Systems in the Management of Patients Care - Assignment Example

Critically examine the challenges facing the NHS in employing the use of computer-based systems in the management of patients care since the introduction of the National Programme for IT in 2005? 1. Introduction The increase of the complexity and the volume of activities in the healthcare sector has led to the need for the development of IT systems that will be able to support medical practitioners in their daily tasks and they will ensure the high quality of the healthcare services provided to people of all ages. In Britain, the introduction of the National Programme for IT (2005) has been considered as the most appropriate solution for improving the services provided through the healthcare settings across the country. In accordance with a relevant report of the National Audit Office (2006) the establishment of the specific Programme was decided mostly because of the following reasons: a) the high volume of cases handled by hospitals and other care centers; it has been estimated that every week about 6 million people are likely to visit their GP (National Audit Office, 2006, p.9), b) the increase of security in regard to the storage and management of personal data, c) the high cost in prescribing in healthcare settings across Britain. Despite the above advantages, the NHS IT Programme of 2005 has faced a series of challenges – an indication of the failures related to its design/ monitoring. These challenges are analytically presented in the next section; it is concluded that the use of the NHS IT Programme has helped towards the increase of quality of healthcare services across Britain; however, appropriate initiatives should be developed so that the above system to fully perform. Such schemes of action would be the training of users, the introduction of simpler guidelines and the continuous review of the system’s needs. 2. National Programme for IT in 2005 - challenges faced by the NHS when using computer-based systems in the management of patients care Through the introduction of information systems in the management of activities across NHS the performance of the specific organization has been improved. The advanced information technologies available to health practitioners have helped to the increase of quality of the services provided to the patients but also to the establishment of services which were not available previously – for instance the services available in the context of the Geographical Information System (GIS) which is incorporated in the IT systems used in NHS’ healthcare settings (Higgs et al., 2001, p.247). However, the performance of information systems in NHS has faced severe delays mostly because of the failures developed across the organization in regard to the management of the specific systems. The update of existing NHS IT systems framework in 2005 has been considered as a necessary solution in order for the above failures to be eliminated – a target that has been achieved, even not fully, in the years that followed. The 2005 NHS IT Programme ‘is managed by the Government agency Connect for Health’ (Barham et al., 2007, p.504). In the context of the specific Programme a variety of services are available to medical practitioners and patients: ‘access to the summary care record through HealthSpace, picture archiving, electronic transfer of prescriptions from general practitioner to pharmacist’ (Barham et al., 2007, p.504). The system includes the NHS patients’ records, which can be appropriately managed in order to meet the needs of patients and medical practitioners. For instance, through the existing NHS infrastructure, it is possible for the care record of a patient to be transferred between medical practitioners – if the patient change his place of living and the new medical practitioner needs to have access to the patient’s care record. In accordance with the above, the IT systems framework established in NHS has helped towards the improvement of services to the patients – referring mostly to the save of time in the development of various administrative tasks but also in the provision of health care services. However, failures have not been avoided. For this reason, the local authorities – as discussed below, have developed appropriate measures, which need to be periodically reviewed as of their effectiveness. The problems related to the NHS National Programme for Information Technology (NPIT) as established in 2005, are highlighted in the study of Becker (2007). In accordance with the above study, the value of the specific IT framework as for a tool for the online access of health records across Britain is limited by two major failures: ‘the access control and patient confidentiality’ (Becker, 2007, p. 432). It is explained by the above researcher that the procedure required for accessing the health care records in Britain are too complex – and thus, difficult to be understood by elderly or people who have not experience on the use of IT systems; moreover, the guidelines related to the specific process (enter the system and access the health care record) are likely to be continuously alternated – under the influence of the relevant changes in the legislation and the ethical standards set for the administration of the system and its accessibility (Becker, 2007, p.432). From another point of view, Norton (2006) noted that bureaucracy in NHS is so strong that it can create severe barriers to innovation (Norton, 2006, p.179); this problem is likely to appear in regard to all projects developed by NHS – including its IT Programme. The impact of bureaucracy on the NHS IT Programme is high because of the following fact: the NHS