Technological Failure in Health Organization - Coursework Example

Technological Failure in Health Organization         Technological Failure in Health Organization Introduction According to health professionals, technology is a tool that is imperative in the improvement of healthcare institutions and healthcare access. As technological evolution has transformed many sectors and realms of life, computational abilities and growing stores of information and data was seen as a promise by experts for elevating the status of clinical practice, clinical decision making and clinical research. However, with the high level of expectation from prevalent stakeholders, the potential for both unintended and intended failure also elevates. Healthcare has been a field that fascinates technology professionals, as IT is well suited in dealing with problems of complexity, scale and waste (Johnson, 2011). Even though proponents have debated on the potential benefits of HIT (health information technology), a substantial gap in literature that dwells on the experiences and debacle of poorly designed information systems. With the perceived benefits by proponents, the Obama administration has registered efforts at speeding up the rate of HIT adoption. This is evident in the 2009, the American Recovery and Reinvestment Act, which included $ 19 billion to ensure the utilization of EMRs (electronic medical records) in healthcare institutions. Numerous health organizations that have adopted HIT systems including EMRs. Examples of organizations are Veterans Affairs (VA) and Kaiser Permanente, which are both health insurers. As a result, this paper will dwell on the Veterans Affair technological failure of August 2007. The Veterans Affairs VistA Failure (August 2007) The deployment and integration of information technology systems in healthcare organizations including Veterans Affair has led to numerous failures most notably the 31 August 2007 case scenario. The HIT failure at VA involved its Sacramento facility, which was one of the four data centers that had been developed because of an ongoing centralization process. Before the centralization process in 2005, the institution had 150 medical centers characterized by their own IT staff, budgets and services. After the process, the institute allocated its local responsibility for information technology infrastructures to four local data processing hubs, in the west (2) and east (2). The process of centralization had a significant effect on development practices such as changes that could be conducted in applications on regional or local areas including VistA (Veterans’ Health Information Systems and Technology Architecture) updates. This and more decentralization practices that were usually conducted before 2005 created a harmonious scenario whereby the 150 stations run on several parallel application versions in a manner that was highly regarded as responsive and effective by IT experts. The centralization also affected the standardization, which is imperative for closer integration of the IT hubs. The distributed practices led to a variety of non-functional requirement concerns including infrastructure administration, security and disaster recovery (Johnson, 2011). Even though there were a series of 14 successive failures since April 2007 after one of the four facilities (Sacramento) began to host the VistA/ Computerized Patient Record System (CPRS) set of clinical applications, the August failure incident is regarded as the most severe as most of the incidents sonly lasted for a short period. The VistA failure lasted for a minimum of nine hours for the information system to be restored in the 17 centers that were significantly affected by the crisis. Effects such as the knock-on disseminated to VA clinics and hospitals from northern California to Alaska, Los Angeles, Guam, Nevada, Idaho, Oregon, Hawaii, American Samoa, west Texas, Washington State and the Philippines. Consequently, the Knock-on effects not only affected clinics and hospital but also spread to pharmacies (Johnson, 2011). Numerous of the pharmacies, clinics and hospitals were subsequently affected as they utilized VistA applications to generate labeling and orders. The impact of the disruption is difficult to be understated in one of the affected health institutions, North California Healthcare System is characterized by 370 000 veterans as well as 2000- 3000 visits on a daily basis. According to the San Francisco VA Medical Center director of clinical informatics, the crisis was the most severe IT threat to the safety of patients (Johnson, 2011). VA Contingency Plan After the incident, end-users of the information system were unable to access the CPRS (Computerized Patient Record System) in medical institutions in Northern California. Consequently, the failure that led to the inability to access patient information in the system and thus there was enormous concern for their safety in the affected medical facilities. This forced the implementation of a three level emergency plan. The contingency plan was developed against a basis of organizational centralization of information technology systems from all the medical institutions (150) to four regional information-processing centers. Two processing center were located in the east and two west of the United States (Johnson, 2011). The two western centers covered regions 1 and 2 fro Sacramento and from Denver. According to the emergency plan, Denver center in region 2 was to handle the services that were previously handled by Sacramento. The second tier of the emergency plan utilized a similar approach but presumed that medical institutions would not be able to update the central copy of their prevalent patient information, as they were to operate a “read only” version. The final level of the contingency plan was for medical institutions to operate and utilize the local files of patient information that had been previously stored in the hospitals’ computers. The information stored in the computers only provided information regarding each patient who either was in the hospital or was scheduled for an appointment in the coming two days. According to the contingency plan, health professional would fail to access information associated to patients that needed emergency or unscheduled healthcare services (Johnson, 2011). Even though the administration developed an emergency plan to curb the prevailing situation, it was ineffective in dealing with the effects the crisis had caused. This is because the first tier of the emergency plan failed as support lacked the ability to transfer information swiftly for the affected areas in Region 1 institutions in Sacramento to Denver, Region 2 hub. The transfer problem was a