems are also vital in the NHS or the National Health Service to enable to create right and cost-effective decisions both in clinical and managerial terms (Geisler & Heller, 1998). Malek (1993) highlighted that information systems are clearly required to monitor the implementation of the overall health strategy at both local and higher levels. At a minimum, the information systems will satisfy this requirement by offering both feedbacks on implementation of existing plans such as detailed budgeting, variance analysis, ratio analysis and standard product costing, and information contributing to future initiatives in support of top-level NHS objectives involving planning interventions influencing the pattern of smoking and coronary-related disease (Malek, 1993, p. 54). Hirschheim (2009) also stressed that under this system, the NHS would be exposed to increased competition with the purpose of increasing efficiency and patient satisfaction. The need to keep records was not only triggered by the need for standards of accreditation (Berg, 2004). An explicit function of records in the HMIS specifically in industrial contexts encompass the monitoring of the activities of the employees by the management even though the employees are physicians; the management could benefit from having control mechanism via the means of such systems at its disposal (Berg, 2004). The Significance of HMIS Tan (2010) pointed out that the new advances in HMIS are vital to the society for the reason that these technologies assist the lives of every individual; for without such technologies, life is deemed to be rather complicated. Tan (2010) cited the example of an intricate life situation by making the reader of his book to imagine an individual visiting a doctor for a check-up where he or she sees his or her doctor prolifically searching for his or her files in a mountain of incoherent, unorganized and piecemeal data about the patient for all the visits he or she made to a variety of clinics which at present may be merged at present in a health maintenance organization or HMO. Moreover, Tan (2010) also mentioned the instance of having the physician allocate his or her time in making clarification phone calls to laboratories and pharmacies to obtain information instead of concentrating on formulating diagnosis and treating the client’s condition to give a picture of what it would be without the HMIS. The Influence and Impact of HMIS on Managers and Clinicians The emergence of satellite-based, wireless, user-friendly portables; the proliferation of cellular networks; new computing privacy and security technologies and new implementation of diverse powerful network-based systems such as sensor networks and Internet-based data warehouses are the rising trends that are presently compelling senior healthcare executives and managers to become earnestly engrossed in grasping and supporting cost-beneficial, integrative and ground-breaking HMIS solutions (Tan, 2010). Moreover, Harrison et al. (1991) cited that the application of such systems resulted to radical changes to the formalities of organization and management in the NHS. It was also discovered that though such systems had been widely recognized in the NHS and brought about some improvements in the management processes, there has been no substantial change in organizational culture and the impact has been limited in comparison with the continued influence of medical autonomy and financial limitations (Harrison et al., 1991). Khosrowpour (1999) discussed the experience of the implementation of Health Management Information System through the analysis of organizational learning, which illuminated a number of problem areas in relation to the impact of the system, its employment and the development process. Recognized impediments to erudition impart crucial obstacles to fulfilling the broader, strategic benefits obtainable from computerised information systems; hence, Khosrowpour (1999) proposed that the concept of organizational learning aligned to flexible development methodologies based on prototyping could promote an effective and valid environment for more successful systems interventions. On the contrary, the results derived in the study conducted by Pollitt et al. (1988) revealed that the lack of major incentives to clinician participation and of significant penalties for non-participation are seen as crucial to the failure of management budgeting to achieve either a rapid or widespread adoption of management information systems. Likewise, it has been sufficiently appreciated that many managers themselves are less than enthusiastic about the prospects for such systems; it is suggested that though novel in some important aspects, such techniques may often suffer similar difficulties (Pollitt et al. 1988). Conversely, Grant et al. (2010) gave emphasis on the view of managers with regards to the HMIS. The managers deemed that it still needed to consider the development and enhancement of systems for not all information systems within the variety of organizations are electronic or computer-based; the opportunities to benefit from integrating systems both within the organization and across organizations and related issues linking to interoperability and standards should be given focus; the need to deliver on strategic priorities and targets which are set internally or externally should be regarded; the importance of IT governance, backup and security issues, the need for effective procurement policies should be further analyzed; users and patients should be involved in the improvement or oversight of the systems and lastly, the significance of knowledge sharing both internally and with external stakeholders or partners should be considered along with the role of the management portal (Grant et al., 2010). Furthermore, Jones and Dewing (1997) stressed that clinical directors and medical managers expected accounting information would assume great significance for institutional control as a consequence of NHS reforms; clinical directors were not comfortable with such modifications accompanied by the creation of new information systems unlike medical managers who were more inclined to accept and respond to such changes. Smith (2002) gave emphasis that a range of managerial instruments had been deployed in an attempt to improve performance, signalling national priorities to local managers and seeking to supply the data, benefits and capability they necessitate to act appropriately; however, the managers presumed that performance in management information systems will not be totally efficient unless enough capacity in information, leadership and managerial resources are made available. Likewise, West (2000) highlighted that for such system to be successful, the combined efforts of individual clinicians and team should be given high regard. Furthermore, some clinicians and managers believe that there should be a framework that offers a flexible yet comprehensive base on which to build or redesign health systems in accordance with local resources and demands (Jordan et al., 2004). Conclusion The utilization of a Health Management Information System or HMIS within the NHS had proven to produce beneficial influences to the delivery of healthcare. However, its impact to the managers and clinicians had moved these individual to seek for further improvements within the system though they all agreed that such system whether benefits were accompanied by disadvantages should be geared towards safety and quality health care aimed in providing patient satisfaction. References Ballantine, J., Brignall, S. and Modell, S. 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