IT Programme is developed gradually; its phases are taken place using specific plans; however, a lack of cooperation has been identified among those participating in the establishment of this project (Bali, 2007, p.46). This fact has resulted to the failure of many of the project’s strategic plans – a fact that has caused delays to the completion of the implementation process. Flynn et al. (2009) evaluated the performance of the NHS IT Programme; the test of the system’s performance was developed through an appropriately customized empirical research. The ‘experiences of a new eHealth service by patients and staff in three primary care settings’ (Flynn et al., 2009, p.588) were monitored; in total 90 patients and 28 members of the medical staff participated in the survey. It was proved that the use of the eHealth service has been rather low; the promotion of the specific service has been found to be limited. On the other hand, it was made clear that the staff is not appropriately trained for handling the specific technology – it is perhaps for this reason that the patients avoid in using the eHealth service. In accordance with Sobh (2007) the application of NHS IT Programme across Britain has been characterized by a series of failures, such as: limited capabilities of people in handling equipment of advanced technology, for instance the mobile phones of new generation. In this way, the accessibility to the NHS IT systems is limited – since only people with knowledge on relevant technology can enjoy the benefits of the system (Sobh, 2007, p.343). Other challenges that the developers and the administrators of the NHS IT system had to face are the following ones: a) security; the risk of loss/ damage of personal data in the context of the NHS IT system is still high, b) lack of skills of visitors – referring especially to the healthcare practitioners who, in their majority, are not aware of the full capabilities and the requirements of the system. The development of IT systems across NHS should be strongly supported. Even if these systems are related to failures, these are limited and, thus, easily controlled. Cresswell et al.(2008) highlight the specific fact adding that through the expansion of the use of IT systems in healthcare settings across Britain, severe failures in the management of medicines could be avoided; it is further suggested that emphasis should be given on ‘the real-time clinical decision support and the reduction of the risk of recurrent exposure’ (Cresswell et al., 2008, p.1112). The above suggestions are considered as quite important for the improvement and the expansion of existing NHS IT Programme; however, attention should be paid on the following issue: the methods used for the development of the relevant tasks – using IT systems – should not violate human rights – referring to the issue of patient’s recognition by the IT systems and the access/ management of the personal health care data. In the study of Jackson et al. (2005) the value of IT systems in the healthcare sector is further supported – reference is made, as an example, to the improvement of the quality of services of Velindre NHS Trust – a cancer hospital – as the result of the update of the organization’s IT systems (Jackson et al., 2005, p.173). Another aspect of the NHS IT Programme can be identified using the study of Protti (2002). In the above study it is noted that the common problems of many IT projects is that the investment made is often difficult to be paid-back (Protti, 2002, p.221). In accordance with Protti (2002) this problem is mostly related with the fact that the plans through which the relevant projects are managed are not appropriate – in terms of the task administered. The Balanced Scorecard is suggested as a potential scheme for evaluating the performance of IT projects; the specific scheme would be also used for evaluating the performance of NHS IT Programme but under the following terms: that the individuals participating in this task would be appropriately skilled. Through the Balanced Scorecard the failures of the NHS IT Programme would be identified in advance and the necessary measures would be developed. In this way, the damages for the NHS – because of the failures of its IT Programme – would be significantly reduced. 3. Conclusion The introduction of the 2005 NHS IT Programme has been regarded as a strategically appropriate method for increasing the effectiveness of healthcare settings across Britain and improving the quality of the services provided to patients. Moreover, the specific plan was expected to positively influence the management of knowledge across Britain (National Audit Office, 2006, p.9). The above project has been reviewed many times since its initial establishment – aiming to improve its elements and increase its performance (House of Commons, 2007, p.13). However, even under these terms, failures have not been avoided. In any case, the problems related to the operation of the system are less compared to its benefits; moreover, the elimination of the system’s failures is not achievable since in certain cases these failures are related with the structure of public services in Britain – referring to bureaucracy. The continuous interventions of the Government to the limitation of the system’s challenges is an encouraging sign – proving that the system will manage to further increase its benefits and control its weaknesses. References Bali, R. (2007). Healthcare knowledge management: issues, advances and successes Health informatics. Springer Barham, C., Madden, A. (2007). The National Programme for Information Technology in the NHS. 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