result of six servers that had crashed in Sacramento information center. Thus, the administration had a contingency plan that worked fairly as the level two and three of emergency plan were successful but proved to be of minimal assistance as clinician sonly operated via a “read only” mode of the information while level three utilized hospital’s computers that had insufficient patient information. Why Veterans Affairs should utilize a Custom Application System Custom software is specifically developed for a given institution and thus can be built to fit the specifications and needs of the client. In this sense, the application is developed in a stage process whereby all hindrances and problems are effectively evaluated and taken into account. This includes the issues that were not specified by the client to avoid future meltdowns like the VA system failure. Healthcare institutions can utilize custom applications as they can store and retrieve relevant and vital patient information at any given time. This ensures health experts transfer the data via a network, which ultimately makes the search for hospital essentials like a suitable blood group easy. Consequently, hospitals can utilize this form of information technology for billing applications (Wager, Lee, & Glaser, 2013). The selection of an appropriate healthcare information technology is a difficult puzzle because there are various factors including finances (benefit and cost), time of market and the implementation size. With the size of Veterans Affairs characterized by its numerous clinical institutions that it serves, it is imperative that custom software is utilized. The implementation would be beneficial as a custom application is cheaper than the proprietary system and more efficient and productive. Consequently, numerous proprietary vendors lack the ability to meet the transparency and interoperability requirements. Therefore, custom software offers a solution. Consequently, the swift clinical adoption of custom software in health institutions is an added advantage in comparison to proprietary models that require the training of clinicians on how to operate the systems, that results in an expensive endeavor that institutions fail to afford (Wager, Lee, & Glaser, 2013). Recommendations With the current level of technology in every organization in the globe, it is vital for organizations to avoid technological failures by adopting measures and practices that mitigate early signs of system breakdown. Risk management is a vital method that organizations can utilize to ensure dealing with unwarranted problems effectively. Risk management incorporates the discovery, evaluation and prioritization of threats. Application of resources follows suit to ensure the minimization and management of the impact of unfortunate events. Project Metrics and Portfolio Management Organizations require well-defined information technology governance to ensure effectiveness and efficiency. Healthcare stakeholder can utilize project metrics and portfolio management are a vital component of ensuring operational efficacy. Healthcare leaders can utilize metrics in numerous ways to ensure effectiveness. Organizations accomplish this when they have effective metrics, which are well measured, defined and assigned to responsible individuals. Otherwise, projects risk the probability of incurring additional costs and failure. This can be avoided by defining the aspects that should be measured, training users on how to manage and operate the metrics effectively and developing ownership and accountability of the metrics system. The aspects that are measured highly depend on the prevalent scenario of the healthcare organization. Generally, metrics ensure that organizations have the appropriate data required to guarantee waste reduction and maximize the quality. To measure the selected metrics, the healthcare leaders must ensure it is clearly defined, supported by reliable data and it is not easily influenced. The effectiveness of each metrics depends on capability of its users in managing it. The establishment of ownership and accountability is an essential component of the deployment of a metric system. The responsible individuals must have relevant knowledge and authority in the management of the metric system (Wager, Lee, & Glaser, 2013). Healthcare organization can also utilize portfolio management in ensuring operational efficacy and effectiveness. This can be utilized in the management of various components in the realization of objectives. The objectives can be reached if the portfolio components represent the planned investments, are aligned with the organizational strategic goals and are quantifiable. The organization can must guarantees that the interrelationship between projects and programs are acknowledged while resources are distributed with prioritization in mind. Government Intervention and Patient Information Initiatives by the United States government to ensure a universal adoption of EHR (electronic health record) by all health providers, clinics and hospitals is viewed as a vital factor in the improvement of US healthcare and cost reduction. However, with the adoption of information technology systems, cases of insecurity have been registered including data breaches of patient information. This has led to the enactment of various federal regulations including HIPAA (Health Insurance Portabilty and Accountability Act) and State Alliance for eHealth (Blobel, 2004). With the numerous cases of fraudulent activities, the security Rule which is under HIPAA is a vital law that requires organizations to implement administrative measures including personnel, physical and policies safeguards to the IT infrastructure as well as technical measures to control inter and intra entities data access. Many organizations pose a threat to personal privacy as they inappropriately access patient’s information by abusing their authority and privileges. As a result, the confidentiality between a patient and a physician is abused ultimately putting the patient at risk. Therefore, it is very important that these laws are in place to take care of the unlawful activities in healthcare institutions (Blobel, 2004). References Blobel, B. (2004). Authorization and Access control for Electronic Health Record Systems. International Journal of Medical Informatics, 73, pp 251-257. Johnson, C. (2011). Identifying common problems in the acquisition and deployment of large-scale, safety–critical, software projects in the US and UK healthcare systems. Safety Science, 49(5), 735-745. Wager, K. A., Lee, F. W., & Glaser, J. P. (2013). Healthcare information systems: A practical approach for healthcare management. San Francisco: Jossey-Bass. Read More